The future of maternity and neonatal services at the Countess of Chester Hospital, where Lucy Letby murdered seven babies, is facing fresh uncertainty as NHS bosses consider major changes that could see some units permanently closed.
NHS Alliance warning on smaller units
The NHS Alliance, an independent body representing health managers, has warned that maternity units delivering 1,500 to 2,000 babies each year might need to close to protect patient safety. The organisation added that up to 20 of 155 consultant-led maternity units in the country face closure.
The NHS Alliance stated that it is "calling for a thorough appraisal of where maternity services should be located, with a recognition that some smaller units, typically those delivering between 1500-2000 babies a year, might need to close."
It added: "The viability of smaller units is not only a question of birth numbers or midwifery staffing. It also depends on maintaining sufficient consultant obstetric, anaesthetic and neonatal capacity, including the availability of specialist staff and sustainable on-call rotas, alongside wider hospital support services."
Declining birth rates at Countess of Chester
The Countess of Chester was among 24 maternity units in England recording fewer than 2,000 births during 2025-26. It has recorded a significant fall in the number of babies born there in recent years, with figures showing births have dropped by almost a quarter compared with the year before Letby was charged.
The Countess of Chester Hospital's number of births has fallen at three times the rate for the north-west of England over the same period, The Telegraph reports. Falling birth rates across the region have reportedly prompted NHS leaders to consider merging maternity and neonatal services, as several units are dropping below safe levels of activity.
According to The Telegraph, 1,842 babies were born at the Countess of Chester hospital in 2025-26 compared with 2,384 in 2019-20, the year before Letby was charged. The Countess of Chester Hospital is also the lowest-performing of the 12 local neonatal units (LNUs) in the North West against national minimum activity standards.
NHS response and ongoing review
A spokesperson for NHS Cheshire and Merseyside told the newspaper: "Our priority is to make sure women, babies and families across Cheshire and the wider North West have access to the safest, highest quality and most sustainable maternity and neonatal services, now and in the future."
They added: "The review of neonatal and maternity services across the region is ongoing. It is considering how these services can best meet the needs of women, babies and families, informed by clinical standards, workforce sustainability, quality and safety considerations and future demand."
"No decisions have been made, and it would not be appropriate to speculate on possible outcomes while that work continues. Any proposals would be developed with clinicians, and would involve patients, staff and the public before any changes were made."
The director of the NHS Alliance's acute and ambulance network, Matthew Hopkins, said last month that "difficult decisions lie ahead, consolidating maternity services to support safer, more sustainable care."
He added: "It is time now to take a step back and consider how we should best organise maternity services across England, and where those services should be located. It is vital that the forthcoming maternity and neo-natal action plan looks beyond tokenistic measures to address these key strategic concerns."
