Sharing best practice in reducing caesarean rates

The journey –

This year-long programme looked at caesarean rates across the NHS south central region in order to identify reasons for variation in practice.  The programme team worked directly with five maternity units whose caesarean section rates were below a benchmarked norm.  In each case they undertook an in-depth investigation into why they were performing particularly well.  These investigations were presented as case studies on best practice and shared with all participating trusts at networking events.

Alongside the case study investigations, the team developed a regional normal birth pathway.



All the units in the programme were able to work on areas of improvement in practice and by the end of the programme everyone was able to share examples of specific improvements.  The process of identifying and sharing best practice reduced variation and raised standards across the region.  A final report summarised the learning from the programme.

As well as driving up clinical standards, the team also noted a maturing of attitudes and behaviours as a result of the programme.



Patient setting

In-patient   X Out-patient Community based
Mental health Chronic illness Cross-systems


Clinical area

Staying healthy Maternity and newborn   X Children and young people Acute care
Planned care   X Mental health Long-term conditions End of life


Information, tools and techniques used

The programme used an appreciative inquiry approach, focussing on best practice.  It was led by a clinical director.



The programme covered maternity units in the NHS South Central region.



This was a year-long programme which took place in 2010 – 2011.

Contact details and further information

Nicky Mason, Midwife Consultant:

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