The National Centre

for Post-Qualifying
Social Work and
Professional Practice

Methods

Service
Improvement
Projects
Supporting social work and health practitioners to improve
services one setting and one service provider at a time.
The improvement of services, for the people we
serve, is at the heart of professional practice. This
is why we have designed a Masters degree to
include a focus on service improvement.

The Service Improvement journey at BU is

split into two Masters degree level units:
PSIP and SIP.

PSIP stands for Preparing for your Service

Improvement Project. Successful completion of

PSIP is a pre-requisite for moving on to the SIP
unit. It allows practitioners to develop a service
improvement proposal over a period of about 5
months and is primarily about THINKING.

SIP stands for Service Improvement Project

and is primarily about DOING or implementing

the proposal in practice. This poster is based on a
SIP completed in 2014.

The National Centre for

Post-Qualifying Social Work
and Professional Practice
(NCPQSWPP)
Professional education at the National Centre
for Post-Qualifying Social Work and Professional
Practice is centred on a commitment, passion
and dedication to develop healthcare and social
work practice.
We believe that by improving the quality of
services through partnering with practitioners
and employers across the health and social care
arena we make a vital contribution to society in
general and vulnerable people in particular.
Over 10,000 practitioners have successfully
undertaken our programmes since the year
2000 and we have won a total of 9 prestigious
teaching awards during this time.
Visit us at: www.ncpqsw.com

There were two main stages to the SIP process.

Stage 1 included a self-completed anonymous
survey of maternal positioning in labour (to
benchmark current practice) and an audit of
documentation. The audit aimed to review
whether women received timely medical
intervention and whether 4-hour action and
alert lines (WHO 1994; NICE 2007) would
impact on decision-making.
Stage 1 findings and stakeholder feedback
facilitated partogram revision.
Stage 2 involved a questionnaire to staff and
notes audit to evaluate the use of the new
partogram.

Service improvement/
changes

Improving the quality of

data collection during
labour
Author: Hannah Doe
Consultant Midwife Trainee, Hampshire Hospitals NHS
Foundation Trust

Context and rationale

Caesarean section (CS) rates across the
UK are rising (HES 2013).
There is a national campaign to
promote normal birth (DoH 2010;
NHS Institute 2010) as caesarean
birth carries significant health risks to
women, unborn babies and their future
pregnancies (RCOG 2009).
The Trust launched an Active Birth
Project aiming to improve normal birth
rates and align practice across the 3
hospitals.
This SIP focused on one objective of
the project: to improve and implement
a new partogram across the 3 care
settings.
A partogram is a graphical record of
important data used during labour; it is
widely embedded in practice.

For more information, please visit us at www.ncpqsw.com or phone 01202 964765

The identified problem

In 2012, the 3 hospitals merged to form
one Trust.
Multiple partogram versions were
apparent and there was a lack of
consistency in their use.
This problem was compounded by a
lack of evidence informing partogram
design (Lavender et al. 2008) and little
evidence to support its use in developed
countries.
Yet, removing the partograms could
have had a detrimental impact on
practice, therefore, developing a
partogram to support practice was
considered crucial.

The new partogram was successfully

implemented on 1st February 2015. Yet, I
had already taken up the post of Consultant
Midwife at Portsmouth Hospital NHS Trust on
1st January 2015.
80% of staff agreed or strongly agreed that the
new partogram was an improvement.
33% of the new partograms were completed
in full and a further 47% were more than 50%
compliant. However, further improvement is
needed to reach to the quality standard of 75%
(NHSLA, 2009).
Unforeseen difficulties with data collection
across the Trust meant that I was unable to
evaluate whether the project met some of its
intended aims.
Unexpectedly, the project highlighted a practice
issue about whether midwives were diagnosing
the onset of labour appropriately or understood
when to commence the partogram further
work is needed in this area.

References:
DoH (Department of Health). 2010. Promoting Normal Birth. Available at:
http://www.dhsspsni.gov.uk/mr-high-impact-promoting-normal-birth-2010.
pdf Accessed 6th June 2014.
HES (Hospital Episode Statistics). 2013. Table 8: Method of delivery 1980
to 2010-11. Available at: http://www.hscic.gov.uk/article/2021/WebsiteSearch?productid=116&q=maternity+statistics&sort=Relevance&size=10&page=1&area=both#top Accessed 6th June 2014.
Lavender, T., Tsekiri, E. and Baker, L. 2008. Recording Labour: a national survey of partogram use. British Journal of Midwifery. 16 (6). pp. 359-62.
NHS Institute. 2010. Sustainability; ensuring continuation in improvement.
Available at: http://www.institute.nhs.uk/sustainability_model/introduction/
find_out_more_about_the_model.html Accessed 6th June 2014.
NHSLA (National Health Service Litigation Authority) 2012-13. CNST Maternity Clinical Risk management Standards: frequently asked questions. Available at: http://www.nhsla.com/search/pages/results.aspx?sq=1&k=Maternity%20Cnst%20Standards Accessed 2nd March 2015).
NICE (National Institute of Clinical Excellence). 2007. Intrapartum care Guideline. Available at: http://www.nice.org.uk/guidance/cg55/resources/cg55-intrapartum-care-full-guideline-corrected-june-20082 Accessed: 6/6/14.
RCOG (Royal College of Obstetrics and Gynaecology). 2009. Statement on
maternal position during the first stage of labour. Available at: https://www.
rcog.org.uk/en/news/rcog-statement-on-maternal-position-during-the-firststage-of-labour/ Accessed 6th June 2014.
WHO (World Health Organization). 1994. Partograph in the management of
labour. Lancet 343: 1399404.