The power of collaboration
Four Trusts unite in Baby Friendly journey
The Power of Collaboration
How a culture of collaboration enhances implementation of the Baby Friendly standards
A case study by the Baby Friendly Initiative
Improving outcomes in care related to breastfeeding and infant feeding for babies, their mothers, parents/primary caregivers and families requires a team effort. This case study showcases the important benefits of a collaborative approach to implementing the Baby Friendly standards and demonstrates how working together across teams and Trusts fosters a supportive and empowering environment for professionals involved in infant feeding.
This case study is based on interviews conducted between January 2023-January 2024 with Baby Friendly Leads working in the SHIP Local Maternity System (LMS) which is comprised of four NHS Trusts across Southampton, Hampshire, Isle of Wight and Portsmouth.
The SHIP LMS collaborative approach: Key elements
What sets this case study apart is the shared workstream approach by the SHIP LMS to fulfil obligations set out in the NHS Long Term Plan around implementing the UNICEF UK Baby Friendly Initiative standards in order to improve care for babies, their mothers and parents/primary caregivers. To date, all maternity units in the partnership have achieved UNICEF UK Baby Friendly Initiative Stage 2 accreditation.
Enhanced implementation structures
A funded offer by NHS England enabled the establishment of robust implementation structures across the four Trusts which resulted in economies of scope and scale. These include:
- A Lead to coordinate cross-collaboration
- Infant Feeding Leads within each Trust with dedicated time to steer implementation of the Baby Friendly standards
- A steering group comprised of Baby Friendly Leads, Baby Friendly Guardians and senior Trust management
- A Local Maternity and Neonatal System infant feeding group comprised of 60 interdisciplinary representatives across infant feeding, senior management, health visiting, neonatal, public health, Maternity Voice Partnership, and more.
The implementation structures resulted in a range of outcomes across the Trusts including:
- Rapid and effective roll out of high-quality training programmes
- Standardisation of knowledge, practice and skills leading to consistent approaches in care
- Increase in knowledge around regional support opportunities for service users
- Co-development of resources and guidelines
- Opportunities to critically review practice
- Increased awareness of key projects by senior leadership.
Camaraderie and team spirit
The collaborative approach also fostered a sense of teamwork that extended beyond individual Trusts. With mutual goals and shared values, the initiative encouraged a sense of camaraderie among professionals.
“Peer support creates camaraderie across the Trusts. We have dedicated time to undertake the role, review audits, deliver education and develop action plans.” – Infant Feeding Lead
“We’re aiming to mirror weight loss guidelines across SHIP Trusts so when doctors rotate between hospitals, the supplementation, calculations, and flow charts are consistent. This means families get consistent information and care.” – Infant Feeding Lead
This collective spirit helped to overcome challenges and create a more positive working environment.
There is a cultural change; people are listening and engaging at a higher level.
Shared training, learning and resources
Collaboration across the four Trusts supported valuable knowledge exchange. For example, the shared delivery of training enabled effective resource deployment, the ability to draw upon a wider range of expertise when designing and delivering the curriculum, and consistent practice.
Between November 2021-December 2023, 913 staff were trained in the Baby Friendly standards. Training is delivered virtually by a minimum of 2-4 Infant Feeding Leads. This supports a range of teaching methods and limits the risk of cancellation due to staffing issues. Trainers debrief after each session and use audit results to inform updates to the programme.
“Training would be cancelled if it occurred at service level and trainers were off sick or pulled clinically. We’ve not had to cancel any training days.” – Infant Feeding Lead
“With four trainers we can draw on a variety of skills and participants benefit from a variety of voices. It keeps it engaging, with new energy throughout the day.” – Infant Feeding Lead
The collaborative approach has also enabled a more systematic and timely response to the training of medical staff. For example, joint investment in Baby Friendly’s e-learning packages has enabled medical staff to better understand their role in supporting the Baby Friendly standards. Across some Trusts, medical staff also support training by monitoring staff completion and creating bespoke resources.
Shared monitoring and evaluation support accountability
A shared approach to monitoring and evaluation has been effective in driving accountability across the Trusts. A monthly review of data by the Trust board helps to share insight and good practice. Infant Feeding Leads described this as generating ‘healthy competition’ between Trusts and being of particular benefit to those smaller in size.
“It’s a small unit with limited staff, which can feel isolating. Opportunities for collaboration and to discuss challenges and work together on policies are beneficial.”– Infant Feeding Lead
Effective monitoring enables Trusts to have a clearer understanding of key indicators and to compare progress across services:
“Skin-to-skin rates have been above 90% for a while. When other leads asked about strategy, I explained our focus on caesarean sections. I made videos on the microbiome and how that can affect future health – staff have just loved them. We are doing such powerful work. Doing it together has reached that wider audience.” – Infant Feeding Lead
Impact of collaboration on outcomes: Embracing a cultural shift
The results of the SHIP LMS collaborative approach are compelling and point to a strong sense of empowerment, confidence, job satisfaction and a coordinated effort to improve breastfeeding rates and care for families.
Whilst maternity and neonatal units within the SHIP Trusts continue to experience many of the challenges confronting units across the country, a collaborative approach has enabled systematic and considered implementation of the Baby Friendly standards and has supported a clearer focus on the transformative potential that can result from engaging in the Baby Friendly programme – including improved breastfeeding rates and provision of care.
For the SHIP LMS, this has resulted in a cultural shift across the four Trusts which has positively impacted outcomes for service users:
Breastfeeding initiation rates have improved, and we are focusing on breastfeeding at discharge. We have an educated workforce, and we are working to Stage 3, where we will see the biggest changes because we are auditing parents and embedding practice.
Lessons learned
This case study offers unique insight into the benefits of a supportive and collaborative collective environment for healthcare professionals working to implement the Baby Friendly standards. By working together through a unified approach, the SHIP LMS fostered a sense of camaraderie and knowledge exchange which supported a more systematic and timely approach to resource development, training, monitoring, evaluation and more. This was supported through the allocation of sufficient time and resources required to support implementation of the standards, as well as buy-in from senior leadership across the four Trusts. The findings of the case study offer a strong case for the power of collaboration in driving meaningful change for babies, their mothers, parents/primary caregivers and families when implementing the Baby Friendly standards.
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