Leeds NHS trust repays £5m over maternity failings

An NHS trust in Leeds has repaid almost £5 million after incorrectly claiming it provided safe care to mothers and babies under the Maternity Incentive Scheme, the NHS’s litigation unit said.

Leeds Teaching Hospitals NHS Trust received £4,887,084 from the scheme over two years after declaring it had met all 10 safety standards, including adequately listening to patients, maintaining staffing levels, and properly investigating deaths. A subsequent review by NHS Resolution found these claims were not borne out and ordered the full repayment of the award.

In June, a Care Quality Commission assessment rated the trust’s maternity services as inadequate, the lowest rating, warning that women and babies were exposed to significant risk. The CQC finding prompted NHS Resolution to require Leeds to re-examine its submissions to the Maternity Incentive Scheme. The review concluded that not all safety standards had been met, forcing the repayment.

The decision to claw back the money comes amid long-running concern among families about the quality of maternity care at the trust. Fiona Winser-Ramm, who lost her daughter Aliona in 2020, described the repayment as long overdue and said it underscored the need for an independent inquiry into the Leeds trust’s maternity services, an idea she said should be led by senior midwife Donna Ockenden. Winser-Ramm was one of several parents who met Health Secretary Wes Streeting last week to press for an inquiry. Streeting has so far declined to commission one, but families said they remained hopeful.

Across the country, families have repeatedly told the BBC that maternity care at the Leeds trust was inadequate, even as the trust highlighted improvements. The Maternity Incentive Scheme, launched in 2018 under former health secretary Jeremy Hunt, was designed to reward trusts that met a set of standards aimed at improving patient safety and experiences. Trusts that met all 10 standards could receive a rebate on insurance premiums and a share of funds from those that did not.

Nationally, the scheme has been dogged by questions about self-reporting. An NHS Resolution analysis published in July showed that 24 trusts had to repay premiums over the first four years of the scheme, with 18 of those trusts forced to repay more than once. Critics, including Winser-Ramm, have argued that the self-assessment process invites inaccuracies and call for independent oversight to ensure consistent reporting across the NHS.

After the repayment decision, Leeds Teaching Hospitals NHS Trust applied for and was allocated £2.1 million from a separate NHS Resolution fund intended to support maternity improvement. The trust’s chief medical officer, Magnus Harrison, said in a statement that the trust had identified non-compliance with the MIS scheme and would use the £2.1 million to support an action plan within its Maternity and Neonatal Improvement Programme. He did not provide a detailed explanation of how the misreporting occurred.

The money-for-improvement arrangement reflects a broader attempt to address persistent concerns about maternity safety and to accelerate improvements in services where failures have been identified. NHS Resolution notes that the aim of the improvement funding is to target resources toward safety and learning, staffing, and governance reforms, even as it seeks to recover sums that were paid in error.

Leeds’ experience echoes earlier cases in which trusts faced repayment after misreporting. In some instances, authorities found that maternity units had not fully met safety targets, prompting later corrective actions and intensified oversight. Analysts say the pattern highlights a tension between encouraging rapid improvements through incentive payments and ensuring robust verification of reported achievements.

The inquiry surrounding the Leeds trust’s maternity services has thus become part of a broader national conversation about how best to monitor safety standards in the NHS’s maternity care system. Families affected by alleged failings have pressed for independent scrutiny and accountability, while health officials have argued that additional funding and structured improvement programs are necessary to achieve lasting change.

In the immediate term, the Leeds trust said the repayment would not hinder its ongoing work to improve maternity and neonatal care. The trust’s leadership emphasized that the MIS repayment, while painful, is part of a process to ensure patients receive safe, high-quality care. The trust said its action plan would be supported by the new £2.1 million improvement funding and would focus on strengthening governance, updating clinical protocols, expanding staff training, and enhancing patient engagement.

The NHS and Parliament have yet to agree on a standardized approach to independent inquiries into maternity care at specific trusts, though several families and campaigners continue to call for a comprehensive review led by an independent figure such as Donna Ockenden. The case at Leeds has intensified that debate and raised questions about how best to safeguard patient safety while maintaining accountability and transparency across national health services.

In the meantime, NHS Resolution has warned that future misreporting of maternity safety standards will be subject to immediate review and repayment, reinforcing the idea that incentives cannot be detached from rigorous verification and public accountability. As Leeds and other trusts pursue improvement plans funded in part by the relief fund, the broader priority remains clear: ensure mothers and babies receive safe, consistent, and compassionate care across the NHS.