The senior midwife leading the largest ever investigation into NHS maternity failures is charging the health service up to £26,000 a month for her advisory services, the Guardian can reveal.
Donna Ockenden, who chairs the independent review into maternity services at Nottingham University Hospitals NHS Trust, receives a daily rate of £850 for every 7.5 hours worked. This arrangement is conducted through her limited company, Donna Ockenden Ltd.
Breaking Down the Review's Costs
When questioned about monthly invoices reaching £26,000 for her advice alone, Ockenden stated she is "working long hours" on the review. She anticipates dedicating the vast majority of her time to the inquiry until its publication in June 2026.
The monthly charges for "provision of independent advice" are separate from the wider costs of the inquiry billed to NHS England. When expenses, clinical and administrative team wages, transcription, insurance, and other operational costs are included, the total monthly invoices from her company can surpass £300,000.
Ockenden explained that a profit element is applied to clinical and administration services to cover miscellaneous costs not included in the NHS England agreement.
Contractual Changes and Tax Arrangements
Initially, Ockenden was on the NHS England payroll, taxed at source. This changed in January 2024 with a new supply agreement, which also saw her daily fee increase by £100 (13%) from £750 to £850.
Subsequent invoices for her advisory services show significant monthly sums: £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 via a limited company can offer tax advantages by structuring income through salary and dividends. Ockenden clarified that her personal capacity retainer with NHS England ended when management of the review was contracted to her company.
High Costs Amid Ongoing Maternity Challenges
Ockenden's daily fee exceeds the UK's weekly median wage of £766.60, highlighting the substantial expense of recent maternity service reviews across the NHS.
This comes as Baroness Amos, investigating NHS maternity services in England, noted in a recent interim report that despite numerous independent reviews since 2015, the country still struggles to provide safe, reliable maternity and neonatal care everywhere.
While Ockenden has been praised for her previous work in Shrewsbury and Telford, Health Secretary Wes Streeting confirmed she would not lead a separate inquiry into Leeds Teaching Hospitals NHS Trust due to her existing commitments in Nottingham, Shrewsbury, and Telford.
An NHS England spokesperson stated the new contractual agreement, initiated in January 2024, ensures the review meets its terms of reference for families. They emphasised that women and families in Nottingham deserve answers, with the final report due by June 2026 being a critical step towards improved maternity services.
