NHS Alliance warns up to 20 maternity units in England may need to close

The NHS Alliance has warned that up to 20 of England’s 155 consultant-led maternity units may need to close or change role because of staffing and safety pressures. Its acute care director, Matthew Hopkins, made the assessment on Monday, 19 October; no national closure programme has been announced.

Hopkins told the Guardian that concentrating childbirth services in fewer hospitals was “inevitable” and the “right thing” for safe care, although he expected a political backlash. His warning raises a difficult question for families who rely on nearby maternity services, particularly in rural and coastal areas where the NHS Alliance says staffing is challenging.

Why smaller maternity units are under pressure

Rising demand for caesarean sections adds to those pressures. The Guardian reported that caesareans accounted for 33% of births in England in 2020 and 45% last year. It said the latest MBRRACE-UK report found that, among women who died during childbirth in 2022–24, some had caesareans delayed or postponed because an obstetric surgeon or operating theatre was unavailable.

Local access and the government response

Hannah Leonard, chief policy officer at the Royal College of Midwives, told the Guardian that women and families rely on local units and called for high-quality services close to home. Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, said other solutions to workforce shortages should be explored before units close.

The NHS Alliance wants the government’s maternity taskforce to address where services should be provided and the pressures behind current safety concerns. The Department of Health and Social Care told the BBC that every woman deserves safe maternity care and said the taskforce would deliver reforms to meet the needs of women and families. The Guardian reported that the taskforce is due to publish its findings before Christmas.

North Devon District Hospital in Barnstaple shows how staffing problems are already affecting access. Its standard birthing services were suspended in August; the trust called that the only safe course because of staffing shortages. The BBC reported that the service remained suspended and that the trust expected a readiness assessment later in October. That local suspension is separate from the NHS Alliance’s warning about possible changes elsewhere.