Baroness Amos’ update on UK Maternity Care: Why recommendations alone will not deliver the change families deserve

Today’s update from Baroness Valerie Amos on the National Maternity and Neonatal Investigation (NMNI) offers yet another stark reminder of the scale of the crisis in UK maternity care. The review is now expected to produce 748 recommendations, an extraordinary number which, while surprising to many, will not shock those of us who work closely with families affected by maternity failures.

In reality, this figure simply confirms what we already know: everything that has been done so far has not worked. The system remains unsafe, inconsistent and deeply strained. What is required now is not another list of recommendations but a fundamental shift in how maternity services are investigated, funded and held to account.

The NMNI is already significantly behind schedule, and today’s comments suggest that its work will continue well into next year. The reason is evident, the problems are vast, entrenched and systemic. But this raises an important question: Is the extended time spent on yet another investigation truly the best way to improve safety when harm is still occurring daily?

Investigations have value, but families continue to endure avoidable injury, trauma and loss while report after report is produced. The pace of change simply does not match the urgency of the situation.

The Amos review follows a series of high-profile investigations into individual NHS Trusts, including East Kent, Shrewsbury & Telford, Nottingham and Leeds. Each exposed harrowing failures: ignored concerns, unsafe cultures, missed opportunities to save lives. Despite these inquiries, infant deaths remain unacceptably high, and we have not seen the sustained improvements that these families were promised.

Real progress in maternity safety requires more than goodwill or isolated initiatives. It demands:

• Leadership at NHS England and government level that is willing to accept the scale of the crisis
• Humility, not defensiveness
• Accountability, not self-protection
• A commitment to long-term structural change, not short-term fixes.

Without this, avoidable harm will persist, and families will continue to pay the price.

One of the most troubling issues highlighted today is that the NMNI, like previous review bodies, can make recommendations but cannot enforce them. From my own experience representing families, I have seen NHS Trusts reject the safety recommendations made by the MNSI (Maternity and Newborn Safety Investigations). If a Trust can simply dismiss the findings of an independent investigation, how can we expect meaningful change?

This is why I, and many others working in maternity safety, believe the UK now needs a full statutory public inquiry into maternity care, with judicial powers to:

• Compel disclosure
• Require full honesty from leadership
• Enforce changes arising from its findings.

The Amos Review has once again laid bare the shortcomings of a system that has relied too heavily on goodwill and non-binding recommendations. While the scale of the problem is now undeniable, the mechanisms currently in place are simply not capable of delivering the level of reform that women, babies and families desperately need.

A statutory public inquiry is no longer a radical proposal; it is the only proportionate and credible response. Unlike the NMNI or previous Trust-specific reviews, a public inquiry would have the legal authority to compel evidence, hold leaders to account and require meaningful, enforceable change. It would provide families with the transparency they deserve and ensure that the lessons learned are not optional but mandatory.

If maternity care in the UK is to become genuinely safe, compassionate and consistent, we must move beyond recommendations that can be ignored. We must commit to a judicial process with the power to transform the system from the top down.

Families have waited too long for change. A full public maternity inquiry is not just necessary, it is overdue.

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