NHS Race & Health Observatory: Have independent maternity service investigations taken an anti-racism or intersectional approach? (6 March 2026)

Summary

Independent investigations into failings in NHS maternity services have repeatedly exposed serious shortcomings in safety, quality, and organisational culture.

These reviews were intended to generate learning and drive improvements, but with so many issues linked to racial and socioeconomic inequities, failure to build this into inquiries risks perpetuating avoidable harm.

The NHS Race & Health Observatory conducted a document analysis of the three major independent investigations published over the past 15 years: Morecambe Bay, Shrewsbury & Telford, and East Kent.

These high-profile, government commissioned reports were examined through an intersectional, antiracist lens to assess whether ethnicity, racism, and deprivation were meaningfully considered as drivers of maternal outcomes.

Content

Findings

Patients’ ethnicity

Across all three investigations, ethnicity was inconsistently addressed and often minimised. The Shrewsbury & Telford report acknowledged national disparities but failed to analyse local data, with nearly 9,300 missing ethnicity records. The East Kent and Morecambe Bay reports briefly noted poor treatment of ethnic minority women and to those born overseas but did not investigate systemic discrimination. In Morecambe Bay, concerns raised by families of ethnic minority patients were dismissed without comparative analysis. The limited attention to ethnicity undermines the relevance of recommendations for ethnic minority women.

Workplace racism and staff experiences

Workplace culture was a recurring theme, yet only the East Kent report explicitly identified racism among staff as a contributing factor to poor care. Allegations of racial abuse were often dismissed without resolution. In contrast, the Shrewsbury & Telford and Morecambe Bay reports described negative cultures but did not consider ethnicity as a source of conflict or harm. This reflects a broader failure to recognise racism within NHS workplaces and its impact on patient safety.

Deprivation and maternal outcomes

The Morecambe Bay and Shrewsbury & Telford reports acknowledged deprivation using national data but did not analyse its local impact. The East Kent report overlooked deprivation entirely. None of the investigations examined how deprivation intersects with ethnicity to worsen outcomes, despite evidence that economically disadvantaged ethnic minority women face compounded risks.

Leadership failures

Leadership failures—including poor oversight, defensive cultures, and high turnover—were common across all three reports. However, none explored whether racial discrimination contributed to leadership breakdowns or staff tensions. This omission reflects a reluctance to confront structural racism within NHS governance.