Maternity teams at the Great Western Hospitals NHS Foundation Trust have introduced a pioneering safety programme that has drastically reduced infections.
In 2022, Health Innovation West of England (HIWE) funded the establishment of the PreCiSSIon Collaborative – a regional safety initiative targeted at reducing surgical site infections (SSIs) following caesarean birth.
An SSI is a wound infection following an invasive surgical procedure.
Digital SSI surveillance was established in five maternity units across the West of England by March 2023, meaning that data from over 9,300 women could be analysed.
Surveillance was achieved through a standard UK Health Security Agency questionnaire for SSIs, plus some additional questions, which was distributed to mothers post-surgery.
After surveillance was established, a PreCiSSIon ‘bundle’ was administered to mothers.
This included items already provided in the existing World Health Organisation SSI bundle, such as antibiotics.
But PreCiSSIon added four other evidence-based interventions, including a repeat dose of antibiotics if more than 1500ml blood was lost by the mother, and a wound protector for mothers with a body mass index (BMI) of over 40.
SSIs can make it very challenging for mothers to care for their new babies, and can affect bonding and breast feeding, due to antibiotics usually being required.
Through digital surveillance, direct patient feedback and continuous measurement PreCiSSIon succeeded in reducing SSI rates following caesarean births from a baseline of 18.5% to 13.3% by the end of the programme, across the region.
This is an equivalent of 364 mothers prevented from developing an SSI, and represents an estimated cost saving to the NHS of up to £1.3 million.
Swindon performed very well in terms of infection reduction, initially falling from 22 per cent to 14 per cent, and then stabilising at 11 per cent in August, September, October and November 2025.
The formal programme ended in March 2025, but implementation and monitoring continued over the course of last year.
Dr Lesley Jordan, the PreCiSSIon programme lead, and Lead Consultant Obstetric Anaesthetist at the Royal United Hospitals Bath NHS Foundation Trust said:
“We are delighted that the programme has resulted in preventing wound infection in a significant number of mothers, and the positive impact that will have had on their recovery.
“The programme has also enabled us to learn much more about the risk of developing a wound infection and we continue to work on specific interventions to lower the infection rates further.
Dr Anita Sinha, Consultant Obstetrician and Gynaecologist at GWH, said: “It would not have been possible without the women supporting it.”
She said that the fact the women took the time to report back to the programme, was a credit to them.
Kathryn Owen, from Matron Maternity and Neonatal Inpatient Services at GWH, said she was really proud of the programme, and the impact it has had.
The collaborative was selected as a winner of the 2025 OneTogether Awards, and the teams will give a presentation at the OneTogether UK Expert Conference 2026 on March 12.
The OneTogether Awards celebrate UK healthcare professionals and teams for innovation in reducing SSIs, from smaller practice changes to large-scale improvement programmes, and for sharing best practices across the surgical pathway to enhance patient care.
“We are really excited to be presenting our work at the national One Together event. We hope to gain interest from other trusts and systems and encourage spread of the programme,” said Dr Jordan.
