The Ockenden Report and NHS Maternity Care: Why NHS Accountability Matters

The findings published in the Ockenden Report into maternity services at Nottingham University Hospitals NHS Trust make for difficult reading. An independent review led by senior midwife Donna Ockenden, involving more than 2,500 families and over 800 current and former staff, concluded that more than 500 mothers and babies suffered avoidable harm or died as a result of systemic failings in maternity care between 2012 and 2025. For 260 of those babies, the report found that different care might have changed the outcome entirely.

These are not abstract statistics. They represent families who trusted a maternity service to keep them and their babies safe, and were let down in ways that, in many cases, could and should have been prevented. As a firm that handles clinical negligence claims across England and Wales, we believe it is important to talk honestly about what reports like this mean, not just for the families directly affected, but for the wider conversation about how the NHS is held accountable when care goes wrong.

What the Ockenden Report Found

The review identified a pattern that goes well beyond isolated clinical error. It described a culture in which concerns were not properly escalated, parental concerns were too often dismissed, and serious incidents were not consistently investigated in a way that allowed lessons to be learned. The phrase used in the report, a “normalisation of deviance,” captures something important: when poor practice becomes routine within a system, it stops being recognised as a red flag, and the opportunity to intervene before harm occurs is lost.

The report also pointed to staff shortages, a difficult workplace culture, and inconsistencies in how incidents were categorised internally, which in some cases prevented proper investigations from taking place at all. None of this suggests that individual midwives or doctors were acting carelessly on any given shift. It suggests a system that, over a sustained period, did not have the structures in place to catch and correct its own failures.

A Statistic Worth Pausing On

Donna Ockenden’s report highlighted what she described as a “startling” statistic: that clinical negligence claims now cost the NHS almost as much as the maternity care budget itself. It is worth being clear about what that figure actually represents, because it is sometimes misread as evidence that solicitors are draining NHS resources.

The cost of clinical negligence claims is a downstream consequence of harm that has already occurred. It reflects the price, in the most literal sense, of failures that took place years earlier, often during a period when warning signs were missed or not acted upon. Importantly, Ockenden’s report did not criticise lawyers or the existence of claims. It focused, correctly in our view, on the care failings that give rise to them in the first place. Reducing that cost in any meaningful and lasting way means reducing the underlying harm, not reducing families’ ability to seek answers when harm has already happened.

Why Compensation Is Only Part of the Picture

It would be a mistake to think that clinical negligence claims exist solely, or even primarily, to secure financial compensation. For many of the families affected by failures like those at Nottingham, compensation matters because it pays for things the NHS cannot otherwise provide, ongoing care for a child with a lifelong disability, adapted housing, therapy, lost income while a parent gives up work to provide care. That is real and necessary. But it is rarely the only thing families say they want.

What families consistently ask for, in cases like these, is an honest explanation of what happened and why. A properly investigated clinical negligence claim does something an internal NHS review, on its own, often struggles to do: it independently tests the evidence, instructs experts who have no institutional stake in the outcome, and produces a clear, factual account of whether the care provided fell below an acceptable standard. That process of independent scrutiny is, in itself, a form of accountability that exists separately from any financial settlement.

This is also where solicitors play a role that goes beyond any individual case. When clinical negligence claims reveal a recurring pattern, as they did in the lead up to both the Ockenden review at Shrewsbury and Telford and the subsequent findings at Nottingham, that evidence becomes part of the wider record. It can support exactly the kind of inquiry that exposes systemic problems rather than treating each case as an unconnected one off.

The NHS Does a Huge Amount Right

It is important to say plainly that maternity care across England and Wales succeeds for the overwhelming majority of mothers and babies, every single day. NHS midwives, obstetricians and maternity teams work under significant pressure, often in understaffed units, and the dedication of frontline staff is not in question here. Reports like Ockenden’s are not an indictment of NHS maternity care as a whole, and treating them as such would do a disservice to the many thousands of NHS staff who provide safe, compassionate care under genuinely difficult conditions.

This is precisely why scrutiny matters. A health service that does so much right deserves a system robust enough to identify, investigate and learn from the occasions when something goes badly wrong, rather than one where warning signs are normalised until a review years later reveals the scale of what was missed. Holding the NHS accountable through properly evidenced claims is not in conflict with supporting it. It is part of what allows it to improve.

What This Means If You Have Concerns About Maternity Care You Received

If you believe you or your baby were affected by substandard maternity care, whether recently or some years ago, it is worth knowing that you do not need to wait for a national inquiry to seek answers. A clinical negligence claim can independently establish:

• Whether the standard of care you received fell below what you were reasonably entitled to expect
• Whether that failure caused or contributed to the harm you or your baby experienced
• What compensation may be appropriate to reflect the financial and personal impact of that harm

The starting point is usually a review of your maternity records, alongside an initial conversation about what happened. From there, independent medical experts assess whether the care provided was appropriate, a process that exists specifically to remove institutional bias from the assessment of what went wrong.

Speak to a specialist like us

We believe reports like the Ockenden Review matter because they confirm what specialist clinical negligence solicitors see, far too often, in individual cases: that warning signs are sometimes missed, concerns are sometimes dismissed, and families are sometimes left without a clear explanation of what happened to them or their baby. Pursuing a claim is not about working against the NHS. It is about insisting that an institution so many of us rely on is held to the standard it owes every patient, and giving families the independently established answers they deserve.

At Satchell Moran Solicitors, our specialist clinical negligence team handles maternity and birth injury claims with the seriousness and sensitivity they require. We are committed to approaching every case with rigour, independence and care.

If you have concerns about the maternity care you or your baby received, contact us today for an initial, confidential conversation.

If reading about maternity care failings has raised difficult feelings, particularly around pregnancy loss or birth trauma, organisations such as Sands (the stillbirth and neonatal death charity) and the Birth Trauma Association offer dedicated support.