Developed in maternity units across the West of England, the ‘PReCePT’ project has been selected by the Health Foundation to be part of an ambitious £3.5 million improvement programme.
The Scaling Up Improvement programme is supporting seven projects in the UK to take their proven health care interventions and approaches and make them work at larger scale to have a positive impact on patient outcomes.
PReCePT, which stands for the Prevention of Cerebral Palsy in PreTerm Labour, has been designed to help reduce cerebral palsy in babies by administering magnesium sulphate (MgSO4) to mothers during preterm labour, at a cost of around £1 per individual dose.
Preterm birth is the leading cause of brain injury and cerebral palsy, which has a lifelong impact on children and families.
NICE recommends administration of MgSO4 in preterm deliveries to substantially reduce the risk of cerebral palsy by 30 per cent, based on evidence in support of its brain protective potential. However, the uptake of MgSO4 in the UK remains relatively low, compared with the leading countries in the developed world.
The PReCePT initiative was developed by University Hospitals Bristol NHS Foundation Trust in collaboration with the West of England Academic Health Science Network (AHSN), and co-designed with both patients and staff. The NIHR Collaboration for Leadership in Applied Health and Care (CLAHRC) West is evaluating the initiative.
Providing a comprehensive package of training and support materials, the intervention was rolled out to all five maternity units in the West of England:
It is estimated that this first phase of PReCePT has so far prevented five to ten cases of cerebral palsy across the region, representing potential lifetime healthcare savings in the region of £5 million and substantially more when including loss of productivity and social care costs over a lifetime.
As a result of the £0.5 million Scaling Up funding from the Health Foundation, support can now be provided to a further 10 hospital trusts around the country to implement PReCePT in their maternity units, covering the South, North West and South West of England, Midlands, Wales and London.
NIHR CLAHRC West will carry out a full evaluation of the wider roll-out of PReCePT and it is hoped that this will inform future spread across all maternity units. If rolled out nationally, it is estimated that up to 1,400 low birthweight babies could benefit from this intervention each year.
Dr Karen Luyt is a Consultant in Neonatal Medicine at St Michael’s Hospital, which is part of University Hospitals Bristol NHS Foundation Trust, and has been the project lead for PReCePT since it was first launched in 2014.
Dr Luyt said:
“Magnesium sulphate is a very cost effective way to prevent brain injury in babies that are born early. We have already demonstrated that this evidence-based intervention can be put into practice rapidly and be sustained when supported by quality improvement (QI) methodology. Our aim with PReCePT2 is to scale up across the UK, ultimately making this potentially life changing intervention consistently available for every eligible preterm delivery.”
University Hospitals Bristol will lead this next phase to scale up PReCePT to 10 further trusts, working in partnership with a wide range of organisations, including:
The Health Foundation’s Scaling Up programme will run for two and a half years and each project will receive up to £0.5 million of funding to put their project into practice and evaluate it.
Sarah Henderson, Associate Director from the Health Foundation said:
“We are very excited to support seven outstanding project teams who have been selected because of their expertise in scaling complex improvement projects, and their ambition to achieve impact by improving care for patients.
“Working together, as part of the Scaling Up programme, we aim to make sustained improvements to health care by testing out proven interventions at a scale. We hope to see the interventions being widely adopted across the UK.”