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As 2025 draws to a close, we want to share some reflections on what a significant year it has been for the Maternity and Newborn Safety Investigations (MNSI) programme.
Strengthening investigation quality
This year, our dedicated team has worked to enhance both the depth and rigour of our investigations. We've further developed our methodology to allow us to examine safety events more thoroughly, ensuring that the learning we extract can drive meaningful safety improvements across maternity and newborn services.
Every investigation we undertake begins with families who have experienced loss or harm. Their willingness to share their experiences, often during the most difficult of times, enables us to identify systemic issues and prevent similar events from affecting other families. We remain deeply grateful to the families who work with us.
We would like to extend our thanks to NHS trusts across the country. Your openness, collaboration, and commitment to learning have been central to our shared mission of improving safety for mothers, babies, and families. Every conversation, every investigation, and every partnership has contributed to building a stronger foundation for the future. As we look ahead, we remain inspired by the dedication of colleagues across the NHS and grateful for the trust you place in us to support this vital work.
Sharing learning nationally and internationally
A key focus for us this year has been amplifying the reach of our safety recommendations and prompts. Through national and international presentations, we've contributed to important conversations about maternity and newborn safety, working to improve services in England, while learning from approaches to safety in other healthcare systems.
Presentations of HEART, HEWS, and COMPASS, alongside our briefing papers, blogs, and bulletins have translated individual investigations into actionable insights for maternity and newborn units, policymakers, and professional bodies working to improve care.
Looking ahead
Our recently published two-year strategy marks an important milestone for the programme. It is built around three core themes:
- Excellence
- Impact
- Relationships
and provides us with a framework that sets out how we'll strengthen the rigour of our investigations, ensure findings drive meaningful change, and deepen our partnerships across the maternity and newborn safety system. Our strategy reflects extensive consultation with stakeholders and our team, providing a clear framework for our work as the landscape evolves.
2026 will be a significant year more broadly, with the Baroness Amos national review and the Maternity and Newborn Taskforce shaping the future of maternity and newborn care. Our strategy positions us to contribute meaningfully to these wider conversations and align our work with system-wide efforts to improve safety.
The festive period can be particularly challenging for bereaved families and those who have experienced harm. If you are reading this and we've investigated your care, we acknowledge this time of year brings a mixture of thoughts and feelings and we hope you have support around you during this time. You will be in our thoughts.
To everyone working in maternity and newborn services - thank you. Our work only has value if it helps you provide safer care.
We look forward to continuing this important work together in 2026.
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