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Maternity incentive scheme

If contact details have changed for your nominated Maternity Incentive Scheme leads please let us know here.

Obstetric incidents can be catastrophic and life-changing, with related claims representing the Clinical Negligence Scheme for Trusts’ (CNST) biggest area of spend. Of the clinical negligence claims notified to us in 2020/21, obstetrics claims represented 11 per cent (1,190) of clinical claims by number, but accounted for 59 per cent of the total value of new claims; almost £4.2 billion.

The Maternity Safety Strategy set out the Department of Health and Social Care’s ambition to reward those who have taken action to improve maternity safety. We are very happy to support this work through the Maternity Incentive Scheme.

Maternity Incentive Scheme: Year four

Year four of the Maternity Incentive Scheme launched on 9 August 2021. The scheme supports the delivery of safer maternity care through an incentive element to trust contributions to the CNST. The scheme, developed in partnership with the national maternity safety champions, Dr Matthew Jolly and Professor Jacqueline Dunkley-Bent OBE, rewards trusts that meet ten safety actions designed to improve the delivery of best practice in maternity and neonatal services.  In the fourth year, the scheme will further incentivise the ten maternity safety actions from the previous year with some further refinement.

Following the re-launch of the fourth year, NHS Resolution and the Collaborative Advisory Group (CAG) have continued to monitor the Trusts’ position in relation to Covid-19, staffing and acuity and the challenges faced by Trusts in achieving the Scheme’s safety actions.

On 27 September 2021 it was decided to extend the Scheme’s interim deadlines to support trusts. There have also been revisions to some of the safety actions’ sub-requirements. These revisions were shared with members on 12 October 2021. Please see below updated guidance

Maternity Incentive Scheme Year four guidance.

In recognition of the current pressure on the NHS and maternity services, the majority of reporting requirements relating to demonstrating achievement of the maternity incentive scheme (MIS) 10 safety actions are paused from 23 December 2021 for a minimum of 3 months. This will be kept under review.

Trusts are asked to continue to apply the principles of the 10 safety actions, given that the aim of the MIS is to support the delivery of safer maternity care. Examples of continuing to apply the principles include: undertaking midwifery workforce reviews, ensuring that as far as possible the oversight provided by the maternity, neonatal and board level safety champions continue, as well as using available on line training resources.

In the meantime, Trusts are asked to continue to report to MBRRACE-UK and report eligible cases to the Health Safety Investigation Branch (HSIB). In addition, every reasonable effort should be made to make the Maternity Services Data Set submissions to NHS Digital.

For more information, please see Pause letter MIS y4 Dec 2021 23122021.

The 10 safety actions

The ten safety actions for year three have been agreed with the national maternity safety champions in partnership with the Collaborative Advisory Group (CAG). The CAG was established by NHS Resolution to bring together other arm’s length bodies and the Royal Colleges to support the delivery of the CNST maternity incentive scheme and has also advised NHS Resolution on the refined safety actions. Members of the group include: the Department of Health and Social Care, NHS Digital, NHS England, NHS Improvement, Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE), Royal College of Anaesthetists, the Care Quality Commission (CQC) and the Healthcare Safety Investigation Branch (HSIB).

How the scheme works

Provision for the maternity incentive scheme has been built into our CNST maternity pricing for 2022/23. As in year two, the scheme incentivises ten maternity safety actions. Trusts that can demonstrate they have achieved all of the ten safety actions will recover the element of their contribution to the CNST maternity incentive fund and will also receive a share of any unallocated funds.

Trusts that do not meet all ten safety actions will not recover their contribution to the CNST maternity incentive fund, but may be eligible for a small discretionary payment from the scheme to help them to make progress against any actions they have not achieved. Such a payment would be at a much lower level their original 10 per cent contribution.

All participating trusts are required to provide clinical and financial contacts to receive and send communications relating to the maternity incentive scheme.

How the scheme is managed

Whilst the maternity incentive scheme is a self-certified scheme, with all scheme submissions requiring sign-off by trust Boards following conversations with trust commissioners, all submissions also undergo an external verification process and are sense-checked by the Care Quality Commission (CQC).

Further information

We have carried out an interim evaluation of the maternity incentive scheme, incorporating feedback from NHS trust maternity services and identifying key outcomes from the scheme to date.

For further information on the maternity incentive scheme please contact, or on the Early Notification scheme please contact

You can find more information on the results of year one and year two of the maternity incentive scheme below.

year one: results overview

year one: results regional breakdown

year two: results overview

year two: results regional breakdown


interim evaluation


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