The Perinatal Culture and Leadership Programme (PCLP) aims to improve the quality of care by enabling leaders to drive change with a better understanding of the relationship between leadership, safety improvement and safety culture. The programme supports perinatal leadership teams to create and craft the conditions for a positive culture of safety and continuous improvement, enabling a more psychologically safe, collaborative, and supportive workplace.

Organisational culture and safety in perinatal services has been commented on in several national reports following high profile patient safety events and inquiries, so, in 2023/2024 all Trusts providing perinatal services were supported to sustainably develop leadership capacity, capability and improvement relating to safety culture in their units and as part of their local systems.

It is envisioned that supporting the on-going culture and leadership development will amplify the aims of the other Maternity and Neonatal workstreams currently delivered by the Patient Safety Commission, as well as the System Safety improvement programme.

The West of England Patient Safety Collaborative has been commissioned to provide on-going support to our local Trusts, to implement and further develop their improvement plans with a quality improvement (QI) lens, including offering and delivering QI coaching.

It is envisaged that this programme will support improved staff satisfaction/ experience for those working within the perinatal services which, in turn, will lead to improved outcomes for women/ birthing people and babies as a result of good perinatal safety culture.

Programme information:

The PCLP programme has three phases:

Phase 1 (complete for all Trusts): Team ‘Quad’ leadership development– this stage focused on the perinatal senior leadership team, responsible for supporting, role modelling and leading the cultural environment, usually consisting of Head or Director of Midwifery, Clinical Lead / Director for Obstetrics, Neonatal Clinical Lead / Director or Head of Neonatal Nursing and an operational representative. This phase enabled Quads to connect as a team with a renewed common purpose and give them the headspace needed to problem solve and plan for the future.

Phase 2 (complete for all Trusts): Optional SCORE culture survey to gain insight into teams’ safety culture ‘how it feels to work here’, to help the team identify strengths and opportunities and to understand the role that relationships have in supporting improvement. (SCORE = Safety Culture, Operational Risk, Reliability/burnout and Engagement)

Phase 3 (completes October 2024): Cultural conversations and planning for improvement – Quads supported by an independent culture coach to have conversations about the culture survey findings (from phase 2) with their teams. Quads and their change team will then be supported to co-develop an improvement plan based around a small number of identified key themes and linking with other work they are doing.

The phased work continues to be led by the Perinatal Culture and Leadership (PCLP) programme team at NHSE.

View the Perinatal Culture and Leadership programme driver diagram.

Project aims:

  • Improve the quality of care by enabling leaders to drive change with a better understanding of the relationship between leadership, safety improvement and safety culture.
  • Support perinatal leadership teams to create and craft the conditions for a positive culture of safety and continuous improvement, enabling a more psychologically safe, collaborative, and supportive workplace.

This will be achieved by supporting perinatal leadership teams to create and craft the conditions for a positive culture of safety and continuous improvement, have a positive impact on the experiences of women, families and babies and enable a more collaborative, supportive workplace.

Expected outcomes:

  • Improvement in safety and culture at Trust and system level as defined by local plans and system agreement.
  • Improved staff satisfaction / experience for those working in maternity and neonatal services.
  • Improved outcomes for women and babies as a result of good perinatal safety culture.

Case study

Great Western Hospitals NHS Foundation Trust provides maternity care to women in Swindon and surrounding rural areas, and approximately 4,000 babies are born here each year. The Trust is part of Bath and North East Somerset, Swindon and Wiltshire Local Maternity and Neonatal Service.

In October 2021, a staff survey raised concerns around organisational/ departmental culture. In February 2022, all Maternity staff were sent a confidential Culture of Care survey to provide more feedback – this was achieved via 104 responses to the survey and 36 staff attending focus groups. A Maternity staff forum, led by the Chief Nurse was held to discuss the findings and identify the next steps. View the Perinatal Culture case study.