The midwife leading the biggest inquiry into maternity failures in the history of the NHS is charging NHS England up to £26,000 a month for her advice through her company, the Guardian can reveal.
Donna Ockenden, who has been chairing a review into maternity failings at Nottingham university hospitals NHS trust since 2022, is paid an £850 daily rate for every 7.5 hours she works.
When asked about her monthly invoices of up to £26,000 for her advice, she said: “I am working long hours.”
The monthly charges for “provision of independent advice” in connection with the review do not include the wider costs of the inquiry that are charged to NHS England (NHSE).
The monthly invoices from Donna Ockenden Ltd can exceed £300,000 a month when costs such as daily expenses, wages of the clinical review and administrative team, transcription, insurance, office space and HR services are added.
Much of those additional charges are invoiced at cost but Ockenden said there was a “profit element on the provision of clinical and administration services, but this is needed partly in order to meet various miscellaneous costs that do not come within the charges that are passed across to NHSE under the agreement”.
Ockenden was initially on the NHS England payroll and taxed at source but the arrangement was changed in January 2024.
Her daily fee also went up by £100 (13%), from £750 to £850, as part of a new supply agreement. For her advice alone, she subsequently invoiced £22,669.50 for March 2024, £20,626.67 for April, £22,329.50 for May, £20,034.60 for June and £26,069.50 for July.
Operating through a UK limited company can offer tax advantages through structuring income through a combination of salary and dividends to minimise tax and national insurance (NIC) costs.
Ockenden said: “The payment details you have are correct. I am working long hours on the review. I anticipate devoting the vast majority of my time to the review up to the point of publication in June 2026.
“The current contractual arrangement provides value to the taxpayer, and involves my running every aspect of the review including coordination of a large team of clinical reviewers.”
Of her tax arrangements, she added: “I was retained in a personal capacity by NHSE along with all those individuals working on the review because at its outset, the review was administered by NHSE. When responsibility for managing and delivering the review was contracted to DO Limited those arrangements naturally ceased.”
Ockenden’s daily fees exceed the UK’s weekly median wage of £766.60 and highlight the high costs of a series of reviews of maternity and neonatal services in NHS trusts undertaken in recent years.
In an interim report published in early December, Baroness Amos, who is conducting an investigation into NHS maternity services in England, noted that despite a significant number of independent investigations and reviews of maternity and neonatal services in NHS trusts since 2015, England was “still struggling to provide safe, reliable maternity and neonatal care everywhere in the country”.
Ockenden has been praised for her work, including a previous review in Shrewsbury and Telford.
In October she said she had the backing from affected families to take on a similar role investigating Leeds teaching hospitals NHS trust.
She said she would be willing to chair the inquiry in Leeds as well as a further maternity review at University Hospitals Sussex NHS trust, describing it as an “honour” to be considered.
Soon after, the health secretary, Wes Streeting, told Woman’s Hour on BBC Radio 4 that Ockenden would not be leading the Leeds review owing to her existing commitments.
“She won’t be leading the Leeds inquiry, not least because she’s leading the work in Nottingham, Shrewsbury and Telford,” he said. “If I could clone her, I would, but because Donna has earned the trust of the families she is working with, everyone wants Donna, I understand that and I have huge respect for her.
“But I’ve got to make sure to protect the work Donna is already doing but I’ve also got to build a wider team of people who can support the government, support the NHS when trouble arises.”
An NHS spokesperson said: “Following the then secretary of state’s appointment of the independent review’s chair in spring 2022, NHS England has worked to ensure the review meets its terms of reference for families, initiating a new contractual agreement in January 2024.
“Women and families deserve answers and improved maternity services in Nottingham, and the publication of the review’s final report no later than June 2026 will be a critical step to achieving this.”
