Developing a licensed, social franchising model for regional hubs to support and sustain the roll out of effective local multi-professional maternity training PROMPT Maternity Foundation

The PRactical Obstetric Multi-Professional Training (PROMPT) programme is a maternity safety intervention aimed at avoiding preventable harm through training, simulation, human factors, system change and tools. It was first introduced at North Bristol NHS Trust in 2000 and has been associated with reduced neonatal hypoxic injuries (caused by lack of oxygen during labour and birth), and permanent brachial plexus (nerve) injuries following difficulties with the birth of the babies’ shoulders (shoulder dystocia).

A training package was developed by the PROMPT Maternity Foundation (PMF) to enable the approach to be used at maternity units across the country, using a ‘train the trainer’ model. Although there was success with this approach, there was also variation in the implementation of PROMPT, and therefore clinical impact. The Exploring Social Franchising programme enabled PMF to take a different approach to scaling up of the intervention. 

The project involved the development of a licensed social franchising model to establish regional, expert ‘hubs’ of PMF facilitators to support and sustain local training.

Five maternity units were recruited to the pilot and the PMF team worked closely with clinical champions to help adapt PROMPT to their local needs. All sites were able to initiate training more rapidly and consistently than the previous ‘train the trainer’ model.

The COVID-19 pandemic meant hospitals could not safely continue to provide face-to-face learning. The PMF team therefore developed an e-learning package which was released free of charge to all UK maternity units.

Social franchising has enabled effective scaling up of PROMPT, although its feasibility on a larger scale, and the financial viability outside of the funded programme, are to be explored further.

Contact information

For more information about this project, please contact Cathy Winter, Midwifery Lead, PROMPT Maternity Foundation.