The Maternity and Neonatal Independent Senior Advocate (also referred to as Maternity and Neonatal ISA or MNISA) roles were new senior positions being piloted to support women, birthing people, and families in England.

MNISAs helped ensure the voices of women, birthing people and families were listened to and acted upon by their maternity and neonatal care providers when they experienced an adverse outcome during their maternity and/or neonatal care.

Current position and the future

In light of the Secretary of State for Health and Social Care’s announcement of an independent investigation into maternity and neonatal care and appointment of a new taskforce, the future roll out of MNISA roles will be decided alongside the development of a national strategy. The pilot phase will therefore close on 31 March 2026, with no further cases taken on from Autumn 2025.

The National Institute for Health and Care Research (NIHR) has published the evaluation of the Maternity and Neonatal Independent Senior Advocate (MNISA) Pilot. The evaluation findings indicate that the MNISA service is uniquely placed to make a valuable contribution to enabling families’ voices to be heard, and their concerns acted upon. Appreciation is extended to the families, colleagues, and partners across the South West who contributed to this important work.

To read the full evaluation or a one page summary click here Mixed-methods evaluation of the Maternity and Neonatal Independent Senior Advocate (MNISA) pilot in England | Nuffield Trust

What do we mean by an adverse outcome?

• A baby died before they were born, after 24 weeks of pregnancy.

• A baby died within 28 days of birth.

• A baby was diagnosed with a brain injury, or this was suspected.

• The baby’s mother or birthing parent has died.

• The baby’s mother or birthing parent had an unexpected or unplanned removal of their womb, within 6 weeks of giving birth.

• The baby’s mother or birthing parent had an unexpected admission to the critical or intensive care unit.

It does not need to be clear if there were mistakes or negligence in the mother’s, birthing person’s or baby’s care to ask for support. If the advocate is not best placed to support as part of their role, they will signpost to other support services available.

How can a Maternity and Neonatal Independent Senior Advocate help?

Maternity and Neonatal Independent Senior Advocates can support women, birthing people, and families by providing support, helping them understand the maternity and neonatal healthcare system, attending follow up meetings where concerns about their care are being discussed, and supporting them through investigation and complaints processes. There are no time limitations, so it does not matter whether they received care recently, or some time ago.

This senior role was co-produced by NHS England working alongside maternity and neonatal service users and staff.

How can people contact a Maternity and Neonatal Independent Senior Advocate?

There are four areas in the South West taking part in the pilot Gloucestershire, Bath and North East Somerset, Swindon and Wiltshire, Somerset and Devon. Service users can contact the Maternity and Neonatal Independent Senior Advocate by calling, emailing, writing to them, or filling out a referral form on their local webpage.

Wherever possible professionals should support families by offering to make a referral on their behalf. This means a member of staff from a hospital, primary care, mental health or any other service can or make a referral, with their consent. A patient information leaflet should be made available to the patient or family to give them further information about the service, this information is also available on the website.