Maternity (Perinatal) Incentive Scheme Year 8: Supporting safer care through evaluation and evolution

NHS Resolution’s Maternity (Perinatal) Incentive Scheme (MIS) Year 8 Core standards and Supplementary guidance have been published today (31 March 2026) alongside the findings of a comprehensive evaluation of the scheme.

A transitional year bridging present and future

Year 8 represents a transitional phase for the scheme, bridging the current framework to future reforms that will be informed by the National Maternity and Neonatal Investigation led by Baroness Amos. The evaluation findings have directly shaped this transitional design.

This approach positions MIS to align with broader NHS reforms and the priorities set out in “Fit for the future: The 10 Year Health Plan for England”, while maintaining flexibility to respond to the National Investigation’s recommendations and the development of a new National Action Plan expected in 2026.

Working closely with our Collaborative Advisory Group (CAG) and key maternity, neonatal, perioperative and service user stakeholders, we have streamlined the scheme to make it more focused and reduce administrative burden on trusts.

Key changes for Year 8

MIS Year 8 streamlines the scheme from multiple actions to six focused core areas, reducing administrative burden while maintaining robust assurance:

A). Workforce and capacity
B). Training
C). Learning from reviews & investigations
D). Service-user voice and equity
E). Care bundles
F). Board oversight, governance, culture and leadership

A new approach focused on outcomes and equity

Year 8 introduces important refinements to how the scheme operates:

Enhanced focus on outcomes – Moving beyond process compliance to measure meaningful improvements in safety outcomes for women and babies
Strengthened service-user voice – Greater emphasis on co-production with women and families, ensuring their experiences directly inform safety improvements
Explicit attention to equity – Focused measures to reduce health inequalities and support trusts facing greater challenges in delivering safe care

A more collaborative approach

Each safety action will be shaped and delivered through collaborative workstreams involving multiple system partners, rather than being owned by one organisation in isolation. This approach has been welcomed by CAG members as a practical step towards better system join-up and national alignment.

We are also developing new approaches to assurance, including peer reviews between trusts, service user reviews, and shared evidence repositories.

The transitional changes in year eight reflect our commitment to reducing administrative burden on the frontline while maintaining robust assurance, bringing a greater focus on supporting outcomes rather than process, and remaining responsive to the evolving maternity and neonatal landscape.
Megan Bidder, Director of Safety & Learning, NHS Resolution

Publishing the evaluation

The MIS evaluation report was published on 31 March 2026 alongside Year 8 guidance. The evaluation, conducted by NHS Resolution’s internal team with support from THIS Institute at the University of Cambridge, examined both internal processes and stakeholder perceptions of the scheme.

This evaluation serves as an interim step ahead of National Investigation findings and the development of a new National Action Plan, informing where to focus improvement efforts.

Key findings

Strengths identified:

The scheme significantly raises the profile of maternity at board level within trusts
The financial incentive is crucial for driving maternity and neonatal safety
The dedicated NHS Resolution MIS team has supported trusts to improve local governance arrangements and achieve substantial improvements in trust compliance rates
The evaluation confirms that the MIS occupies a unique position in the maternity and neonatal safety landscape, effectively translating recommendations into actionable steps for improved safety.

Supporting the wider maternity and neonatal safety agenda

NHS Resolution continues to engage actively with the National Maternity and Neonatal Investigation. Our Chief Executive Helen Vernon and Director of Safety and Learning Megan Bidder met with the investigation team in January 2026 to share our insights and data.

We have also contributed to the Terms of Reference for the Taskforce that will follow the investigation, emphasising the importance of local accountability and how schemes like MIS support this through requirements and incentivisation.

Our commitment to continuous improvement

Preventing avoidable harm in maternity and neonatal care is both the right thing to do for families and helps reduce long-term clinical negligence costs. The evaluation evidence informs where to focus improvement efforts most effectively.

Future MIS development will focus on:

Further streamlining to reduce any additional administrative burden on trusts
Exploring outcome-focused measures that demonstrate real-world impact
Enhancing synergy with other safety programmes across the system
Maintaining equity support for trusts facing greater challenges
Supporting local accountability and improved governance
Continued focus, investment, and learning remain essential to achieving safer maternity and neonatal care for all women and babies, particularly addressing persistent health inequalities.

NHS Resolution remains committed to transparent evaluation and continuous improvement of all our maternity and neonatal safety initiatives. Our evaluation of the Early Notification Scheme is also progressing, with findings expected later in 2026/27.

Next steps

We will continue to work collaboratively with system partners to ensure the scheme remains effective in supporting safer maternity and neonatal care across England.