Learning from the Early Notification Scheme –
Out of Programme Experience to Enhance Risk Management Training for Future Maternity Leaders
Dr Lucy Maudlin, Dr Katherine Barton, Dr Alexandra Lu, Dr Alex Crowe and Professor Tim Draycott
NHS Resolution Early Notification Team (Clinical), London –  Contact: lucy.maudlin@nhs.net 

Objective

Families using maternity services and staff working in maternity care value safety above all. The NHS remains an extremely safe healthcare system, but avoidable errors still occur. Designing and delivering safe and inclusive maternity care requires an understanding of system level NHS function.  The national fellowship programme at NHS Resolution enables obstetricians, midwives and neonatologists to take a year out of practice to acquire this system level experience to become future leaders. Insights into national learning strategies including legal issues can be difficult to obtain during specialist training. Taking the next step to become a clinical leader in maternity requires surmounting new challenges for the clinician to take in terms of managing risk responsibilities, event investigation and learning from adverse outcomes. Exposure to high level risk management and a greater understanding of the national maternity risk sphere of work and collaborations is crucial in becoming a good maternity leader.

Method
The national fellowship programme for NHS Resolution provides opportunities for clinicians to join the Early Notification team in
proactively investigating specific brain injuries at birth for the purposes of determining potential liability There is a huge range of
responsibilities and learning opportunities Work includes in depth clinical and multi disciplinary reviewing of cases which fulfil Early
Notification criteria for term babies with brain injuries[ 1 The fellowship allows the clinician to develop close educational
relationships with legal and clinical specialists not readily available outside of this programme Significantly, the fellowship allows
development of specific learning plans for trusts and regions which have encountered difficult outcomes for some of their families
and also allowed for participation in national NHS England initiatives

Results
The General Medical Council and the Royal Colleges determine that time out of training
should “enhance clinical experience 4 especially highlighting areas more difficult to
access in training programmes Understanding and working alongside different
stakeholders in maternity has enabled all the current fellows to offer insights in their
clinical and leadership work that would be difficult to find outside of this role Fellowship
experience can help ensure the clinician is “equipped to undertake leadership roles
where the focus is on improving quality” as desired by the Government for future
healthcare leaders 5 and working at a national level is a unique chance to contribute to
improving outcomes 6 Significant understanding of data extraction and analysis is
learnt development themes of learning to take back to affected teams to improve future
care Other fellowship programmes from anaesthesia, surgery, care of older people and
a Quality and Safety programme in Scotland resulted in creation of peer networks,
increased academic output and “career changing benefits” from the fellowships

Conclusion
Experience
of the NHS at system level is essential for future maternity leaders and there should be
consideration of this type of learning out of training for all trainees wishing to expand their experience Clinical
expertise, leadership and knowledge of maternity services are all improved through these opportunities,
allowing fellows to take their knowledge with them back into clinical practice and improve care in their future
posts