The review into maternity deaths at Leeds Teaching Hospitals tells staff to follow a duty of candour law that does not exist yet. The bill creating it is still in a Lords committee, and the terms of reference name no penalty for ignoring it.
Estimated reading time: 5 minutes
In short. The terms of reference for the independent review into maternity and neonatal services at Leeds Teaching Hospitals NHS Trust, published 28 September 2026, tell public officials to engage with the review "as though the duty of candour and assistance set out in clause 2(1) of the Public Office (Accountability) Bill... applies" [2]. Parliament's own record of that bill shows it in committee stage in the House of Lords [3], not law. Separately, the review lists "enable accountability" among its objectives [2], but its own methodology says the grading tool it will use "does not provide a standalone basis for determining clinical negligence" [2]. Two documented mistakes: four stars.
Leeds Teaching Hospitals NHS Trust describes itself as "one of the largest and busiest acute hospital trusts in Europe", with a budget above £2.1 billion, 20,000 staff and close to 1.8 million patients treated last year [4]. On 20 October 2025 the then Secretary of State for Health and Social Care announced an independent review into its maternity and neonatal services, citing one of the highest extended perinatal mortality rates in the country, families' own accounts, and an "inadequate" rating from the Care Quality Commission [2]. Donna Ockenden, who chaired the reviews into maternity failings at Shrewsbury and Telford and, more recently, Nottingham University Hospitals, was appointed chair on 10 March 2026 [2]. The terms of reference, published 28 September 2026, set out how that review will work [1].
A duty of candour that Parliament has not created
Under "Governance", the document states: "All current and former NHS staff, relevant NHS organisations and regulators are expected to co-operate with the review as is normal, professional practice, including supplying documentation, as and when requested by the review team. Public officials and public authorities are expected to engage with the review as though the duty of candour and assistance set out in clause 2(1) of the Public Office (Accountability) Bill as at the date of these terms of reference applies. Upon the enactment of the Public Office (Accountability) Bill and commencement of the relevant provisions, public officials and authorities will be expected to comply with the duty of candour and assistance as it applies to them by law" [2].
Parliament's own Bills API record for the Public Office (Accountability) Bill confirms it is a bill to "impose a duty on public authorities and public officials to act with candour, transparency and frankness... to make provision for the enforcement of that duty in their dealings with inquiries and investigations" [3], matching the clause the terms of reference lean on. The same record shows it is not law: "isAct":false, originated in the Commons, now sitting in the Lords at committee stage, with sittings scheduled for 12, 19 and 21 October 2026 [3]. Bills at Lords committee stage still face report stage, third reading, a return to the Commons to consider any Lords amendments, and Royal Assent before they take legal effect. The terms of reference ask officials to behave now as if that whole sequence has already happened.
What happens if an official declines is also in the document: "If the chair has any significant issues regarding non-co-operation that cannot be resolved, this will be escalated to the DHSC sponsor team" [2]. Not a sanction, not a referral to a regulator, an internal escalation to a sponsor team inside the same department that commissioned the review. Until the bill the terms of reference invoke actually passes, that escalation is the entire enforcement mechanism.
An accountability objective its own grading tool cannot carry
The document's stated objectives include, in full: "enable accountability and provide clear answers to families. This will be achieved by reviewing individual cases through a team of multidisciplinary clinicians and providing personalised feedback following publication of the report" [2].
The mechanism for that review of individual cases is a four-point grading scale, adapted from the Confidential Enquiry into Stillbirths and Deaths in Infancy, running from "0: Appropriate" through "3: Major concerns" [2]. Immediately beneath that scale, under "Methodology", the terms of reference say: "A grading of care score does not provide a standalone basis for determining clinical negligence. Families should be made aware of this point to avoid confusion" [2]. Accountability, if a family gets it, will have to come from a coronial inquest, a regulator or a civil claim running in parallel; the review says as much itself, noting those other processes "may draw different conclusions from those reached by the review team" [2]. What the review can promise, on its own terms, is a grade and a written explanation. What it cannot promise is a finding that sticks.
Credit where due
Set against those two gaps, the document is unusually candid about its own limits and unusually careful about the families it is built around. The opt-out methodology, applying automatically to every eligible case from 1 January 2015 with an opt-in window for the earlier 2011 to 2014 period, is designed to catch cases families might not think to bring forward themselves rather than relying only on those who complain [2]. DHSC has separately commissioned a trauma-informed psychological support service for the full duration of the review, including the closedown phase [2]. And DHSC deliberately kept Leeds out of the separate, larger National Maternity and Neonatal Investigation covering twelve other trusts, "due to the separate maternity inquiry announced by the Secretary of State" [5], rather than folding a trust already under its own dedicated review into a wider exercise it might have been lost inside. None of that is undermined by the two findings above; it just is not accountability, and the document should not use the word "shall" and cite a law before that law exists to suggest otherwise.
The claims, tested
| The claim | What the evidence shows | Verdict |
|---|---|---|
| "Public officials and public authorities are expected to engage with the review as though the duty of candour and assistance set out in clause 2(1) of the Public Office (Accountability) Bill... applies" (Governance) [2] | Parliament's Bills API: the bill is at committee stage in the House of Lords, "isAct":false, with further sittings scheduled into October 2026 [3] |
A duty described as though it already binds officials does not yet exist in law |
| Objectives: the review will "enable accountability and provide clear answers to families" (Objectives) [2] | The same document, Methodology: "A grading of care score does not provide a standalone basis for determining clinical negligence" [2] | The review's own tool cannot deliver the accountability its objectives promise |
Two documented mistakes. (1) The terms of reference ask public officials to engage with the review as though a legal duty of candour already applies to them, under the Public Office (Accountability) Bill; Parliament's own record shows that bill at committee stage in the House of Lords, not enacted, and the document names no consequence for non-cooperation beyond an internal escalation to a DHSC sponsor team. (2) The review lists "enable accountability" as an objective, but its own methodology states the grading tool it will use to assess individual cases "does not provide a standalone basis for determining clinical negligence." Rated four stars out of five.
Sources
- Independent review into maternity and neonatal services at Leeds Teaching Hospitals NHS Trust: terms of reference (GOV.UK publication page, Department of Health and Social Care, published 28 September 2026)
- Independent review into maternity and neonatal services at Leeds Teaching Hospitals NHS Trust: terms of reference (full HTML document)
- Public Office (Accountability) Bill, bill 4019 (Parliament Bills API; the human-readable bills.parliament.uk page returned a Cloudflare bot challenge on direct and browser-agent fetch, so this data endpoint is cited directly)
- About us (Leeds Teaching Hospitals NHS Trust)
- Independent maternity and neonatal investigation: terms of reference (GOV.UK, Department of Health and Social Care)