1. Access

All trusts highlighted the importance of improving women’s timely access to services to improve outcomes and quality of care and mentioned a number of barriers to achieving this.

Inconsistency in the quality, cost and availability of language and translation services is a significant barrier in maternity services. Trust leaders told us that they would welcome a standardised approach to translation and interpretation services. To this end, we are pleased to see the commitment to publish a framework for community language, translation and interpretation, which was recently announced in the ‘Patient safety healthcare inequalities reduction framework’ (NHS England, 2025).

Some trusts have integrated digital solutions to support patients that do not speak English as a first language, providing translation support during consultations and for written materials. Other trusts have identified the most common languages in their area and ensured written information and leaflets are available. It was noted that there are a range of approaches to tackling the inconsistencies in language and translation provision, so a greater national steer would be valuable.

Similar calls have been made by trust leaders in other forums – last year we collated feedback from trusts on provision of language and translation services, which highlighted a growing demand for services alongside insufficient availability and inconsistency in the quality of services available, having real impacts on patient care and outcomes.

The increasing reliance on digital booking systems and maternity care models that prioritise a digital-first approach can disadvantage those experiencing digital exclusion. This could include women from lower socio-economic backgrounds or those with limited access to technology or internet services (for example, one trust leader noted barriers here specifically for the Orthodox Jewish community). A trust leader from the mental health sector noted that the size of the geographical areas covered by perinatal mental health services can also act as a barrier to access, as they cover large areas and can mean a lot of travel for patients or require patients to be able to access services via video-calls. One trust has provided women with sim cards and handsets to enable digital access to care, enabling access to antenatal resources, appointment reminders and educational support.

Trust leaders reported that women from disadvantaged socio-economic backgrounds and ethnic minority groups are more likely to have their first contact with maternity care later in their pregnancies, meaning may not receive crucial advice and support that could improve their outcomes and prevent issues from escalating into more severe problems.

A number of trusts have implemented proactive outreach services to target communities that are less likely to access services via traditional routes – for example, one trust is providing community-based care for Gypsy, Roma and Traveller communities. Another trust has developed a mobile app providing antenatal information, which is available in eight languages spoken locally and provides maternal health information, overcoming traditional access barriers. Initial evidence has found that the app has led to a 70% increase in engagement from black and Asian women in attending antenatal classes.

Call to action: Provide national guidance and a framework for language and translation services in maternity services, including recognition of the specific need for out-of-hours provision. Ensure clinicians are trained appropriately to effectively utilise language and translation services.

Call to action: Target funding towards areas with higher rates of inequalities in access (such as digital inclusion and proactive outreach measures).