Nottingham University Hospitals NHS Trust has been told that obstetric staffing remains a “significant challenge” within its maternity services, with the issue being flagged as a board-level alert ahead of a public meeting this week.
The warning is included in the trust’s latest Perinatal Quality Oversight Report, which will be considered by NUH’s board at its open meeting on Thursday 14 May.
The report covers maternity and neonatal services at Nottingham’s hospitals and provides data up to the end of February 2026. It says there were 642 babies born during February, and that midwifery and neonatal nurse recruitment and retention remain positive, with stable staffing levels.
However, the report says obstetric staffing continues to be a significant challenge, with plans in place to manage risks on both a daily and longer-term basis. The board is specifically asked to note an “alert” against obstetric staffing issues.
The same report asks board members to review and consider the medical workforce and midwifery workforce information shared with the paper, including the February 2026 BirthRate Plus report. The board is also asked to note continued “advise” ratings for third and fourth degree tear rates, and for the number of pregnant women being booked by 10 weeks.
NUH says most core clinical quality improvement metrics remain within expected levels of variation, but three areas continue to be managed through targeted improvement work. These are perineal injury, booking by 10 weeks and postpartum haemorrhage of more than 1,500ml.
The report says overall perineal injury rates remain above national benchmarks, with the OASI care bundle being rolled out and expected to be fully implemented by mid-2026. Booking by 10 weeks remains significantly below the 85 per cent target, which the paper links to administrative and system issues following the roll-out of Nervecentre, the trust’s electronic patient record system.
The board papers say term admissions to the neonatal unit also remain above target, with themes from case reviews being used to develop an ATAIN action plan. ATAIN stands for Avoiding Term Admissions Into Neonatal Units and is a national programme aimed at reducing avoidable admissions for babies born at or after 37 weeks.
The latest warning follows discussion at NUH’s March board meeting, when senior maternity leaders said obstetric staffing at both consultant and resident doctor level remained a key challenge. The March minutes say there were 25 programmed activity vacancies in the consultant workforce, with five consultant roles due to be advertised. The board was told that successful candidates were unlikely to join the trust for a further three to six months.
The March meeting also heard that long-term sickness and adjustments to duties were creating pressure for colleagues, and that a business plan had been developed to recruit five resident doctors to help with rota management and short-term sickness. Three of those posts had been advertised at that point, with interviews and appointments expected by the end of April.
Board members were also told in March that gaps in consultant leadership roles were affecting improvement work.
The papers also link staffing pressures to the wider context of scrutiny around NUH’s maternity services. In March, the board heard that the Independent Maternity Review was continuing to affect morale and was creating stress for staff. Clinical Director Sophie Wilne told the board the impact on psychological safety was significant and was also affecting recruitment into senior leadership roles.
NUH’s maternity services remain under close public scrutiny following long-running concerns raised by bereaved and affected families, and ahead of the publication of Donna Ockenden’s Independent Maternity Review. The trust’s chair, Nick Carver, has said he expects to remain in post long enough to receive the review with chief executive Anthony May and lead the board’s initial response before stepping down in July.
The March board minutes also refer to the Care Quality Commission’s latest report on maternity services, published on 4 March following an inspection in May 2025. The CQC did not change the trust’s overall “Requires Improvement” rating for maternity services at Queen’s Medical Centre and City Hospital. Both sites were rated “Good” for being effective, caring and responsive, but “Requires Improvement” for being safe and well-led. The CQC identified breaches of regulation relating to security, staffing and management of the service.
NUH said at the March meeting that the midwifery staffing position had improved, and that the trust had committed to increasing obstetrician staffing over establishment. The board was also told that security policies had been reviewed and safety drills completed at both hospital sites to test the abduction policy.
The latest perinatal report says there are also areas of assurance. It says one-to-one care in labour was provided 100 per cent of the time in line with BirthRate Plus reporting, and that fresh eyes reviews — where clinicians review fetal monitoring together — continue to show improvement. The report also says compliance with all 10 Maternity Incentive Scheme safety actions has been confirmed by NHS Resolution.
The board is being asked to note the current position, take assurance from areas of stability and improvement, and consider whether any additional reporting is required.
