To register interest or suggest a question for the series, complete the registration form or email hello@consultationinstitute.org.
How should trusts and ICBs act on what is already required, prepare for national requirements that are not yet settled and involve women and families in decisions about local services while national policy develops?
Why this matters now
The Independent National Maternity and Neonatal Investigation, chaired by Baroness Amos, reported on 30 June 2026. It found that women and families were too often not listened to, that racism and discrimination were driving inequalities in care and that services had not been designed to ensure consistent safety. It recommends that the Department of Health and Social Care and NHS England design a Modern Service Framework of national standards within 12 months and review the optimal size and configuration of maternity and neonatal units. As at 8 October 2026 the Government has not published a decision on the framework; the National Maternity and Neonatal Taskforce said in July it would consider a plan for one.
Some national requirements already apply. NHS England published a national maternity triage specification in July, and its assurance process for the Maternity and Neonatal 10 Point Plan asks trust boards to approve returns due by 25 September and 31 December 2026. The Taskforce is preparing a national action plan that draws on the Amos recommendations and the independent review of maternity services in Nottingham. The Government has said the plan will be published in December 2026.
For local leaders the questions arrive before any formal proposal. Women, families and staff will reasonably ask what the national work means for their own unit, especially where a service already runs under a temporary change made for safety reasons. Trusts and ICBs need to act on the safety concerns they already know about and be clear which requirements are settled and what remains open to local decision. How they do that will affect whether women and families trust any later proposal for change.
What national requirements do and do not change
National safety requirements may narrow the configurations that clinical evidence can support. They do not decide the future of individual sites or displace the statutory duties that apply to service change. These include the duties to involve the public (section 242 of the NHS Act 2006 for trusts, section 14Z45 for ICBs) and to consult the local authority on a proposal for substantial variation, the public sector equality duty and the health inequalities duties. In Nettleship (2020) the Court of Appeal held that commissioners need not consult on options they have judged unviable, so the reasons for excluding one should be recorded with the evidence. Where safety requires an urgent temporary change the local authority should be informed as soon as possible but it does not have to be consulted. The full process applies if it is later proposed as permanent. It is not necessary to return the service to its previous state first. NHS England’s service-change guidance (updated June 2026) explains how these duties apply and may change with the Health Bill.
Three linked roundtables
Session one: Before the action plan
What should trusts and ICBs have ready before December?
What should boards know, from triage audits and 10 Point Plan progress to services under temporary change and what Maternity and Neonatal Voices Partnerships are hearing? How should leaders answer questions about local implications without making commitments that are not theirs to make?
Outcome: preparation questions for boards and executive teams.
Session two: After the action plan
When does a national requirement narrow local options?
When does a requirement make an option unviable, and what evidence is needed to exclude it from engagement or consultation? How can organisations separate national requirements from local judgement, so women and families are neither offered a choice that does not exist nor denied one that does?
Outcome: tests for assessing and explaining service-change options.
Session three: Engaging while the framework develops
How do proposals stay formative while national policy moves?
Held as detail of national standards emerges. How should programmes record the policy assumptions behind their options, decide when a new requirement should trigger a review and keep equality and health inequalities analysis current, so that women and families can still influence proposals?
Outcome: guidance on engaging and deciding while policy changes.
Who should take part
The series is for a small group of senior leaders from trusts that provide maternity services and from ICBs, combining those who take service decisions with those who lead the involvement of women and families: chief operating officers, strategy directors, directors of midwifery, senior obstetric and neonatal leads, local maternity and neonatal system leads and directors of communications and public involvement. tCI may invite a few people with national policy or assurance roles to explain published policy. The discussions do not replace the involvement of women, families and communities in local decisions, and no decision about any service is taken in them.
Each roundtable lasts about 45 minutes: a short briefing from tCI, then facilitated discussion under the Chatham House Rule. tCI will not quote or identify any participant or organisation without permission. Dates, format, cost and attendance: [tCI to confirm]
tCI will send a short note after sessions one and two for comment and, after session three, an NHS practice briefing that separates settled requirements from open questions. Participants see the draft first and no one is named without permission.
To register interest or suggest a question for the series, complete the registration form or email hello@consultationinstitute.org.
Policy references
Amos investigation final report (30 June 2026); Government announcement of the action plan (30 June 2026); Taskforce meeting note (14 July 2026); national maternity triage specification (July 2026); 10 Point Plan assurance process (12 August 2026); Planning, assuring and delivering service change for patients (updated June 2026).