What next for the maternity services in England? AIMS responds to NHS England’s 2025/26 Operational Planning Guidance

By the AIMS Campaigns Team
18 February 2025

Based on guidance documents published last month, by the Government and by NHS England¹, AIMS is pleased to see that maternity improvement continues to feature strongly in the priorities for every Integrated Care Board (ICB) and Trust across NHS England for the coming year. AIMS will continue to play our part in supporting maternity service improvement across the UK, as we have for the last six decades. But we note that it is one thing to plan; it is another to deliver.

This note sets out where, on the basis of these new documents, maternity service improvement sits within the Government and NHS England priorities, and offers initial reflections from AIMS.

It is notable that maternity did not feature specifically in the Government mandate to NHS England. This raises questions about the Government’s lack of focus on maternity. It seems evident that the Government is content to leave NHS England for now to continue with its NHS England - Three year delivery plan for maternity and neonatal services, published in March 2023. We thus expect to see a progress report against this plan within the next two months, and also wait to see whether the 10 Year Plan will offer further detail on the Government’s approach to maternity reform.

For a truly safe, equitable and personalised maternity care, we need to see a far more ambitious agenda for change in the updated 10 Year Plan, and the subsequent more specific national delivery plan for maternity and neonatal services, later this year. AIMS has submitted our views on what we want to see in the new Ten Year Plan as part of the Change NHS consultation process as well as the feedback from our community engagement workshop.

In NHS England’s operational planning guidance, maternity does feature.

• First, as part of the national priorities and success measures for 2025/26, a key priority will be to “Maintain our collective focus on the overall quality and safety of our services”. Whilst this priority should of course go without saying, we are pleased to see that the related success measure here is to “Improve safety in maternity and neonatal services, delivering the key actions of the ‘Three year delivery plan’”;

• In addition, there is a further overarching priority to “address inequalities and shift towards prevention”. This is a key issue for maternity service users, so we are pleased to see that one of the two success measures listed is to “Reduce inequalities in line with the Core20PLUS5 approach for adults and children and young people”. Maternity is one of the key priorities in the CORE20+5 approach, where there has been a commitment to “Ensuring continuity of care for women from Black, Asian and minority ethnic communities and from the most deprived groups. This model of care requires appropriate staffing levels to be implemented safely”.

Whilst AIMS has previously voiced our reservations about the ambition of the Three Year Delivery Plan, AIMS supports its implementation as a foundation for a much needed transformational change in the maternity services. We are concerned, however, that delivery is behind schedule, and have thus asked for a discussion about this at a forthcoming NHS England Maternity and Neonatal Stakeholder Council meeting, with a particular focus on NHS England’s progress to date against its own deliverables.

In the context of the CORE20+5 approach to resolve the shocking inequities in maternity experiences and outcomes, AIMS is also highly concerned about the slow progress to deliver on a commitment to the priority rollout of Midwifery Continuity of Carer for those most at risk of poorer outcomes. As we have communicated to NHS England, we note that this deliverable has featured in NHS England plans since at least 2019. Even allowing for the severe disruption of the Covid-19 pandemic, AIMS is hugely disappointed at the slow pace of implementation. Certainly, this reminds us that planning documents - and even new funding - count for little unless accompanied by a willingness and determination to deliver, from the national to the local level. Our understanding of progress - and insight into the barriers being encountered - would be increased significantly with a step-change in NHS England’s approach to accountability and transparency, including around the use of funding that has been given to systems to deliver on this priority. All Integrated Care Boards (ICBs) and Trusts should be required to publish their plans for implementation and report progress against these.

Finally, AIMS is clear that meaningful action to achieve the required maternity transformation relies on a sufficient number of midwives and doctors being employed, appropriately skilled and located in the areas that need them. We have raised our concerns about the lack of accountability and transparency on this issue. There seems to be no nationally accessible dashboard to offer interested stakeholders a sense of progress towards this workforce goal, nationally, across regions, at Integrated Care System level and in Trusts. If we are to have confidence that the ongoing work will be sufficient to deliver safe, equitable and personal maternity care, then we need to see this data now.

1. In January 2025, two key documents were published that are intended to set the priorities for the whole of NHS England for the forthcoming year (starting April 2025). The first was the Government’s Mandate and the second was NHS England’s operational planning guidance for 2025/26.