The Amos Review: What is it, and what does it say about maternity care in the UK?
The publication of Baroness Valerie Amos’ Independent Investigation into Maternity and Neonatal Services in England, commonly known as the Amos Review, is one of the most significant developments in maternity care in England in recent years.
Published alongside the Government’s commitment to extend Martha’s Rule to all maternity services in England and following Donna Ockenden’s final report into maternity services at Nottingham University Hospitals NHS Trust, the review looks beyond the failings of individual NHS trusts and asks a much bigger question:
How can maternity and neonatal services become consistently safe, compassionate and equitable across England?
If you’re pregnant, planning a family or simply following recent developments in maternity care, it’s understandable to wonder what the Amos Review means in practice. Here, we explain the key recommendations, why they matter and what they could mean for women and families.
What is the Amos Review?
The Amos Review is an independent, system-wide investigation into maternity and neonatal services in England, led by Baroness Valerie Amos.
Unlike previous maternity investigations, which examined the care provided by individual NHS trusts, the Amos Review considers the maternity system as a whole. It explores why variation in care continues to exist across England, why similar themes continue to emerge from successive maternity investigations and what changes are needed to improve maternity care nationally.
The review also brings together learning from previous investigations, including:
- Morecambe Bay
- Shrewsbury and Telford
- East Kent
- Nottingham
Its aim is to examine what went wrong in the past to create recommendations for how maternity and neonatal services can become safer for the future.
What are the key recommendations of the Amos Review?
Although the report contains many recommendations, several themes run throughout.
- More consistent maternity care across England
The review concludes that the quality and safety of maternity care should not depend on where a woman lives.
It recommends stronger national leadership and oversight to reduce variation between NHS maternity services and ensure consistently high standards of care across England.
- Stronger leadership and accountability
The Amos Review recommends clearer national leadership, improved accountability and stronger oversight of maternity and neonatal services.
The aim is to ensure that learning from previous maternity investigations leads to lasting improvements across the NHS.
- Listening to women and families
A recurring theme throughout the report is the importance of listening to women and involving them in decisions about their care.
Women should feel respected, informed and supported to raise concerns throughout pregnancy, labour and after birth.
- Supporting the maternity workforce
The review recognises the significant pressures facing maternity services and recommends improvements in workforce planning, education, leadership and creating environments where staff feel able to speak up about concerns.
- Reducing inequalities
The Amos Review also highlights the persistent inequalities in maternity outcomes, particularly for Black women, Asian women and women living in areas of deprivation.
Reducing those inequalities is identified as a national priority.
What is Martha’s Rule?
Following the publication of the Nottingham Ockenden Report, the Government confirmed that Martha’s Rule will be extended to all maternity services in England.
Martha’s Rule provides women and families with a route to request a rapid clinical review if they are concerned that deterioration in the condition of a mother or baby is not being recognised or responded to appropriately.
Its introduction reflects the growing recognition that women and families have an important role to play in patient safety.
Should pregnant women be worried?
No.
The overwhelming majority of pregnancies result in healthy mothers and healthy babies, and maternity professionals across the NHS provide excellent care every day.
However, the Amos Review acknowledges that there remains unacceptable variation in the quality of maternity care across England and that further improvements are needed to ensure every woman receives consistently safe care, wherever she lives.
What should you do if something doesn’t feel right with your pregnancy?
One of the strongest messages emerging from successive maternity investigations is that women should never feel reluctant to raise concerns.
If you notice:
- reduced or changed baby’s movements;
- persistent pain;
- bleeding;
- severe headaches;
- changes in vision;
- swelling;
- or simply feel that something is not right,
contact your maternity team.
Most concerns turn out to have a reassuring explanation.
However, healthcare professionals would usually rather assess you and find everything is well than have you remain at home worrying.
If you continue to feel concerned after speaking to your maternity team, explain why. If your concerns remain unresolved, Martha’s Rule will provide an additional route for requesting a rapid clinical review once it has been fully implemented across maternity services.
What happens next to the UK’s maternity care?
The publication of the Amos Review won’t change maternity care overnight.
Its recommendations will now inform the Government’s National Action Plan for maternity and neonatal services, alongside the findings of the Nottingham Ockenden Report and the national rollout of Martha’s Rule.
The real measure of success will be whether those recommendations translate into safer, more consistent care for women and babies across England.
Our thoughts on the Amos Review
The Amos Review represents an important opportunity to improve maternity services across England. Alongside its recommendations, it reminds us that safe maternity care depends not only on national leadership but also on women feeling heard, professionals feeling able to speak up and every clinical decision being informed by meaningful joint decision-making.
If you’re interested in that wider discussion, you can also read our companion opinion article: Maternity services: why the next challenge is local, not national.
You can read the full Independent Investigation into Maternity and Neonatal Services in England (the Amos Review) here: https://www.matneoinv.org.uk/
Need advice?
If you or your family have been affected by negligent maternity care or a birth injury, our specialist clinical negligence solicitors are here to help. We offer compassionate, practical advice and can discuss your circumstances without obligation.