Background: Retaining midwives to the workforce is essential in ensuring safe and effective care, with understaffing of registered midwives (RMs) associated with an 11% increase in harmful incidents. It is therefore crucial to maternal and neonatal safety that midwives’ health, safety and wellbeing in the workplace is a key focus for maternity employers.

Aim: To develop and validate a Caring for You (C4Y) staff wellbeing evaluation which can accurately measure the implementation success of the C4Y Charter

Methodology: A mixed-methods evaluation including an online questionnaire and semi-structured interviews.  Internal consistency of the Likert scale questionnaire items will be tested using Cronbach’s alpha. Quantitative data will be analysed using descriptive statistics and qualitative data will be thematically analysed.

Ethics: This study has been reviewed by and received ethics clearance through the Maternal and Child Health Proportionate Review Committee. City St George’s, University of London (ETH2425-1713)

Results: 62 questionnaire responses were received from midwives working across all 7 Local Health Boards. 8 midwives took part in an interview. Data was collected around the following topic categories: Action plans, Shift Patterns, Organisational Culture and Support and Compassion. The results show a pattern of midwives’ reporting issues with short staffing, breaks and organisational culture. The study data also suggests that the C4Y campaign is not equally understood by all midwives.

Conclusion: For the C4Y Charter to be fully realised, an organisational culture shift required, where midwives’ co-designed and shared values are embedded in NHS maternity services.

The Maternity and Neonatal Safety Support Programme (MatNeoSSP) Wales, is a collaborative national initiative designed to strengthen safety, quality, and equity across maternity and neonatal services in Wales. Working with all Welsh health boards and the Welsh Ambulance Services Trust (WAST), the programme began with a comprehensive ‘discovery phase’ to assess current strengths and identify areas for improvement. This work was led by Improvement Cymru, conducted by and for the maternity and neonatal community in Wales, and informed the development of a strategic, system-wide improvement approach.

In November 2024, the MatNeoSSP Implementation Network was established to bring together Perinatal Teams across Wales to co-ordinate a number of improvement projects in Wales, including:

• Supporting health boards in the national implementation of MEWS and NEWTT2 early warning score tools through improvement networks, training, and resource development.
• Embedding a standardised Newborn Risk Assessment tool to support early identification and monitoring of at-risk neonates.
• Creating a Community of Practice to improve Maternity Triage across Wales. Outputs from this include and All Wales Audit Tool, agreed Key Performance Indicators and working with colleagues in HEIW to publish a competency framework.

The programme demonstrates how coordinated leadership, community ownership, and data-driven collaboration can create meaningful change in maternity and neonatal care.

Aims and Objectives:

PROMPT training has been embedded within maternity services in Wales for several years and includes a strong focus on multidisciplinary working and non-technical skills alongside technical simulation. However, national and local reviews continue to highlight persistent challenges related to communication, civility, speaking up, and psychological safety, reflecting the complexity of cultural change in maternity care. This project aimed to introduce and pilot a new PROMPT session focused specifically on non-technical skills, in-house reflection on culture and psychological safety, and the influence of hierarchy. The objective was to explore whether facilitated discussion, supported by Active Bystander Training (ABT), could strengthen confidence to speak up and support safer team cultures.

Methodology:

An in-house multidisciplinary working group designed and delivered a new non-technical skills session within the PROMPT training day. The session created a facilitated, psychologically safe space for discussion, using scenario prompts and shared reflection to explore team culture, communication, incivility, and barriers to speaking up. Active Bystander Training was introduced as a practical framework to help participants recognise problematic behaviours and practise constructive responses. A mixed-methods evaluation used pre- and post-session Likert-scale questionnaires alongside qualitative thematic analysis of written reflections. This work was undertaken as quality improvement and did not require ethical approval.

Outcomes / Results:

Quantitative findings demonstrated modest improvements in confidence speaking up during maternity emergencies (mean 3.7 to 4.1) and psychological safety when challenging hierarchy (3.4 to 3.9). Understanding of how hierarchy influences communication was high at baseline and showed smaller change (4.2 to 4.4). Qualitative findings identified hierarchy, fear of judgement, incivility, and prior negative experiences as key barriers to speaking up. Post-session reflections demonstrated increased psychological safety and shared accountability, with participants describing feeling acknowledged within the team (‘I feel seen’) and a commitment to act when concerns arise (‘I will do my best to avoid being a bystander when a situation arises’).

Conclusions:

Introducing a dedicated non-technical skills session within PROMPT represents a meaningful enhancement of simulation-based training. While quantitative change was modest, qualitative findings suggest early movement towards improved psychological safety and shared accountability. As a quality improvement intervention, this approach supports ongoing cultural change and offers a scalable method to strengthen teamwork alongside technical excellence in maternity care.

Aims and Objectives:

Recognising variability in interprofessional role understanding and limited opportunities for professions to learn together early in training, this project aimed to strengthen collaborative working from the outset of professional formation. The goal was to design, deliver, and evaluate an Interprofessional Learning (IPL) pilot for midwifery students and graduate-entry medical (GEM) students, enhancing role clarity, communication, and teamwork during training.

Methodology:

A multidisciplinary group co-designed the pilot using interprofessional education principles, simulation-based learning, and structured reflection. Core themes included role clarity, psychological safety, communication, and teamwork. The programme combined role-focused teaching, immersive simulations, and facilitated reflection. A mixed-methods evaluation used pre- and post-session Likert-scale questionnaires and qualitative thematic analysis of reflections and feedback. This was conducted as service evaluation and did not require ethical approval.

Outcomes / Results:

Mean Likert-scale scores showed improvements across all domains following the IPL session. Understanding of the midwife role increased from 3.5 to 4.6, and confidence in explaining role overlap rose from 3.4 to 4.4. Knowledge of when to escalate care increased from 3.4 to 4.5. Confidence initiating interprofessional discussions also increased (3.8 to 4.6). Pre-session scores were moderately high, limiting large numerical change.

Qualitative findings revealed improved understanding of professional scope and psychological safety, with participants recognising how breakdowns in communication, documentation, and respect could undermine patient safety. Post-session reflections demonstrated strong intention to adopt safer collaborative behaviours, including increased openness and respect for professional roles.

Conclusions:

By embedding interprofessional learning early in training, this pilot demonstrates how proactive role clarity and psychologically safe collaboration can support safer maternity care before adverse behaviours or working patterns become embedded. This IPL pilot aligns with national maternity safety priorities and offers a scalable model for strengthening teamwork, communication, and safety culture in maternity care.