What is the Maternity (Perinatal) Incentive Scheme?
The Maternity (Perinatal) Incentive Scheme (MIS) is a financial incentive program designed to enhance maternity and neonatal safety within NHS Trusts. It refunds the MIS payment made to NHS Resolution for Trusts that can demonstrate they have implemented a set of core safety actions that are known to make the biggest difference to outcomes for women, babies and families, ultimately aiming to improve the quality and safety of care.
Through the scheme, Trusts are asked to demonstrate that they have effective systems in place to support safe, high‑quality maternity and neonatal care. The MIS is intended to support learning, improvement and strong local governance, rather than to create additional reporting burden.
Obstetric and neonatal incidents can be catastrophic and life-changing for families. NHS Resolution are working together with our colleagues across the whole perinatal safety space in England to do all we can to help prevent these occurring.
Evaluation of the MIS
The MIS has been evaluated to understand how it works in practice and how it supports perinatal safety.
NHS Resolution partnered with The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge to evaluate MIS.
The evaluation explored:
- how the scheme is experienced by Trusts, clinicians and leaders
- how the safety actions are understood and applied in practice
- the perceived impact of the scheme on maternity and neonatal safety
- the experiences of women, families and staff
Learning from this evaluation has informed the development of the MIS, including the move to a more proportionate, outcome‑focused approach in MIS Year 8.
Who is involved in developing the scheme?
The MIS and its safety actions are developed by NHS Resolution in partnership with national clinical leaders, senior maternity and neonatal experts, and service user representatives.
This includes close working with NHS England, Royal Colleges, professional bodies, investigation programmes and representatives of women and families, to ensure the scheme reflects national priorities and lived experience.
What is different about MIS Year 8?
MIS Year 8 reflects learning from previous years of the scheme, the evaluation findings, national reviews, and feedback from perinatal services, clinicians and families.
From Year 8 onwards:
- the scheme focuses on six revised safety actions
- requirements are less prescriptive than in previous years, supporting organisations by sharing examples of ‘what good looks like’
- Trusts are expected to use professional judgement and local governance to demonstrate assurance that align more closely with local priorities and needs
- there is greater emphasis on outcomes, learning and impact, rather than the volume of evidence
This approach recognises that maternity and neonatal services operate in different contexts and that effective safety assurance should build on existing effective governance arrangements.
What are the six revised safety actions?
From MIS Year 8, the scheme focuses on six core safety actions. These reflect the essential foundations of safe maternity and neonatal care and are intended to support consistent, high‑quality services across England.
Each safety action brings together national expectations, professional standards, learning from reviews and investigations, and lived experience.
1. Workforce and capacity
This safety action focuses on ensuring that maternity and neonatal services are safely staffed and sustainably resourced.
Trusts are expected to have effective systems in place to plan, monitor and manage workforce and capacity across maternity and neonatal services, identify and escalate staffing risks, and ensure appropriate senior clinical presence.
Strong workforce planning supports safe care, timely escalation and effective decision‑making for women and babies.
2. Training
This safety action focuses on ensuring that staff have the skills, confidence and support needed to provide safe maternity and neonatal care.
Trusts are expected to provide regular, multidisciplinary training that reflects local and national learning, and to maintain oversight of training participation through established governance routes.
High‑quality training supports teamwork, communication and effective responses in both routine and emergency situations.
3. Learning from reviews and investigations
This safety action focuses on how services learn when things go wrong, including reviews and investigations, and listening to families’ experiences.
Trusts are expected to have systems in place to identify and review qualifying events, involve parents and families meaningfully, and use learning to drive improvement and reduce the risk of harm.
The emphasis is on learning, improvement and compassion, rather than blame.
4. Service‑user voice and equity
This safety action focuses on ensuring that the voices of women, families and carers are heard, valued and acted upon, and that care is equitable.
Trusts are expected to capture and use feedback from women and families, understand the needs of their local population, and address barriers to safe, accessible and inclusive care.
This includes recognising and responding to differences in experience and outcomes across different groups.
5. Care bundles
This safety action focuses on the implementation of national maternity and neonatal care bundles, which bring together evidence‑based practices to improve outcomes.
Trusts are expected to prioritise implementation based on local safety intelligence, monitor progress through established governance routes, and ensure Board‑level oversight of care bundle delivery.
Care bundles support consistent, evidence‑based care across services.
6. Board oversight, governance, culture and leadership
This safety action emphasises the role of Trust Boards in leading and overseeing maternity and neonatal safety. They are ultimately accountable for ensuring safe perinatal services in their organisation.
Trusts are expected to demonstrate that Boards receive clear, regular information on safety and quality, that risks are identified and escalated appropriately, and that leadership supports a positive safety culture.
Effective Board oversight is crucial to ensure that learning leads to sustained improvement, and to facilitate appropriate Trust resource allocation.
How does the scheme work?
