Mackey issues 10-point ‘urgent’ maternity plan

The CEO of NHS England has ordered trust boards to enforce joint accountability for maternity between medical directors and chief nursing officers, following criticisms of “siloed” leadership in major reviews.

In a letter circulated to hospital trusts, Sir Jim Mackey said he had been “deeply moved” by recent reports by Baroness Valerie Amos and Donna Ockenden.

In the note, seen by HSJ, Sir Jim said it must be a “turning point”, adding: “We cannot allow failures in care to persist and be followed by reviews that continuously highlight the same themes.”

He announced a “10-point plan for maternity and neonatal services”, saying there are parts of the reviews that “we must focus on delivering now.”

This includes asking boards to complete audits of their triage services within three months, and implement improvements within a year.

They should ensure all pregnant women have 24/7 access to maternity units, with dedicated round-the-clock midwifery staffing to answer calls and provide face-to-face assessments, which should be separate from the labour ward. National standards for triage services will be circulated by the end of this week.

Triage services were a major focus of criticism in the Amos review.

Trusts must also check mortuaries by 31 July, in response to findings about shocking treatment of bodies, particularly by Ms Ockenden at Nottingham hospitals. 

Both reviews found leadership had become “siloed”, with conflicts between obstetricians and midwives. In response, Sir Jim said all trusts must establish clear joint accountability at board level for maternity and neonatal services.

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Source: HSJ, 1 July 2026