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Table 4 Thematic structurea

From: Transformational Change in maternity services in England: a longitudinal qualitative study of a national transformation programme ‘Early Adopter’

Best rules

Blend designated and distributed leadership

Establish feedback loops

Attend to history

Engage physicians

Involve patients and families

Maternity transformation policy elements

Choice and personalisation


Safer care

Perinatal mental health


Neonatal care

Multiprofessional working

Electronic patient record

Cross boundary working

Payments, personalised maternity care budgets

The transformation programme

Structure and organisation

Funding and resources

Targets and vision

Local innovations

Support and sharing learning

Capacity and time to transform

Use of theory and evidence

Approach to health inequalities

Interdependencies and uncertainty


  1. aIncludes themes relating to the Best rules, and additional themes from the wider evaluation, which are not reported in this paper