PERIPrem 

PERIPrem (Perinatal Excellence to Reduce Injury in Premature birth) is a bundle of care interventions designed to reduce the risk of injury and death in pre-term babies.

Babies born prematurely are at risk of lifelong brain damage or death. In the South West of England, rates of brain damage among pre-term babies is higher than in other regions of the UK. Perinatal clinical care interventions can reduce mortality in pre-term newborns and increase the chances of very pre-term babies enjoying bright futures free from brain injury.

Across 2020 the South West Academic Health Science Network (SW AHSN) is working in collaboration with the West of England Academic Health Science Network (WE AHSN) to pilot test the PERIPrem bundle across NHS trusts in the West and South West of England.

Developed by the WE AHSN with obstetric and neonatal teams at University Hospitals Bristol NHS Foundation Trust and Great Western Hospitals NHS Foundation Trust, the bundle comprises ten evidence-based care interventions designed to improve rates of survival free from brain injury in premature newborns.

  • Antenatal steroids
  • Caffeine
  • Delayed cord clamping
  • Early breast milk
  • Magnesium sulphate
  • Place of birth
  • Probiotics
  • Prophylactic hydrocortisone
  • Thermoregulation
  • Volume targeted (guided) ventilation

The PERIPrem project is supporting the aim of the NHS Long Term Plan (LTP), which has made reducing neonatal mortality and serious brain injury a priority for the next decade. PERIPrem also aligns with the strategic aims of the South West Neonatal Operational Delivery Network (ODN) and builds on the work the network has done in supporting the South West’s 12 regional units to improve outcomes for pre-term babies.

In addition to improving clinical outcomes for neonates, PERIPrem is expected to develop perinatal team culture at unit level and increase quality improvement (QI) capability within the South West region.

How does PERIPrem work?

There are 12 NHS trusts participating in the PERIPrem project, seven across the South West peninsula coordinated by the SW AHSN and 5 in the West of England coordinated by the WE AHSN.

Due to the COVID-19 epidemic, PERIPrem was soft launched on 20 May 2020. Each AHSN is currently working with the maternal and neonatal units of trusts in their region, their patient partners and the wider regional clinical community to co-design the implementation of the bundle within their trust and to work to individual targets specific to the culture and operational nuances of their units, particularly in the context of COVID-19. Design and implementation of the bundle is being informed by QI methodology and learnings from how the AHSN Network implemented its successful PReCePT programme across England last year.

All maternity and neonatal units across the South West and West of England are being supported to achieve 70% compliance with the complete bundle for all eligible mothers who deliver their babies at less than 32 weeks’ gestation.

PERIPrem on the peninsula

Across our South West patch, the following trusts are participating in PERIPrem:

  • Northern Devon Healthcare NHS Trust
  • University Hospitals Plymouth NHS Trust
  • Royal Cornwall Hospitals NHS Trust
  • Torbay and South Devon NHS Foundation Trust
  • Royal Devon and Exeter NHS Foundation Trust
  • Somerset NHS Foundation Trust
  • Yeovil District Hospital NHS Foundation Trust

Each participating trust is supported by our South West Patient Safety Collaborative.

The South West PERIPrem clinical team is led by consultant neonatologist Dr Wisam Muhsem (University Hospitals Plymouth NHS Trust) and Dr Tracey Kay, consultant obstetrician and gynaecologist (Royal Devon & Exeter NHS Foundation Trust).

Dr Wisam Muhsem

Neonatal Consultant, University Hospitals Plymouth NHS Trust

Dr Muhsem specialises in neonatology including intensive care, neonatal haemodynamics and neonatal transport.

Dr Tracey Kay

Obstetrics & Gynaecology Consultant, Royal Devon & Exeter NHS Foundation Trust

Dr Kay specialises in high risk obstetrics, including pre-term birth, and obstetric governance and safety.

As the NHS works to reduce neonatal mortality and serious brain injury by 50% by 2025, the PERIPrem pilot is a chance for trusts in the South West region to be among the first in England to demonstrate the potential of this innovative initiative - and its suitability for future spread across the country.

Find out more

Visit the official PERIPrem webpage by the West of England Academic Health Science Network.

Follow PERIPrem on Twitter @peri_prem

For more information on how PERIPrem is being implemented in Somerset, Devon, Cornwall and the Isles of Scilly, please contact SW AHSN PERIPrem Lead, Sally Hedge (sally.hedge@swahsn.com).