Board to Ward March 2026
In March’s Board to Ward we share three highlights:
How we have improved care for our most vulnerable babies
How do we know we’re giving patients the best possible care and what do we do when the evidence suggests we’re not? Today our Board leaders heard an example from a team that has driven improvement for our youngest patients, babies admitted to our Neonatal Intensive Care Unit (NICU).
Consultant Neonatologist Dr Mel Philipps said there is plenty that we do in Plymouth’s NICU and transitional care to be proud of, where we are national leaders. But she shared the story of an instance where we were an outlier for the wrong reasons and how her team learned from that and drove improvement.
Dr Philipps described the National Neonatal Audit Programme (NNAP), which is a national programme that neonatal units submit data to about the care they provide. The audit programme looks at a number of measures for example outcomes of neonatal care, maternal breastmilk feeding and parental partnership in care. One of the measures assessed in the audit is the use of non-invasive breathing support for babies born at less than 32 weeks gestation during the first week of life as an alternative to invasive ventilation (via a trachial tube).
For many premature babies the avoidance of invasive ventilation is a good thing. The team in Plymouth’s NICU were surprised when an alarm was triggered by the data they submitted for the calendar year of 2024. This showed that only 25% of babies admitted to Plymouth’s NICU received non-invasive support compared to an average of 52% nationally, meaning 75% of babies admitted to the NICU in Plymouth that year were invasively ventilated at some point within the first week of being born. Although intubation is sometimes necessarily, Plymouth was an outlier here with high numbers of pre-term babies being intubated.
Dr Philipps explained that as a clinical leadership team they felt this measure was really important as an indicator of good care and they wanted to be able to say to families: “We are doing the right thing for vulnerable babies.”
The multi-disciplinary team, led by Dr Mel Philipps, Dr Alex Allwood and Mrs Diane Keeling (Consultant Practitioner), checked the data (some errors had been made in inputting) and reached out to other NICUs which were high performing for this measure to learn from them. They used a Quality Improvement approach to look at the issue and focus on safely achieving higher rates of non-invasive ventilation. The measures included better data accuracy and quality, a framework for team approach to respiratory care for premature babies and improving the availability of non-invasive respiratory support in the delivery room. One of the changes involving all of the team supporting premature babies at and around the time of birth focused on introducing a special piece of equipment (CPAP) in the delivery room as an alternative to intubation, where appropriate, and making sure all colleagues were well trained and confident in using this.
As a result of using a Quality Improvement approach, the Plymouth NICU team have achieved improved rates of non invasive ventilation for 2025 (50%) and the beginning of 2026 (>60%). The team will continue to focus on improving care and helping other teams by sharing their learning and experience. The Board thanked the NICU team for their work.
Delivering high quality care
Stroke thrombectomy service
February saw the 1st patient in the peninsula receive specialist treatment for stroke in the middle of the night. The specialist mechanical stroke thrombectomy service, which is already one of the best in the country in terms of access for patients, has improved by expanding from being a day only service to now being a full, around-the-clock, 24/7 service.
Prior to February, around 200 patients per year benefited from thrombectomy. With this change, the number of patients benefiting from this specialist treatment which helps people recover from stroke faster and better, is likely to double. Stroke thrombectomy is a specialist service which is offered in 26 specialist centres across the country and these specialist centres work together with local hospitals to care for patients.
University Hospitals Plymouth NHS Trust is the specialist centre in the peninsula working with colleagues at Royal Devon University Healthcare, Torbay and South Devon NHS Trust and Royal Cornwall Hospitals NHS Trust to care for patients. Specialist centres undertake the interventional procedure and then patients are returned to their local hospitals for their recovery. These are early days but together, clinical teams across the peninsula are working hard to provide a comprehensive, robust service to patients suffering from a stroke emergency.
Environment
The environment we deliver care in has been rated very highly by patients. A recent Patient-Led Assessment of the Care Environment (PLACE) assessment rated the Condition, Appearance and Maintenance of our Derriford Hospital site at 99%. PLACE helps NHS trusts understand how well they are meeting patient needs and where improvements can be made. All of our sites, including Tavistock and South Hams Hospitals, scored above the national benchmark for Privacy, Dignity and Wellbeing. We also exceeded the national average in five areas: Cleanliness (98.6%), Privacy, Dignity and Wellbeing (93.7%), Condition, Appearance and Maintenance (99%), Dementia (89.9%) and Disability (89.1%). These results reflect the dedication of our Estates, Facilities and clinical teams, who work tirelessly to maintain safe, clean and welcoming environments.
Progress in Maternity
We entered the national Maternity Safety Support Programme (MSSP) in April 2024, following a diagnostic review triggered in response to concerns requiring strengthened external oversight. Since entry we have undertaken a wide-ranging Maternity and Neonatal Improvement Programme, incorporating 5 major workstreams: equity of care, safety culture, digital and estates infrastructure, workforce development, and organisational culture. This structured programme reflects our commitment to achieving measurable, sustainable improvement. In January 2026 we received confirmation that we had met the nationally defined conditions required to exit the programme, which is great news.
Ending Corridor Care
Our number one patient safety priority for this year (2026/27) is to eliminate corridor care. Corridor care is unacceptable. It affects the dignity of patients being cared for and it affects the dignity and morale of staff caring for patients in areas that are outside of normal bed spaces.
NHS England now requires trusts to record any instance where a patient spends 45 minutes or more in a clinically inappropriate area of the Emergency Department or on a general and acute ward, with the threshold planned to reduce to 30 minutes in 2027/28. We are implementing the new national definition across our Emergency Department and inpatient areas, strengthening real-time data capture and ensuring visible clinical and executive oversight. Our existing programmes, such as optimising front door pathways, improving ward processes to reduce unnecessary boarding, and working closely with system partners on discharge and flow, align strongly with NHS England’s expectations.
We welcome the emphasis on transparency, leadership accountability and staff experience. We have already begun work which has reduced the number of patients being cared for in corridors and other clinically inappropriate places. We are holding a Corridor Care Summit next month with colleagues and patients to co-design how best we eliminate corridor care and then move into co-delivering how we deliver this sustainably.
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