By: 23 July 2019
Bristol–born innovation to protect premature babies from cerebral palsy scoops national award

An innovation developed at St Michael’s Hospital in Bristol to protect very premature babies from developing cerebral palsy has won a prestigious national Patient Safety Award.

PReCePT, which stands for the Prevention of Cerebral Palsy in PreTerm Labour, was the brain child of Dr Karen Luyt, a neonatologist at University Hospitals Bristol NHS Foundation Trust.

With the support of the West of England Academic Health Science Network (AHSN) back in 2014 and working with both parents and hospital staff, Karen designed PReCePT to help reduce cerebral palsy in babies by administering magnesium sulphate to mothers during early labour before 30 weeks, 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. The lifetime health and social care cost for an individual with cerebral palsy is around £800,000.

When magnesium sulphate is given to mothers via an intravenous drip within 24 hours of delivering their preterm baby it can reduce the chances of their babies developing cerebral palsy by 30 per cent.

The West of England AHSN helped to spread PReCePT to all five maternity units in the West Country, and it has been estimated that since the regional project’s launch in August 2014 16 cases of cerebral palsy have been prevented.

As a result of this initial work in the West, NHS England is now funding the national rollout of PReCePT by the AHSN Network (the 15 AHSNs covering the whole of England), led by the West of England AHSN and Karen Luyt as clinical lead. This makes PReCePT the first ever perinatal programme delivered at scale across England, bringing together midwives, obstetricians and neonatologists in all 152 maternity units in the country.

In the first year of PReCePT going national (2018-19), 511 additional mothers in England received magnesium sulphate. An estimated 13 cases of cerebral palsy were avoided nationally, representing a saving of around £10.4 million in lifetime health and social care costs.

Recognising its significant impact on the quality of care for very premature babies and their families, PReCePT won the award for ‘Maternity and Midwifery Services Initiative of the Year’ at the annual HSJ Patient Safety Awards, held in Manchester on Tuesday 2 July 2019.

The award judges said: “This [PReCePT] was on a different scale to the other entries. It has had a huge impact with good engagement from other organisations. The judges were particularly impressed with the patient and parent involvement.”

Natasha Swinscoe, Chief Executive of the West of England AHSN, said: “We’re absolutely thrilled PReCePT has won an HSJ Patient Safety Award and for the success of the programme to be recognised at this prestigious event.

“PReCePT started as a brilliant evidence-informed idea from Dr Karen Luyt at St Michael’s Hospital, which the West of England AHSN helped to spread to all our maternity trusts in the region, using strong quality improvement methodology and involving both parents and staff. And with the coordination and leadership of the entire AHSN Network, it has grown into the national programme it is today, bringing together the entire neonatal community and working with all 152 maternity trusts in England.

“I’m immensely proud of what the team has achieved. Congratulations to everyone who has contributed to PReCePT and made a huge impact on the lives of very premature babies and their families.”

Emma Treloar, consultant obstetrician at UH Bristol and obstetric lead for PReCePT said: “Working with Karen Luyt and being involved in the success of PReCePT at St Michael’s Hospital and the South West is hugely satisfying. Knowing that we are giving the best start to preterm babies born locally and, beyond this, sharing the work of PReCePT nationally is incredibly rewarding. For the programme to be recognised by the HSJ is fantastic for everyone involved.”

Dr Karen Luyt, Neonatologist at UH Bristol, commented: “I’m thrilled PReCePT has won an HSJ Award! It has been amazing to see PReCePT grow from a small programme in the West of England to the national neonatal programme it is today, and I’m really proud to have been part of the team. Congratulations to everyone who has contributed to PReCePT”.

The national PReCePT programme is also running in tandem with the PReCePT Study, a research trial, funded by The Health Foundation and in partnership with local health research body CLAHRC West, which will assess the effectiveness of different approaches to implementing the intervention.

Professor John Macleod, Principal Investigator, CLAHRC West commented: “PReCePT is a deserving winner as it’s a low cost intervention that can make a huge difference to premature babies’ lives. CLAHRC West are proud to be evaluating the programme.”

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