Not all training is equal or effective

The reduction of preventable harm for mothers and their babies is core to our activities and our education, training and research are the means through which we endeavour to provide this public benefit both in the UK and internationally.

Whereas many published training interventions have not led to an improvement in clinical outcomes, in Bristol the introduction of PROMPT has led to:

In Kansas in the USA the introduction of PROMPT has led to:

In Victoria in Australia the introduction of PROMPT has led to:

PROMPT Training has transformed the way healthcare professionals are trained worldwide, improving the implementation of best practice and outcomes for mothers and babies. In 2015, a major review of the NHS maternity services was undertaken by Baroness Julia Cumberledge and a panel of experts and representative bodies. The scope of the review was to asses current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.

PMF and North Bristol NHS Trust were delighted to be commended in the NHS Maternity Review, Better Births as a framework for learning.

PROMPT training in maternity units is having a significant impact, not only in the UK, but internationally.  Published evidence from Kansas (US) and Victoria (AUS) demonstrates similar improvements to the UK. PROMPT Training benefits staff groups and hospital departments as well as individuals, their families and society in general.

Maternal outcomes

PROMPT training aims to eliminate preventable harm in childbirth. Thankfully, in high income countries, maternal outcomes following childbirth have improved to the extent that maternal death and life-threatening maternal illness are now rare. However, preventable harm still complicates half the cases that have poor maternal outcomes.

Maternal mortality in low and middle-income countries remains a significant problem. The introduction of PROMPT training in these settings has resulted in improved maternal survival:

Financial impact

Unsafe maternity care leads to a huge drain on financial resources; litigation costs were £700 per birth in the UK in 2012 (NHSLA 2012). This results in less money being available to provide care for women and their babies. The PROMPT programme has improved clinical outcomes in other units across the world, as well as the UK; these impacts have been associated with published reductions in litigation costs in the US, Australia and the UK;  the benefits to individuals and families not withstanding.

The introduction of PROMPT has led to:

PMF have also started to explore the value proposition of PROMPT, and training for intrapartum  emergencies more generally, using the improvements in brachial plexus injury (BPI) as a vehicle for investigation. In particular we aim to measure the impact of BPI on utilities and then Quality of Life Years for both individuals with BPI, and also their carers.  This will permit us to express the value and/or benefit of training in the same way that the National Institute of Care Excellence (NICE) uses for the benefits of other treatments.

This is part of an ambition for the PROMPT team to inform policy, as well as practice, to improve outcomes as widely as possible.