NHSE culture change programme failed, says external review

An NHS England programme designed to improve leadership behaviours and culture in maternity departments following high-profile scandals failed to achieve its aims, an external review has concluded.

NHSE’s perinatal culture and leadership programme launched in 2022 as part of the three-year delivery plan for maternity and neonatal services, with five intakes covering all 120 trusts by mid-2025.

It followed reviews by Donna Ockenden at Shrewsbury and Telford Hospital Trust and Bill Kirkup at East Kent Hospitals University Foundation Trust, which identified common challenges, including flaws in leadership, culture, and teamworking.

The PCLP sought to address these by bringing together senior leaders in maternity and neonatal services as a perinatal quadrumvirate (quad).

But an external review by academics at the University of Birmingham, shared exclusively with HSJ, has found “limited” evidence of change and that improvements “did not often ripple up/across and down throughout services”.

The report said: “This was due to an entrenched culture of siloed working within different staff groups, which the PCLP did not create the conditions to overcome, in large part due to quads and staff not having sufficient time to work on this alongside day-to-day operational pressures and a lack of sustained support for quads… from the wider trust.”

It added: “These challenges were exacerbated in trusts where divisional structures did not lend themselves to collective perinatal working.”

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Source: HSJ, 2 March 2026