Mixed methods evaluation of The RealBirth Workshop at Epsom and St Helier Hospitals

How we worked with the organisation

Following a previous evaluation of implementation at East Kent Hospitals, this evaluation of The Real Birth Company at Epsom and St Helier Hospitals, funded by SBRI Healthcare, aimed to explore the impact of the Workshop on expectant mothers, staff, and the wider health system.

Using a mixed methods approach, looked to understand acceptability amongst staff and users, impacts on outcomes for mother and baby, and economic and environmental benefits.

Activities undertaken to perform this evaluation included development and deployment of surveys and undertaking of semi-structured interviews, as well as quantitative analysis of Workshop usage data and trust outcome data.

Particular areas of focus included health inequalities and environmental analysis, as well as health economic cost-benefit analysis, aiming to expand the evidence base behind the impact of The RealBirth Workshop.

What were the impacts of this evaluation? What impacts did the evaluation show?

The Workshop was welcomed by staff who considered that the Workshop allowed them to offer more tailored care (78%), and improved patient outcomes (85%). Staff described the Workshop as “a lifeline”, and “reassuring”, with content that is “really good quality, helpful information”.

Workshop users were also appreciative of the Workshop, finding the content easy to understand (85%), the software easy to use, (85%) and the Workshop helpful (100%).

The Workshop may have reduced health inequalities in terms of ethnicity, with usage rates among those of Asian and Asian British backgrounds at 26% compared to a wider population of 18%, a statistically significant difference (z = 4.94, p < 0.05).

Analysis of carbon savings identified of over 16,000 tonnes of CO₂ equivalent.

Comparison of outcome data between Workshop users and non-users, and demonstrated improvements across a range of metrics, including reduction in length of stay by 0.13 days, post-partum haemorrhage (-2.6%), perineal tears (-1.6%) and pre-eclampsia (-0.2%). There were nonetheless increases in rates of unplanned caesarean section (+1.1%), inductions and epidurals (+0.9%), and episiotomies (+1.5%).

These benefits combined to suggest a return on investment of between £1.60 and £2.00 for every £1 spent, although emerging data on additional benefit streams suggest there is potential for the Workshop to demonstrate value for money.

Financial value

£4,285

Number of trees

328

Miles driven in a car

60,945

What value did this evaluation add?

Through the evaluation, we developed a range of recommendations to drive greater uptake in the future, as well as learnings in relation to data linkage and normalisation which can be carried forward to future analyses, and introducing a measurement technique for assessment of reduction in anxiety amongst users.