The Core Study - Exploring the implementation of maternity and neonatal multi-professional training in England

Plain English summary of protocol

Background and study aims
This project seeks to evaluate an NHS England initiative to improve the organisation and delivery of staff training in maternity and neonatal services. There is widespread concern about the quality and safety of maternity and neonatal services in England. There are worrying inequalities in outcomes. Reports repeatedly indicate the crucial role of skilful and knowledgeable staff, working well together. Yet it is known that training is not always prioritised within busy maternity and neonatal services and that there is variability in such training. To address this, NHS England launched a ‘Core Competency Framework’ (December 2020) to support the organisation of effective training for all maternity and neonatal staff. The Framework includes suggested training modules. The second version of the Framework (December 2023) built on this, with a training needs analysis tool that calculates the number of days of training each staff group should receive and a ‘how to’ guide. It also highlighted key ‘best practice’ principles: service user involvement; learning from local feedback/incidents/good practice; multidisciplinary team learning; and shared learning across Local Maternity and Neonatal Systems. The Framework is intended to drive improvement in maternity and neonatal care, but its impact is currently not known. Although some basic measures are now monitored (e.g. number of staff attending training), there is no built-in evaluation. This means there is no national-level insight into how the Framework is delivered, and its impact on organisational, team and individual skills and knowledge. Nor its impact on the quality of care and outcomes, particularly for those most at risk of poor outcomes. This project aims to fill that gap by exploring the implementation, operation and impact of the Framework. There is widespread support for this study amongst service user representatives. An advisory group, local service user panels and local and national Forums built into our evaluation design will create spaces in which service user questions and concerns can be heard. Stakeholder perspectives will be gathered through three linked pieces of work (Work Packages (WP)).

Who can participate?
The study will invite staff from across all 121 maternity and neonatal units in England, who take a lead on the CCF in their NHS Trust to complete an online survey about the way the CCF is implemented in their organisation. Part of this study will be based in six NHS Trusts across England that will remain anonymous. Maternity or neonatal staff, and service users representatives, who are responsible for the planning or delivery of the CCF, from the NHS Trusts, will participate in interviews, observations, and a meeting to learn about, and feedback on, their local data. Service users who gave birth at each of the six NHS Trusts to take part in small group discussions or interviews will also be invited.

What does the study involve?
A national survey will be conducted to gather views about the Framework's implementation across England’s maternity and neonatal units. The study will undertake ethnographic research to explore in detail implementation at six selected sites; this will also include local service user focus groups drawn from groups most at risk of poor outcomes. Joint interpretive forums will be held at the local and national level, which will help to make sense of the data and feed into the development of a logic model and implementation toolkit for NHS England, to support the next version of the CCF (December 2026). A short animation will be created offering service user perspectives on maternity and neonatal staff training, to increase NHS engagement with this initiative. The project team has worked with NHS England, and their service user group, on the study design; NHS England supports our planned evaluation. Findings and an implementation toolkit will be shared at regional and national conferences and publish at least two high-impact academic papers.

What are the possible benefits and risks of participating?
There are no direct benefits to those participating, but it is hoped their input will help improve multi-professional maternity and neonatal training in future. Reflecting on issues relating to maternity and neonatal care can sometimes prove challenging for women and members of staff alike. In group discussions or interviews, the team researchers, who are experienced in handling conversations of a sensitive nature, will ensure that participants have opportunities to pause, stop, re-schedule, or withdraw from the group discussion or interview. Systems are in place to ensure participants receive confidential support.

Where is the study run from?
The study is run by researchers based at King's College London and will be conducted across six NHS Trusts in England.

When is the study starting and how long is it expected to run for?
The study started in September 2024 and will run until June 2026

Who is funding the main study?
The study is a Health and Social Care Delivery Research Programme funded by the National Institute for Health and Care Research.

Who is the main contact?
Dr Rebecca Whybrow, rebecca.whybrow@kcl.ac.uk

Study website

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• England
• United Kingdom

Study participating centre

Sponsor information

King's College London
University/education

Room 8.11, 8th Floor Melbourne House, 44-46 Aldwych
London
WC2B 4LL
England
United Kingdom

Phone	+44 (0)207 848 7306
Email	vpri@kcl.ac.uk
Website	https://www.kcl.ac.uk/
"ROR"	https://ror.org/0220mzb33

Funders

Funder type

Government

Results and Publications

Editorial Notes

02/07/2025: The following changes were made to the study record:
1. The date of first enrolment was changed from 01/01/2025 to 01/06/2025.
2. The date of final enrolment and completion date were changed from 30/04/2026 to 30/06/2026.
3. Ethics approval details added.
11/11/2024: Study's existence confirmed by National Institute for Health and Care Research (NIHR) (UK).