NHS Trusts in England that deliver perinatal services and are members of the Clinical Negligence Scheme for Trusts (CNST) contribute to the MIS as part of their CNST premium.
During the MIS year, Trusts are expected to:
- monitor progress against the six safety actions
- use local governance systems to review risks, learning and improvement
- provide robust assurance to their Trust Board that the safety actions are being met
At the end of the MIS year, Trust CEOs make a Board‑level declaration confirming whether they meet the MIS requirements.
The scheme is not based on routine submission of detailed evidence to NHS Resolution. Instead, Trust Boards are responsible for assuring themselves that the standards are met and that appropriate evidence is retained locally.
Evidence and assurance
MIS Year 8 does not require Trusts to follow a fixed evidence checklist.
Trusts are expected to:
- use evidence that is proportionate and meaningful
- rely on information that should already be being used for local and Board assurance
- focus on how safety actions are embedded in day‑to‑day practice all year round
Evidence should demonstrate how risks are identified and managed, how learning leads to improvement, and how Boards maintain oversight of maternity and neonatal safety.
Additional external assurance models and support will be introduced in year 8 to ensure these processes are happening effectively.
What is reverification?
As part of the MIS conditions, at any time if concerns are raised about a trust or submission, NHS Resolution are required to investigate these. This may be following a CQC inspection, or concerns raised by an individual. If information that conflicts with the trust MIS submission is identified, then Trusts may go through a ‘reverification’ process:
- Trusts asked to re-confirm and declare whether they meet all ten safety actions based on evidence sent to their Board at the time of the initial submission.
- If their findings do not coincide with the concerns raised, NHS Resolution will ask to review the evidence of their submission.
- There will be a request to review previous years’ submissions if the outcome of a declaration is changed following this review.
- Any MIS contribution and any surplus monies paid to the trust will need to be repaid for non-compliant years.
- The trust will be given the opportunity to develop an action plan and apply for discretionary funding to support this.
This is a transparent process and is reflected in the published details on the website.
How does MIS support women, babies and families?
The MIS aims to support maternity and neonatal services to provide care that is:
- safer
- more equitable
- more responsive to women and families’ voices
- focused on continuous learning and improvement
- encourages sharing of best practice
By strengthening the foundations of safe care, the scheme supports Trusts to reduce harm and improve experiences for women, babies and families.
Key documents and further information
Supporting guidance, financial details, annual results and national reports are published alongside the scheme and updated as the MIS evolves.
Trusts should refer to the MIS Year 8 documents for full details of the safety actions and reporting arrangements.
Our team
You can read more about our Maternity Incentive Scheme team by viewing their bios below:
Bridget Dack
Selina Dubison
Sophie Jackson
Paddy Carley
How to keep in touch
Why join the FutureNHS workspace? An NHS Resolution FutureNHS workspace was launched in April 2024.
This includes information and a forum for queries about each action, and information and resources that will hope will support MIS compliance:
- Allows improved communication with members.
- Open and accountable responses to queries.
- Encourages sharing of resources and best practice.
Why join the contact list?
In order to ensure that essential communications reach the right people in organisations participating in our maternity incentive scheme, we are asking for Trusts to nominate at least two link individuals as leads for the Maternity Incentive Scheme.
These individuals will be responsible for receiving, cascading and acting as a conduit for responding to all communications relating to the maternity incentive scheme.
If your nominated link individuals change you will need to advise us in order to ensure continuity of communications. Please upload their new details here and alert us via nhsr.mis@nhs.net
Please ensure that you notify us if these individuals leave your organisation.
Key documents
Year 8
MIS Year 8: Board notification form
MIS Year 8: Audit tool (open in desktop)
MIS Year 8: Supplementary guidance
Year 7
MIS Year 7: Board notification form
Year 6
MIS Year 6: Board notification form
MIS Year 6: Overview letter to trusts
Other
Results
MIS Y1-6 Finance data by Trust 01-08-2025
MIS reconfirmation log April 2026
Year 3: results overview February 2022
Year 2: results regional breakdown
Year 1: results regional breakdown
Events
In April 2025 the MIS team hosted a virtual, half day webinar alongside expert speakers, sharing crucial updates on scheme changes for Year 7. The event was recorded and is available for catch up on our dedicated webpage, where you can also access the presentation slides.
A year in the Maternity Incentive Scheme 2025/26 – report
Our MIS team have released a new report: A year in the Maternity Incentive Scheme 2025/26. This provides a clear overview of the national results from Year 7 of the MIS in the new accessible format.
Key messages:
- The report offers a national perspective on Year 7 results, reflecting data correct as of 6 August 2026.
- Year 7 ran from 2 April 2025 to 3 March 2026.
- 119 trusts participated, accounting for all maternity units in England.
- 107 trusts achieved full compliance (10/10) after validation, the highest since the scheme began.
- This report is not intended to provide commentary on the results of individual trusts.
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