‘Profound disappointment’ as ICBs are allowed to cut safety funding

The concerns follow more than £90m of service development funding being cut from maternity allocations and transferred into core integrated care board budgets in 2025-26, as revealed by HSJ this week.

NHS England said “maternity care remains a top priority” and it was “misleading” to suggest otherwise. But leading maternity safety campaigners and royal colleges expressed concerns that funding will now be lost because of deficits and competing demands.

NHSE 2025-26 planning guidance says organisations must still “improve safety in maternity and neonatal services, delivering the key actions of the ‘three-year delivery plan’”, as well as “paying particular attention to challenged and fragile services, including maternity and neonatal”.

Donna Ockenden, a former senior midwife, chaired a government-commissioned review into maternity failings in Shropshire and is currently leading its inquiry into Nottingham Hospitals. One of the System Development Funding (SDF) pots that was axed was dedicated to improvement work in response to her findings.

She said on social media site X she had learned of the changes this week in HSJ and added: “Talking to colleagues across perinatal services, the sense of disappointment is profound, with everyone I’ve spoken to tonight expressing significant concern about safety and the wellbeing of children and mental health.”

Influential safety campaigner James Titcombe said the move was “pulling in the opposite direction to promises health and social care secretary Wes Streeting had made to families failed by poor maternity care”.

He told HSJ: “The obvious concern is that unless this is ring-fenced, trusts are under so much pressure that things are never spent as they are intended.

“It was ringfenced for a reason. This is a time when they need to be redoubling focus on maternity safety and not risking budgets being diverted elsewhere. We would be expecting more investment and focus rather than deprioritising something that needs prioritising. This sends the wrong message.”

And Royal College of Midwives chief executive Gill Walton referred to the changes as “cuts” and said they were “more than shocking, they will rip the heart out of any moves to improve maternity safety”.

“The government has taken a wrecking ball to the work that’s being done up and down the country to improve maternity safety, something which is desperately needed,” she added.

Increasing freedoms

SDF ring-fenced funds in 2024-25, which are no longer funded in 2025-26, include £59.7m for NHSE’s three-year delivery plan for maternity and neonatal services; and £22m for implementation of “Ockenden II” workforce plans, which include growing staffing and improved training planned in response to her inquiry findings. 

From 2024-25 ring-fenced maternity spend, only two small pilots — “genetic risk services” and “independent senior advocates”, who will support families who have had an “adverse outcome” — will continue in 2025-26.

Wes Streeting and NHSE said in January they were axing many national planning asks and ring-fenced funding pots, described as ”increasing the freedoms systems have to allocate their resources by releasing most funding ring fences”.

At the time they did not state which pots were being kept and which moved, but the health and social care secretary criticised a “cottage industry” of lobby groups calling for a focus on their area. He said NHS leaders should stop “trying to do everything for everyone, everywhere, all at once, because that is the path to failure and we won’t do it”.

But asked about the concerns over maternity funding, an NHSE spokesperson told HSJ: “This story is misleading and maternity care remains a top priority for providers, as demonstrated in the planning guidance, and we continue to implement our three-year delivery plan for maternity and neonatal services.

“As set out in the guidance, the NHS is reducing the number of national priorities and ring-fenced budgets in order to give systems more flexibility, and maternity funding, which formed part of the SDF in 2024-25 has been transferred to ICB core allocations for the coming year.”

The Department of Health and Social Care said local leaders were “best placed” to decide how to use funding, but added: “We are clear that too many women are not receiving the safe, personalised, and compassionate maternity care they deserve, but through our Plan for Change, this government is determined to change that. This starts with listening to women and families to learn lessons, to improve care, and ensure mistakes are not repeated.”