We have a strong track record of bringing together colleagues from across all three of our local integrated care systems to take a joined-up approach to preventing sickness and reducing the risk of harm to patients in our care.
In the last couple of years, we have combined this approach with our focus on getting proven evidence into practice through the introduction of care bundles.
165
lives have been saved to date in the West of England through use of our non-invasive ventilation care bundle
364
mothers have been prevented from getting a surgical site infection through our PreCiSSion programme
£1.3 million
estimated savings to the NHS through our PReCiSSIon programme
Challenge
Surgical site infection (SSI) is a wound infection following an invasive surgical procedure. SSIs account for 14.5% of all hospital-acquired infections in the UK.
Caesarean birth is one of the most common surgical procedures but most trusts are unaware of their caesarean SSI rates. Local spot audits indicated SSI rates of up to 18% in the West of England.
SSIs can have a huge impact on the wellbeing of mothers, as well as their ability to look after their child. The need for antibiotics can also affect breastfeeding and bonding. Scarring following infection can increase complications of any future caesareans.
Approach
The PreCiSSIon programme (Preventing Caesarean Birth SSI across the region) supported all six hospitals and maternity units to reduce SSIs following caesarean births by introducing an evidence-based care bundle of four elements.
We worked with Cemplicity to digitise the standard UKHSA tool for identifying SSI at 30 days post-surgery. All mothers received a digital questionnaire, making it easier for them to provide feedback following surgery.
The care bundle was introduced in all units to help prevent SSI, and data-enabled risk factors for infection were evaluated so that specific interventions could be targeted and tracked. The data showed that women with a higher body mass index (BMI) at booking have an increased risk of an SSI, so we implemented specific interventions for this group.
Result
Between November 2022 and March 2025, we have analysed SSI data from 9,600 women. Across the West of England, SSI rates following caesarean births fell from 18.5% before the launch of PReCiSSIon to 13.3% by March 2025.
Modelling demonstrates we helped prevent 364 mothers from developing an SSI, representing an estimated cost saving to the NHS of up to £1.3 million.
Patient feedback has also led to specific interventions to help improve patient experience.
Challenge
Non-invasive ventilation (NIV) can be an effective way to support a patient’s breathing when they have type two respiratory failure, helping get more oxygen into their body and clearing carbon dioxide.
However, while there has been a slight improvement in recent years, mortality rates for patients receiving non-invasive ventilation (NIV) in England remain higher than in many other countries.
Approach
Through our Improving NIV Care programme, we have successfully worked with all six hospitals across the West of England to introduce a standardised ‘NIV 5’ care bundle, based on the British Thoracic Society’s quality standards.
We supported introduction of the care bundle with quality improvement (QI) approaches and tools to ensure that the right support is given to clinicians.
Result
Mortality rates after implementation of the NIV 5 care bundle have dropped from 28% to 22% across the West of England. Modelling indicates that this has saved 165 lives to date.
Clinical colleagues from the participating trusts have established a network for sharing learning and resources. More widely we have seen improved staff confidence and competence in the correct application of NIV treatment.
The programme completed in autumn 2024. We will share evaluation report later this year.
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