A report into the largest maternity scandal in NHS history will expose serious and wide-ranging failures in care at two Nottingham hospitals, including racist treatment of patients, when it is published on Wednesday. The findings from Donna Ockenden's inquiry into services at Queen's Medical Centre and Nottingham City Hospital are expected to be, in the words of one senior source familiar with the conclusions, "horrendous".

Ockenden, a senior midwife with extensive experience in maternity safety, began her inquiry in May 2022 and has spent more than four years examining approximately 2,505 cases involving maternal and infant deaths, stillbirths and serious injuries at Nottingham University Hospitals NHS Trust between April 2012 and May 2025. The report will run to more than 350 pages and draws on evidence from around 850 current and former members of staff, making it the most extensive maternity review the NHS has faced.

Regulatory and potential criminal proceedings are running in parallel. The Nursing and Midwifery Council is investigating 96 midwives and nurses at the trust for alleged misconduct, of whom 15 are under full investigation. One midwife has been suspended under an interim order while fitness to practise proceedings continue. Nottinghamshire Police are separately considering whether to charge the trust with corporate manslaughter. The force's Operation Perth has been examining care provided to at least 200 families.

The Nottingham Maternity Families Group, which represents those affected, has called for Ockenden's recommendations to be adopted without exception. In a statement, the group said the findings must be "implemented in full", warning that anything less would constitute a betrayal of the families whose suffering prompted the review. It is also pressing the government to commission a statutory public inquiry into maternity and neonatal services across England, on the basis that the failures uncovered in Nottingham are not unique to the trust.

James Murray, the Health Secretary, met affected families in Nottingham last Thursday and has stated that the recommendations produced by the inquiry will not be left unimplemented. His comments follow a pattern of previous inquiries whose findings were not acted upon. Michelle Welsh, the Labour MP for Sherwood Forest and the government's newly appointed maternity adviser, told a Medical Journalists Association conference last week that she is in discussions with the Department of Health and Social Care about establishing a full statutory public inquiry into maternity care nationally. She noted that Ockenden's non-statutory process had been hampered by its inability to compel senior figures to give evidence, with some individuals in senior NHS positions choosing not to engage at all. Welsh, who gave birth at Nottingham City Hospital in 2020, described being approached by a senior obstetrician at the trust who sought to persuade her that no problem existed, despite a continuing flow of families and staff coming forward.

Ockenden is understood to have concluded that the trust's maternity culture has shown signs of improvement in 2026, though the Care Quality Commission, following an inspection in May 2025, continued to rate maternity services at both hospitals as requiring improvement. Anthony May, the trust's chief executive since 2022, has pointed to better staff recruitment and retention as evidence of progress and has apologised to families harmed under the trust's care.

A separate government-commissioned inquiry into maternity services across England, led by Lady Amos, is due to report the following week. Together, the two reports are expected to place substantial pressure on ministers to commit to structural reform of maternity care, with families and their representatives having made clear they will not accept further delay.