NHS England: Maternity and neonatal infrastructure review findings (11 September 2025)

Summary

Each day, over 1,500 babies are born in hospitals in England, with 1 in 7 of them needing specialist neonatal care.

In 2023, as part of the Three year delivery plan for maternity and neonatal services, NHS England committed to undertaking a comprehensive infrastructure review (survey) of the estate that enables maternity and neonatal service delivery across the NHS in England. This survey is the first of its kind, bringing together estates leads and clinicians to review and understand service specific infrastructure.

This report summarises the data collated from a national survey of all maternity and neonatal units in England. It responds to the Ockenden review and the Care Quality Commission’s (CQC) national review of maternity services in England, both of which cited how poor infrastructure contributes to significant challenges to maternity and neonatal services for patients and staff.

This report sets out the key findings from the survey. It also highlights ways to enhance patient and staff experience and improve services for women, babies and their families – giving children the very best start in life.

Content

There is a clear link between the condition of service infrastructure, the experience of service users and staff, and safety.

In the last 3 years, there have been 14,519 formally reported instances in the maternity and neonatal estate where clinical services have been interrupted or service delivery has been impacted as a direct result of poor physical conditions.

Significant clinical time has been lost to estate-related issues, such as power outages, water leaks and faulty nurse call systems. This puts additional pressure on already stretched staff to provide high-quality and safe care and can directly lead to procedures delays, such as planned caesarean sections.

Feedback from staff highlights critical challenges related to space, privacy, equipment and wellbeing in these facilities. The most significant issues reported by many trusts can be organised into 4 main areas.

• Inadequate space for critical clinical activities in some trusts, such as scanning and birthing suites, reduces staff effectiveness and compromises privacy for women during assessments. 69% of organisations failed to meet the space standards set out in the HBN, and staff feedback makes clear an urgent need for larger waiting areas and other essential facilities.
• Lack of storage facilities for equipment and medicines, adding stress to daily activities. 86% of service areas reported insufficient storage to avoid equipment being stored in corridors. This can negatively impact staff and service user experience and can compromise safety and efficiency.
• Insufficient rest areas, with 30% of units being found to be non-compliant with the space requirements outlined in the HBN standards. This indicates a significant proportion of units falling short of the prescribed benchmarks for adequate rest area provision.
• Poorly maintained physical infrastructure in many trusts, affecting the quality of care, staff and patient experiences, and overall service efficiency. This includes non-opening windows, peeling paint and mismatching flooring, which contribute to over 30% of negative experience incidents.