The Maternity (Perinatal) Incentive Scheme (MIS) is a financial incentive programme, established by NHS Resolution (NHSR) in 2017, which aims to enhance maternity and neonatal safety within NHS Trusts in England. In March 2026, NHSR published an evaluation of the first six years of the MIS, which found that the scheme has raised the profile of maternity and neonatal safety at Board level and that compliance has improved. However, understanding the impact of the scheme’s overall impact on maternity and neonatal safety remains a challenge, along with the risk of unintended consequences.

While some findings from the evaluation have been integrated into the MIS Year Eight core standards (April 2026 to March 2027), this will be a transitional year as NHSR responds to the evaluation findings as well as the findings of the National Maternity and Neonatal Investigation (due to be published in June 2026) and the subsequent work of the Taskforce.

This briefing will explore some of the key findings within the evaluation, whilst highlighting areas for further consideration by NHSR and the Taskforce, including:

• The purpose of the scheme, its theory of change, the effectiveness of each safety action and how they contribute to the scheme’s impact. Consider output, outcome and impact metrics which could make evaluation more feasible.
• How to ensure that Trust Boards focus on the safety of maternity and neonatal services by proactively seeking out and resolving issues rather than focusing on compliance and reputation management.
• What external assurance of MIS submissions and the use of reimbursements and discretionary payments is needed to build confidence in the scheme and reduce perverse incentives