Referrals to the Maternity and Neonatal Independent Senior Advocate closed on 17th October 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. We are grateful to the families, colleagues, and partners across Gloucestershire who contributed to this important work.

Following consideration by the National Maternity & Neonatal Programme Board, it has been agreed that the pilot will conclude on 31 March 2026. New referrals will no longer be accepted after the 17th October 2025. Families who have been referred before this time will continue receiving support the end of the pilot, with plans in place for ongoing guidance and points of contact where needed.

The MNISA Pilot has been vital in highlighting what families need when they have experienced adverse outcomes. This will continue to inform future developments and system change locally and help ensure that families feel safer and more supported during their maternity and neonatal experience.

Find more about the evaluation, access the full report or read the one page summary here.

Accessing support

Whilst the MNISA pilot is coming to an end there is still support available.

Patient Advice and Liaison Services (PALS)

The PALS provides help, information and non-medical advice about your care and treatment. It can help you with queries, resolve concerns or make a formal complaint.

Maternity and Neonatal Voices Partnership (MNVP)

The role of the MNVP is to listen to the experiences of women and families and bring together service users and staff to plan, review and improve maternity and neonatal care.

Visit the Gloucestershire MNVP website

Perinatal Mental Health Support

A list of local and national support options for your mental wellbeing during pregnancy or after birth.

NHS Complaints Advocacy

POhWER provide NHS complaints advocacy in Gloucestershire. If you need help to make a complaint or want to find out more about your options you can access this free, independent and confidential service.
Visit www.pohwer.net/nhs-complaints-advocacy

On this page...

Maternity and Neonatal Independent Senior Advocates help make sure the voices of women and families are listened to, heard and acted upon by their maternity and neonatal care providers when they have experienced an adverse outcome during their maternity and/or neonatal care.

  • Your baby died before they were born, after 24 weeks of your pregnancy.
  • Your baby died within 28 days of birth.
  • Your 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.

You do not need to be sure 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 you as part of their role, they will signpost you to other support services available.

It is up to you if you wish to use an advocate. If at any time you don’t want their service you can tell them, and don’t need to give a reason why.

If during your maternity or neonatal care in Gloucestershire you experienced an adverse outcome, whether recently or some time ago, you can go to a Maternity and Neonatal Independent Senior Advocate for help.

The role has been created because important reports tell us that families who have had these experiences have not always felt listened to, and care didn’t always get better.

If you have experienced an adverse outcome, your advocate can:

  • support you through the maternity and neonatal healthcare system to help you understand what happened in your care
  • support you through investigation and complaints processes
  • help and support you and your family to be listened to and heard by your maternity and neonatal care providers

A Maternity and Neonatal Independent Senior Advocate is independent from the trust that provided your care. They work for the local NHS Integrated Care Board which is in charge of healthcare in your area.

Everything you say to your Maternity and Neonatal Independent Senior Advocate is confidential unless you ask or agree with them to share it with others. The only exception to this is if they are worried about your safety, or the safety of others, but they would talk to you about this first.

Why was the pilot created?

The Maternity and Neonatal Independent Senior Advocates role is a new role being piloted to support women, birthing people and families in England. The plan to introduce advocates was put in place because of reports such as the Ockenden review. These reports show that those who had distressing experiences in their maternity and/or neonatal care in the past have not always been listened to.

The role was developed by NHS England working alongside people who have experienced adverse outcomes and NHS staff.

What happens at the end of the pilot?

At the end of the pilot, if your case is still ongoing a follow up support plan will be discussed with you.