Maternity care in the NHS is facing a decisive moment, with growing evidence that repeated inquiries are no longer driving safer outcomes. In this blog, Dr Richard Dune reflects on Donna Ockenden’s warning that the system already knows what is going wrong and must now focus on action rather than further investigation. Drawing on lessons from Shrewsbury, Nottingham and Leeds, he examines how workforce shortages, gaps in training, weak leadership and cultural failures continue to undermine safety. The article explores why implementation, accountability and competence assurance must now take priority if maternity services are to deliver meaningful, lasting improvement for mothers and babies.

CQC ratings reveal the deeper systems that shape safety, culture and patient experience. In this blog, Dr Richard Dune examines why hospitals fall into an inadequate rating, what the CQC looks for when judging leadership and safety, and how services like Hull Royal Infirmary’s emergency department have begun turning fragile progress into meaningful improvement. He explores the structural issues that drive failure, from weak governance and unsafe staffing to poor IPC and medicines management, and shows how leadership, culture change and quality improvement can transform care. This analysis outlines what health and care leaders must prioritise to rebuild trust, strengthen compliance and move confidently from inadequate to good.