Empowering staff in changing times
Guest blog by Leah Hazard
Empowering staff in changing times: integrating national reports into clinical practice
Guest blog by Leah Hazard | September 2026
Leah Hazard is a midwife and a Sunday Times bestselling author. Leah is a trustee for Amma Birth Companions and a frequent media commentator on women’s health and maternity care. Most recently, she led a campaign for safer midwives’ working hours, delivering a petition to Downing Street and meeting with former Health Secretary Wes Streeting. Her next book, Birth Wars: Delivering Safe Maternity in a Changing World, will be published in January 2027.
We look forward to welcoming Leah to the 2026 Baby Friendly Annual Conference (Virtual), taking place online 18-19 November, where she will examine how maternity and infant feeding teams can apply national safety recommendations in practice by listening to women and families, working effectively together, and escalating concerns safely.
What would you do if someone handed you the recipe for a cake with over 700 ingredients? Would you bake it, or would you give up before you’d even begun, when faced with the sheer complexity of the task?
What if someone told you that this would be the most delicious cake in the world – a cake that would truly change the lives of the people lucky enough to try a slice? You might think twice. You might attempt a version of the cake with a fraction of the suggested ingredients, but this souffle would be almost guaranteed to be a soufflop. Maybe the batter wouldn’t rise, the crumb would be too dense or too light, the flavour would be seriously sub-par, and as for those life-changing effects? Null and void.
This is exactly what’s happened to maternity services in the UK. Investigations and inquiries over the last decade have yielded over 700 individual recommendations, from Bill Kirkup’s Morecambe Bay report to England’s recent National Maternity and Neonatal Investigation.
If we accept that many of those recommendations are similar or identical, then let’s make the sweeping guesstimate that there are, say, 300 core concepts. Still, faced with limited money, time and energy, would you bake a cake with 300 ingredients?
You can see where this is going. The NHS’s general response to all these recommendations has been scant and scattershot, with the result that maternity services remain underbaked and overstretched.
It’s easy to see why, on a systemic level, the complex ‘cake’ of maternity has been tricky to master, and change has been slow to come. Successive governments have demonstrated a lack of will and become complacent about a shortfall of funds. Maternity care remains the ‘poor relation’ of the healthcare system, deemed a niche women’s issue that will sort itself out somehow over time. No sooner are promises made than the revolving door of government swings round again, and a new minister, adviser or commissioner is charged with reinventing the recipe.
It’s easy to see, too, why individual practitioners might feel overwhelmed, frustrated and demoralised. We are on the shop floor; we see the system’s strengths and flaws every day, and we carry the burden of service users’ hopes and expectations. Governments come and go, reports become yesterday’s chip paper, and still, there are women and birthing people who need our help, babies that need to be fed, and families who deserve equitable, safe, compassionate support. It’s all well and good for politicians and executives to nod sagely and issue yet another list of recommendations, but how can we possibly translate them into real, tangible action on every shift?
Perhaps what we need to do is identify some of the most urgent, common messages that keep coming through, report after report, and distil them into ‘ingredients’ of a realistically bake-able cake. You already have so much to think about every time you put on your uniform and head into work, and you can’t be solely responsible for the problems of an entire system, but you can prioritise a few manageable themes in your day-to-day work.
When I speak at UNICEF UK’s Baby Friendly Initiative conference in November, I’ll be focusing on how we can bring these concepts to the forefront of our practice:
- listening to women and families
- providing equitable, inclusive care
- effective teamwork
- safe escalation of concerns
You’re already doing these things, I know. But there are always new ways of reframing the conversations we have with families, making sure the right messages get through, re-examining our own biases and beliefs, and using our professional autonomy to raise concerns when things aren’t right.
You can’t possibly hold 700 ideas in your head while you head out on community visits, support a new mother with positioning and attachment, or talk to a concerned relative about a baby’s weight loss, but you can keep a few new tips and tricks in your professional toolbox as you go about your day. Delicious, life-changing and definitely do-able.