Summary
Research and data can save lives and improve health care and helps deliver better outcomes. NHS trusts that are highly research active have better outcomes for patients across their services. All patients have better health outcomes in research active hospitals, even if individual patients are not part of research.
Clinical research embedded in the NHS creates a research-positive culture in which all health and care staff feel empowered to support and participate in clinical research as part of their job. This requires a sustainable and supported research workforce – which offers rewarding opportunities and exciting careers for all healthcare and research staff of all professional backgrounds. It also requires boosting areas of high research need and historical under-investment in groups such as midwives.
The Health and Care Act strengthened the duties on NHS England and integrated care systems (ICSs), which are now required to ‘facilitate and otherwise promote research’. To make ‘research everybody’s business’ this strategy sets out how embedding evidence and research in maternity policy and programmes and supporting under-represented groups such as midwives to lead research will support this vision.
Introduction
The vision for maternity and neonatal services is to provide safer and more personalised care for women and their families across England. It builds on the landmark Better Births Review, and Neonatal Critical Care Review to deliver the NHS Long Term Plan commitments to halve the number of stillbirths, neonatal and maternal deaths and brain injuries by 2025, and the Core20PLUS5 intention to reduce healthcare inequalities at a local and system level.
In 2023 the Delivery Plan for Maternity and Neonatal Care will bring together actions required following the Reading the Signals, the Report of the Independent Investigation into Maternity and Neonatal Services in East Kent, the Ockenden Review into maternity services at Shrewsbury and Telford NHS Foundation Trust, and the NHS Long-Term Plan and Maternity Transformation Programme deliverables. Further reports have set out the significant systematic inequalities that remain, both in outcomes and in the experiences for women from ethnic minorities and those living in social deprivation.
This Chief Midwifery Officer for England’s strategic plan for research will support NHS England commitments in the Department of Health and Social Care (DHSC) UK Clinical Research Recovery, Resilience and Growth Programme and clinical research vision to support the healthcare workforce to embed research in the NHS. This includes ensuring that healthcare staff have the capacity and capability to incorporate research into their day-to-day activities; increasing knowledge and skills of NHS maternity leaders about different ways staff can get involved in research; increasing awareness of the value of research for safe and high quality care; and supporting frontline staff to lead delivery and use research in practice to improve care, experience and outcomes for women and babies and organisational performance.
This document sets out plans for maternity and perinatal research and strengthening careers for under-represented disciplines, such as midwives, as the backbone of maternity care over the next three years. Themes are shaped by policy and research priorities, and informed by colleagues across NHS England. It is aligned with the NIHR Research Strategy and NIHR Strategic Review of Training Council of Deans of Health, Royal College of Midwives, Royal College of Obstetricians plans, the Chief Nursing Officer’s (CNO) strategic plan for research, and draft NHS England Strategy for improving use of Evaluation.
Aims
The Chief Midwifery Officer for England’s strategic plan for research has three overarching themes:
- NHS England maternity policy and programmes are informed by the highest quality evidence and the voices of service users to close the loop between evidence, policy, programmes, and frontline practice.
- NHS England maternity policy and programmes embed evaluation to inform and assess programme delivery improvements and impact.
- The contribution of midwives to research and the evidence base is visible and valued, and supported by strengthening research capacity.
Implementation
NHS England maternity policy and programmes are informed by the highest quality evidence and voices of service users to close the loop between evidence, policy, programmes, and frontline practice:
| Aim | Action |
|---|---|
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Timely identification of research priorities and evidence gaps with NHS England maternity policy and programme teams contributes to improved quality of, and access to care, experiences, and outcomes for women, babies, and their families.
| Develop a systematic approach to embed the identification of research and evidence gaps that are important to maternity services, aligning this to NHS England’s wider approach to identification of research needs and demand signalling. |
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NHS England maternity policy and programme teams are kept up to date with relevant research in progress to inform planning and programme delivery. |
Engagement and collaboration with external stakeholders and partner organisations to share ongoing activity through research insight events and meetings to enhance complementarity of research effort. |
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NHS England maternity policy and programme teams have access to relevant evidence in a focussed and concise format. |
Collaborate with evidence dissemination stakeholders with a remit to map, oversee and/or disseminate research findings on key topics, and highlight policy priorities for these stakeholders. |
NHS England maternity policy and programmes embed evaluation to inform and assess programme delivery improvements and impact:
| Aim | Action |
|---|---|
|
NHS England maternity policy and programme teams have timely access to well-designed and responsive evaluation to improve programme delivery and impact. |
Work with policy and programme teams to prospectively establish evaluation needs, and support consequent data generation, to inform programme implementation and delivery. |
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NHS England maternity policy and programme delivery is informed by high quality data to enable successful delivery of maternity policy and programmes. |
Work with NHS England Evaluation and Analytics teams and external stakeholders to improve the quality of data collected, and enable effective analysis of external and routine data available to NHS England. |
The contribution of midwives to research and the evidence base is visible and valued, and supported by strengthening research capacity:
| Aim | Action |
|---|---|
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Diversity of expertise informing decisions at a strategic level increased by midwife research leaders informing and advising NHS England policy and programmes. |
Support inclusion and impact on the content of such policies and programmes. |
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Increase bi-directional learning of research led by midwives working in international healthcare systems. |
Contribution of midwife research leaders in international and global research is increased through engagement with WHO/ICM, WHO collaborating centres and Senior Research Leaders internationally. |
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Achieve a greater diversity of researchers and evidence to inform improvements in health and care through realising aspiration and potential for midwives |
Collaboration with key stakeholders, funders, HEIs and the NHS to develop a fair, equitable research career pipeline. Through events, webinars, and support for specific funded research and career development opportunities from undergraduate level onwards. |
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Contribute to building the pipeline of future midwife research leaders across |
Collaborative action with colleagues leading the NHS England CNO Research strategy, and in NHS England Innovation, Research and Life Sciences Group, NIHR, Council of Deans of Health and Royal Colleges to improve opportunities and funding for midwives to become research leaders. Mapping survey of midwife research leaders in the NHS and HEIs, and establishment of communities of practice supported through the NHS Futures CMiDO National Maternity Research platform |
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Better quality care, experiences and outcomes for service users, and improved midwife recruitment, retention, and staff experience through maternity staff leading, delivering and supporting research in the NHS. |
Promote benefits of multi-disciplinary research to NHS maternity leaders through a range of collaborative activities which enables research to become business as usual across the NHS. |
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Better co-ordination and collaboration of HEIs, NHS organisations and NIHR organisations working in research and maternity and perinatal health professionals. |
Support and develop regional research networks through regional chief midwife leadership models.
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Governance and future actions
The CMiDO’s research team collaborate closely with colleagues across NHS England and the Maternity transformation directorate, CNO Research team, the Innovation, Research and Life Sciences Group and the communications team in NHS England. The CMiDO and Maternity Transformation Advisory Groups will be consulted on specific issues.
The Chief Midwifery Officer for England’s strategic plan for research Steering Group will oversee delivery of this plan, monitor progress, and regularly review the ambition.
An external stakeholder group will ensure the steering group has access to advice, support, and guidance from a group of senior maternity and neonatal health and care professionals and managers (from NHS England regions, integrated care boards and provider organisations), academics, service users, and the public to inform delivery and embedding of the plan.
Summaries of progress to date and future plans will be published in CMidO and Maternity Transformation Programme Bulletins and the NHS Futures Collaboration Platforms.
Publication reference: PRN00293