Introduction:
Keeping every new baby with their mother after birth is an undisputed international goal. Neonatal transitional care is an increasingly important concept whereby babies with additional care requirements are supported to stay with their mothers who remain their primary care givers as opposed to being managed in a neonatal unit. Successful implementation has the potential to prevent thousands of avoidable neonatal admissions, reduce length of stay by engaging and empowering parents earlier and reduce postnatal readmissions through education and proactive risk identification. Essential to the successful implementation of NTC however is effective joint working between midwifery, neonatal nursing and paediatrics, and training of all frontline staff to ensure everyone caring for these families have the required knowledge, skills and confidence to deliver this service and keep these babies safe. We describe a joint-led neonatal and midwifery NTC educational program which is the first of its kind to be developed and delivered nationally across England to our knowledge, aimed at equipping staff working in postnatal clinical environments with the skills required to facilitate the rising demand for delivering NTC services.

Material and Methods:
The project involved analysing the current learning needs of frontline staff and creating a tailored digitally delivered NTC study day in partnership with the multidisciplinary team. This was subsequently delivered to 295 frontline healthcare professionals from across 19 NHS trusts. Staff’s self-reported confidence in managing a range of NTC scenarios were recorded before and after the intervention, whilst waiting for training in a delayed intervention group to assess for confidence changes without intervention, and 12 months after the intervention to assess for retention of benefit.

Results:
A total of 295 healthcare professionals were trained from 19 NHS trusts across England through 6 NTC study days run between January 2022 and February 2023. Overall confidence in working in NTC increased by +1.8 points on a 5-point scale. Learning needs were met or exceeded for 99% of attendees and participants ranked the usefulness of the training day as an average of 9.4 on a 10-point scale. Across all participants where pre and post course surveys were completed in full (n=198), the scenarios where the intervention saw the greatest increase in confidence ranking included managing babies with neonatal sepsis (+2.2), being first on scene to a sick neonate (+1.8), preventing postnatal collapse (+1.8), managing babies with nasogastric (NG) tubes (+1.8), managing late preterms (+1.7) and managing babies with underlying paediatric conditions (+1.7). Of the 54 participants followed up 1 year after intervention, confidence levels for managing all NTC scenarios remained within a +/-0.3 points average on a 5-point scale to the post course results, and 100% felt such training should be mandatory for all frontline staff looking after babies requiring NTC.

Conclusions:
Taking a multidisciplinary approach to designing and delivering training interventions for areas where integrated working is crucial to care is essential. A targeted jointly delivered NTC study day can be an effective tool for increasing frontline staff’s confidence in safely managing these babies and should be mandatory for all staff working in postnatal clinical environments.