The midwife leading the largest investigation into maternity failure in the history of the NHS is being paid up to £26,000 a month from the NHS in England for her advice through her company, The Guardian has revealed.
Donna Ockenden, who has been leading the review into maternity failings at Nottingham University Hospitals NHS Trust since 2022, earns a daily wage of £850 for every 7.5 hours she works.
When asked about her monthly bills of up to £26,000 for her advice, she said: “I work long hours.”
The monthly fee for “providing independent advice” in relation to the review does not include the wider costs of the inquiry charged to NHS England (NHSE).
Monthly bills from Donna Ockenden Ltd can exceed £300,000 per month when costs such as daily expenses, clinical review wages, administrative team, transcription, insurance, office space and HR services are added.
Many of these additional fees are billed at cost, but Ockenden said there is “an element of profit in the provision of clinical and administrative services, but this is partly necessary in order to meet the various miscellaneous costs that are not within the fees that are passed on to the NHS under the agreement”.
Ockenden was initially on the NHS England payroll and taxed at source but the arrangement was changed in January 2024.
Its daily fees have also risen by £100 (13%), from £750 to £850, as part of the new supply agreement. For her advice alone, she then issued an invoice of £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.
Working through a UK limited company can provide tax advantages by structuring income through a combination of salaries and profits to reduce tax and National Insurance (NIC) costs.
“The payment details you have are correct. I am working long hours on the review. I expect to devote the vast majority of my time to the review until publication time in June 2026,” Ockenden said.
“The current contractual arrangement provides value to taxpayers and includes management of every aspect of the review including coordination with a large team of clinical reviewers.”
Regarding her tax arrangements, she added: “I was appointed in my personal capacity by NHSE along with all the individuals working on the audit because initially, the audit was managed by NHSE. When responsibility for managing and delivering the audit was contracted out to DO Limited, these arrangements naturally ceased.”
Ockenden’s daily fees exceed the UK average weekly wage of £766.60, and highlights the high costs of a series of reviews of maternity and neonatal services in NHS trusts carried out 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 large number of independent investigations and reviews of maternity and neonatal services in NHS trusts since 2015, England “is still struggling to provide safe and reliable maternity and neonatal care everywhere in the country”.
Ockenden has been praised for her work, including previously reviewing in Shrewsbury and Telford.
She said in October that she had received support from affected families to play a similar role in the investigation into Leeds Teaching Hospitals NHS Trust.
She said she would be willing to chair the investigation in Leeds as well as another maternity review into Sussex University Hospitals NHS Trust, and described it as an “honour” to be taken into consideration.
Shortly after, Health Secretary Wes Streeting told BBC Radio 4’s Woman’s Hour program that Ockenden would not lead the Leeds review due to her existing commitments.
He said: “She will not be leading the Leeds investigation, not least because she is leading the work in Nottingham, Shrewsbury and Telford.” “If I could clone her, I would, but because Donna has gained the trust of the families she works with, everyone wants Donna, and I understand that and have great respect for her.
“But I have to make sure that the work that Donna is already doing is protected, but I also have to build a wider team of people who can support the government, and support the NHS when a problem arises.”
An NHS spokesperson said: “Following the then Secretary of State’s appointment of the head of the independent review in the spring of 2022, NHS England worked to ensure that the review met its terms of reference for families, and commenced a new contractual agreement in January 2024.”
“Women and families deserve answers and improved maternity services in Nottingham, and publishing the final report of the review no later than June 2026 will be a crucial step to achieving this.”