When basic practice Is overlooked, Maternal medicine is left in the dark

The findings of the Ockenden Report and the Independent National Maternity and Neonatal Investigation, led by Baroness Valerie Amos, have rightly focused national attention on culture, staffing, and governance failures across NHS maternity services.

Both reviews, drawing on hundreds of family testimonies and multiple NHS trusts, conclude that urgent reform is needed across the system.

But amid the scrutiny of leadership and listening, one overlooked variable deserves equal attention: the basic clinical accuracy of the tests maternity services rely on every single day.

Urine dipstick testing is among the most frequent diagnostic touchpoints in prenatal care, screening for infection, protein, and glucose at nearly every antenatal appointment. Yet specimen contamination during prenatal screening runs as high as 20–30% on average.

Contaminated samples produce unreliable dipstick and laboratory results, undermining the very diagnostic foundation maternity teams depend on to catch problems early — at the exact moment maternal and foetal risk is highest. This is not a peripheral inefficiency. It is a basic practice gap hiding in plain sight, one that compounds every other pressure documented in recent reviews: missed escalations, delayed recognition, and women not being heard.

A test result that clinicians cannot trust, is a test that cannot protect anyone. The fix doesn’t require new infrastructure or years of culture change, it requires GP-conceived innovation designed specifically to solve this problem. A device like Peezy Midstream, developed by an NHS GP, brings precision to specimen collection, reducing contamination, eliminating costly repeat lab tests (currently around £15 each), and cutting unnecessary patient recalls, which can be expensive and inconvenient for women taking them away from work, requiring additional childcare and more.

The benefits compound, starting with accuracy, hygiene, and dignity for every woman tested. Secondly, right-first-time midstream urine collection generates meaningful savings for the NHS. Forte Medical’s cost-benefit modelling, applied to the 4.2 million urine screens conducted annually across the UK, points to £11.5 million in direct annual retest savings, and £103.5 million in longer-term efficiency gains across the wider pathway — from patient to lab, and the single-use items in between. This model is available for scrutiny upon request.

As policymakers and maternity leaders respond to this year’s reviews with structural reform, it’s worth remembering that safety doesn’t begin with a committee. It begins with a basic urine dip, performed accurately, every time.

Get urine collection right, and everything that follows with diagnosis, treatment and trust have better chance of falling into place.

Watch our Peer to Peer film about why Midstream Matters.

Ockenden Review

National Neonatal and Maternity Review

Author’s note:
Latest Maternity evidence to be published in coming weeks shows Peezy Midstream reduces first-time urines being sent to the lab by 37% with a 20% reduction of retests.

More clinical evidence including two published Maternity outcomes from West Herts NHS Trust and the Royal Surrey NHS Foundation Trust can be downloaded here.