Who is ultimately responsible and accountable for patient safety in maternity services?

This article is written in the aftermath of yet another tragic patient safety story where, in 2017,

failings in health care at a United Kingdom (UK) maternity unit resulted in a newborn baby boy

tragically sustaining brain damage (Ulke 2020). The senior midwife on duty was taken to a hearing

at the Nursing and Midwifery Council (NMC) and held accountable for her failure to question poor

decision making by the registrar on duty. What happened is very likely a recurring nightmare for

any midwife who has experienced registration within the UK. Sadly our health care system is not

designed to allow staff to do the right thing, and each of the recent investigations into poor health

care provision within maternity services in the UK has been instigated by the general public, and in

particular by local families, rather than by any protective public body, which speaks volumes about

transparency and candour within the National Health Service (NHS) (Kirkup 2015, Weaver 2019).