The Perinatal Culture and Leadership Programme (PCLP) was established to support maternity and neonatal teams in strengthening culture as a foundation for safer, more equitable care. Health Innovation Oxford and Thames Valley (HIOTV) was commissioned by NHS England to support the local network delivery of PCLP (2024-26).
The programme brought together maternity and neonatal teams to build capability in culture and leadership, develop locally owned improvement priorities informed by data, and test practical approaches to embedding behavioural change in everyday practice.
This included strengthening multidisciplinary team working, supporting the role of culture coaches as local change agents, using data to identify and prioritise areas for improvement, and introducing structured approaches such as MOMENTS to enable reflection and learning in practice. Across all of this, the focus was on linking culture directly to safety and to the experiences of both patients and staff.
The formal commission for HIOTV support has now come to an end. However, the real work – embedding and sustaining these changes – continues within local teams and our Maternity and Neonatal Safety Improvement Programme.
It has been a privilege to work alongside such committed, thoughtful and passionate colleagues across maternity and neonatal services. The willingness to reflect, challenge and keep improving – often under significant pressure – has been a consistent and humbling feature of this work.
Key insights
Across the programme, one insight has stood out consistently: improving safety and experience in perinatal services is not only about clinical knowledge or technical skill. It is about how teams function in real time – how concerns are noticed, interpreted and acted upon, and how people respond to one another in those moments.
These are not abstract cultural concepts. They are everyday behaviours, shaped by the environments in which people work.
It is not only about what we do, but how we do it.
Enabling action requires more than individual willingness. It requires systems that make it clear what to do, support people to do it, and respond constructively when they do. Leadership plays a critical role here – not only in setting expectations, but in shaping the conditions that make action possible.
When insight is not followed by action, frustration grows. When action is enabled, trust grows – and with it, the capacity for continuous improvement.
One example in practice
One local team used the PCLP support offer to strengthen shared purpose, direction and cohesion at a point where clarity and alignment were limited. Through facilitated coaching sessions, structured support tools and staff survey data, the team was able to re-establish shared priorities and develop a clearer foundation for ongoing culture improvement work.
This support helped strengthen collaboration within the team and created greater clarity around vision, leadership, and delivery priorities.
One staff member reflected: “It’s been a real pleasure having you involved as a fresh pair of eyes on the project – your insight has genuinely helped us see things from a different perspective. I also want to acknowledge the invaluable mentorship you have provided to a member of staff and the wider team of culture champions. Your guidance has made a real difference.”
Key takeaways
- Behaviour change depends on context, not intention
Staff do not need more motivation to do the right thing. They need the conditions that make it possible. Time pressure, hierarchy and unclear processes often get in the way – not lack of care or commitment.
- Psychological safety is local
It varies from team to team and shift to shift. Organisational statements are not enough; what matters is whether, in a specific moment, people feel able to speak up and be heard.
- Culture is inseparable from safety
How teams communicate, challenge, and support each other directly affects escalation, decision-making and outcomes. Culture is not an ‘add on’ – it is part of the safety system.
- Data helps focus improvement
Using data to identify patterns in outcomes, experience, or staff feedback helps teams prioritise where culture change is most needed, rather than relying on assumptions.
- Local roles sustain change
Culture coaches have played a key role in translating learning into practice – supporting teams, modelling behaviours and maintaining momentum beyond the programme.
- Structured reflection strengthens teams
Approaches such as MOMENTS create space to pause, reflect, and learn together within busy clinical environments. These small, consistent practices build shared understanding and trust over time.
What this means going forward
The PCLP initiative has reinforced that culture is not separate from care – it is part of how care is delivered. The ability to notice, understand, respond and act is what turns knowledge into safe and equitable practice.
At its core, this is about compassion – not as an abstract value, but as a practical way of working: noticing what matters, understanding what is happening, valuing different perspectives and taking action to help (West, 2021). When systems and leaders enable these behaviours, teams are better able to respond early, work together effectively, and deliver safer, more equitable care.
That is where meaningful and lasting improvement continues.
Reference
West, M. (2021) Compassionate Leadership: Sustaining Wisdom, Humanity and Presence in Health and Social Care. London: Swift Press.
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