In the East of England, the strategic health authority (SHA) sets up ten clinical pathway groups in early 2008 to design the clinical vision for all aspects of health care from the newborn period to the end of life. The purpose of the clinical pathway group was to develop the strategy and vision that was clinically led and evidence-based. The vision set out by the Maternity and Newborn Clinical Programme Board in the Towards the Best, Together report is to plan and deliver a maternity and newborn service for the East of England that will ensure the best outcome for mothers and babies. The key aim is to improve the quality of service, safety, outcomes and satisfaction for all women through offering informed choice around the types of care throughout pregnancy, birth and postnatally. The key challenge to date has been that of clinical engagement.