A multi-professional team at Southmead Hospital in Bristol evaluated the effect of their local obstetric emergency training day. They compared maternal and neonatal outcomes in the four years before training and four years after the training had been introduced. It was found that the training not only improved knowledge & teamworking, but was also associated with significant improvements in outcomes:

  • 50% reduction in neonatal hypoxic brain injuries
  • 70% reduction in injuries after shoulder dystocia
  • Improvements in Category 1 emergency caesarean sections


As a result of the positive findings of the SaFE Study and also the associated outcome improvements at Southmead Hospital, the PROMPT (PRactical Obstetric Multi-Professional Training) Train-The-Trainers package was developed by a dedicated group of health care professionals based in maternity units in the South West of England, UK.  The package was designed to be used locally and to improve outcomes for mothers and their babies.

The PROMPT ‘Course in a box’ was published with the assistance of the Royal College of Obstetrics and Gynaecology (RCOG).   National recommendations for multi-professional obstetric emergencies training for all maternity staff in the UK, coupled with data demonstrating improved outcomes for mothers and their babies led to PROMPT being adopted by most units in the UK.


The 2nd edition of the PROMPT 'Course in a box' was published with continued Train The Trainers (T3) Courses being presented both in the UK and internationally.


The 3rd edition of the PROMPT 'Course in a box' was published with updated modules including the new and popular PROMPT CiPP (Care of the Critically Ill Pregnant Patient).


The PROMPT team have been successful in securing a grant from the Health Foundation to generate a deeper understanding of the potential of Social franchising and Licencing models for scaling effective health and social care interventions within the NHS.  PMF will be supported by Spring Impact, who have been recruited on behalf of the Health Foundation, to develop a replication model for scaling up PROMPT from its original site.


The PROMPT Partnership Programme (Pilot)

PMF currently uses a 'Train the Trainer’ (T3) model for the distribution of PROMPT across the UK, this requires multi-professional teams of staff from each unit to attend the T3 training and learn how to utilise the PROMPT training resources and set up local PROMPT training in their own units. They are provided with the PROMPT 'Course in a Box' which includes Course and Trainer’s Manuals and downloadable evidence-based multi-media materials and tools, with the aim of helping maternity units to implement effective training and make ‘the right way the easy way’.

As NHS Resolution has incentivised local multi-professional training of all maternity staff, there has been an increased demand for PROMPT training.  However, based on PMF's research, experience and also information that has been received via market research from many units that have implemented PROMPT locally, there appears to be significant variation in each unit’s success at setting up, and sustaining, their local training. This is a common problem when trying to introduce training interventions at scale, and as a consequence, the impact on improving outcomes and unit culture is not always observed. Some of the difficulties that units have identified are:

  • Delays in implementation of local training following T3 attendance
  • Lack of multi-professional engagement from all members of the team
  • Reduced authenticity of training
  • Problems with administration and team coordination
  • Difficulties with management ‘buy in’ and commitment to release staff to attend the training and to be faculty
  • Elements of PROMPT that go beyond training and encourage behaviour change are not enacted, such as multi-professional ward rounds; effective collection and use of data and role modelling by senior staff.

To address some of these implementation difficulties and support units to ensure the effective uptake of PROMPT to fulfil CNST training requirements, PMF has been developing an enhanced package of support; the ‘The PROMPT Partnership Programme’. In collaboration with the Health Foundation and supported by guidance from Spring Impact (a social franchise organisation), PMF have commenced a pilot project to introduce this enhanced training implementation support package and selected 5 maternity units to participate in this exciting new programme.