The Independent Maternity Review, chaired by Donna Ockenden, has published its independent report reviewing maternity services at the Nottingham University Hospitals NHS Trust. The report covers care provided in 2,026 clinical cases from 2012–25 involving nearly 2,500 families. It identifies systemic failures in governance, leadership and culture, with suboptimal care found in 21% of maternity cases reviewed. The report outlines system-wide learnings and local actions for learning that staff at the trust must undertake. It issues 18 immediate and essential actions for England's maternity services across eight areas including staffing, governance, incident investigation and post-death care, with Martha's Rule as the overarching escalation principle.