PERIPrem

The solution

Perinatal Excellence to Reduce Injury in Premature Birth (PERIPrem) is a unique care bundle of 11 evidence-based interventions for mothers and preterm babies that demonstrate a significant impact on brain injury and mortality rates amongst babies born earlier than 34 weeks.

The bundle takes a co-design and co-production approach, rooted in Quality Improvement (QI) methods.

Our work in partnership

PERIPrem was launched in 2020 by Health Innovation South West and Health Innovation West of England in partnership with South West Neonatal Network.

Our evaluation on the barriers and enablers to the implementation of PERIPrem was published in BMJ Open Quality in 2022.

Our evaluation on the barriers and enablers to the implementation of PERIPrem has been published in Research Square. Maternity, neonatal and obstetric staff reported capability, motivation and opportunity were the three main enablers to implementation. 

Since its successful implementation and evaluation, PERIPrem has been adopted into national perinatal pathways, recognised in several national reports, and is being adopted by other health innovation networks. 

In 2025/26 Health Innovation South West continued to engage and work with our pre-term birth leads across the region on maintaining and improving bundle elements. This has been enabled by clinical lead trust visits, SIMs, and supporting education sessions, including perinatal QI, data reviews, and shared learning opportunities across the region.

PERIPrem work in the South West has been a brilliant example of collaborative improvement. Opportunities for QI training and shared learning have strengthened clinical confidence and consistency in delivering the bundle elements. [The] efforts have not only improved care but also deepened the region’s commitment to long-term, sustainable change.

Mary Leighton – Network Manager, South West Neonatal Network 

Our impact so far

PERIPrem is now six years old. Since its launch in the South West of England in 2020:

• The PERIPrem bundle and QI approach has increased the uptake of 11 interventions in 12 NHS Trusts across the South West, as well as improved perinatal team culture, according to an independent evaluation by Health Innovation South West published in BMJ Open Quality in 2022
• 26% more mothers with babies born prematurely in the South West received care interventions they were eligible for in the implementation period we evaluated, compared to before PERIPrem started
• 1,497 sets of staff resources have been downloaded (to June 2022)
• Patient resources translated into top 8 locally used languages
• Winner of Best National/Regional Project, British Association of Perinatal Medicine Gopi Menon Awards 2022
• Highly Commended in the Health Service Journal (HSJ) Patient Safety Awards 2021, in the Patient Safety Pilot Project of the Year category, and a finalist in the Provider Collaboration category of the main HSJ awards.
• Featured in NHS England’s Saving Babies’ Lives Bundle (2023, element five)
• Recognised in several national reports, including the House of Lords – Preterm birth: reducing risks and improving lives – Preterm Birth Committee.
• In 2024/25 alone, 329 families benefitted from receiving elements of the PERIPrem care bundle
• In 2024/25, neonatal units across the South West achieved, on average, the lowest mortality rate for babies born at less than 32 weeks’ gestation, and the highest rates of eligible mothers receiving antenatal magnesium sulphate – proven to prevent cerebral palsy in babies – and the highest rate of delayed cord clamping in England and Wales for the fourth year in a row*.

*As measured by the National Neonatal Audit Programme’s (NNAP) latest report, published in October 2024. 

PERIPrem is spreading countrywide: the bundle has been adopted across Wales, East Midlands and West Midlands, and is now in use in 46 maternity units. 

PERIPrem, as a QI project, has had the greatest impact I’ve seen in 10 years at Torbay and South Devon.

Dr Richard Tozer – Consultant Paediatrician, Torbay and South Devon NHS Foundation Trust