Tim Draycott is a consultant obstetrician at North Bristol NHS trust with a research interest in patient safety, quality improvement and multi-professional obstetric training.

He led development of the PROMPT (Practical Obstetric Multiprofessional Training) course which has been associated with improved knowledge, communication, team-working and direct improvements in perinatal outcome. He also led the Research into Safety & Quality (RiSQ) Group at his trust which also developed an automated maternity dashboard and a simple tool to measure maternal satisfaction after delivery.

Tim’s project

Most births in the UK are safe but some are not as safe as they could or should be; many women and their babies still suffer preventable harm.

A large randomised study demonstrated that simulation-based emergency training improved knowledge, clinical skills and team-working of staff managing simulated emergencies.

An adapted version of the same training programme was introduced at Southmead Hospital in 2000, resulting in a reduction in preventable harm – specifically a 50% reduction in babies born starved of oxygen and a 70% reduction in babies born with a paralysed arm.

Based on these results, Tim’s team developed the same training programme into an ‘exportable package’, the PROMPT Course in a Box, which could be set up in other maternity units.

Multi-professional teams of experienced staff from eight hospitals in south west England attended a PROMPT ‘train-the-trainers day’ in December 2008 and received practical guidance and training materials to enable them to set up training in their own unit. Additional support via telephone and email was also provided.

Understanding training implementation

Tim’s project investigated some of the contextual elements of training implementation to help inform future implementation of training and patient safety programmes in the NHS and overseas.

He explained: ‘This project will help us understand training implementation and its relationship to outcomes, we aim to identify barriers to training and develop interventions to help resolve them’.

‘If training were as effective nationally as it is at Southmead Hospital, over 100 severe birth injuries would be prevented each year, which would significantly benefit children and their families, and could also potentially reduce £64 million per year in NHS litigation claims alone’.

Tim says he sees leadership as a responsibility to the team, an opportunity to create a shared vision, and a means of supporting the development of others.

‘I firmly believe that we need to make quality improvement easier for NHS staff. In particular if we can make the right way the easiest way, then everyone will do it’.

Achievements so far

The improvements to maternity care enabled by Tim’s fellowship have made Bristol the safest place in the world to have a baby and have been sustained over time. If similar reductions in harm at birth were made across England there would be NHS savings in maternity claims alone of £2.8billion in a decade.

The PROMPT approach is now being used in 85% of UK maternity units and is being adopted globally by countries including Australia, New Zealand, Hong Kong, China, the USA, Egypt, Mongolia and Singapore.

The first edition of the PROMPT course manual was the biggest-selling text ever published by the Royal College of Obstetricians and Gynaecologists Press, beaten only by the second edition! It has been adapted for use in other countries and a new course has been developed for paramedics and community midwives.

As well as authoring numerous peer-reviewed articles about his research, Tim is the lead author of two books and he has written three guideline documents for the Royal College of Obstetricians and Gynaecologists. He has also secured over £3million of funding awards and four prizes including the Queen’s Anniversary Award.