The national Maternity and Neonatal Perinatal leadership and culture programme aims to improve the quality of care and experiences of women, babies and families.
HIEM is working across the East Midlands to support teams to create the conditions for a positive culture of safety and continuous improvement.
In this blog, Ellen Cutler, Neonatal Matron at Nottingham University Hospitals NHS Trust, reflects on how the programme has changed their service.
When I reflect on the past few years within Nottingham University Hospitals’ Neonatal Service, one word comes to mind: change. Our teams have navigated significant structural and operational shifts moving from two separate sites to a newly integrated, larger unit at Queens Medical Centre. While these changes were essential for improving efficiency and patient care, they brought challenges that tested our resilience and adaptability.
Alongside this transformation, maternity and neonatal services faced intense external scrutiny. Regulatory reviews and public attention added pressure to an already demanding environment. It became clear that if we were to thrive, we needed more than new processes we needed a strong, positive culture that united us.
Why Focus on Culture?
Culture shapes how we treat each other, how we respond under stress, and ultimately, how we care for families. During times of upheaval, behaviours can drift, and clarity can be lost. I wanted to ensure our staff felt valued, supported, and empowered to deliver the best care possible. This wasn’t just about morale it was about creating a safe, collaborative environment for both staff and patients.
What We Did
We started by co-developing roles and responsibilities for Band 7 nurses, giving clarity and direction to our clinical leads. Alongside this, we introduced a Behavioural Charter, setting expectations for how we interact and resolve challenges respectfully.
To embed these principles, we created Culture Action Plans and launched initiatives that celebrate diversity recognising that our team represents many cultures and traditions. From Diwali to Eid to Christmas, these celebrations have brought joy and connection to our unit.
Another cornerstone has been the introduction of Professional Nursing Advocates (PNAs). Every new nurse now has access to PNA sessions, ensuring they feel seen and supported from day one. These advocates, alongside psychologists, provide resilience-based clinical supervision a lifeline for staff wellbeing.
The Impact
The results speak volumes. Staff turnover has dropped to less than one per month, and feedback from families shows they appreciate the inclusive, celebratory atmosphere. Our “You Said, We Did” boards show changes inspired by them, reinforcing trust and transparency. Most importantly, individuals feel recognised not just for their work, but for who they are.
Lessons Learned
Culture change doesn’t happen overnight. It takes time, consistency, and listening. Too many changes at once can overwhelm, so we focused on small, meaningful steps. Empowering staff to challenge poor behaviours and giving them a voice has been vital.
Looking Ahead
We’re committed to sustaining this work continuing cultural celebrations, maintaining clarity in roles, and valuing our staff and being shortlisted for an NUH Honours Award is a testament to the progress we’ve made, but the journey continues.
If you’d like to learn more or share ideas, I’d love to connect: