PremPath: Improving the optimisation and stabilisation of the preterm infant

This is a research project funded by the National Institute for Health and Care Research Policy Research Programme (NIHR204242) between April 2023 and June 2025. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The project was a collaboration between the University of Leicester and Bliss charity. The Principal Investigator was Professor Nicola Mackintosh and the Co-Investigators were: Professor Natalie Armstrong (City St George’s, University of London); Professor Carolyn Tarrant (University of Leicester); Professor Elaine Boyle (University of Leicester); Dr Penelope McParland (University Hospitals of Leicester NHS Trust); Josie Anderson/ Beth McCleverty (Bliss) and Thomas Padden (Parent representative). The Researchers were Dr Julie Roberts and Dr Janet Willars. The perinatal optimisation pathway brings together a number of evidence-based interventions to reduce the risk of neonatal death and associated preterm morbidities. This project was commissioned to examine how the pathway is working in practice. We aimed to explore how multiple clinical teams work together to make decisions about the optimisation and stabilisation of preterm infants and to explore the experiences of staff delivering the pathway, and parents and families receiving care. We took a qualitative approach, firstly conducting scoping interviews with 40 staff (Patient Safety Collaborative workstream leads and regional leaders) working in twelve of the fifteen regions in England. We then purposively selected four case study sites for our ethnographic enquiry, conducting 137 hours of observations, 90 informal interviews, 29 staff interviews and 40 interviews with parents of preterm babies.