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This evaluation was a joint project between, the Perinatal Institute and 3 local units:

Birmingham Heartlands Hospital,
University Hospital Birmingham,
Sandwell and West Birmingham NHS Trust.

The findings of which were presented at a regional meeting in January 2012. At this meeting a decision was made to widen the pilot for three months across the West Midlands region to all diabetes maternity services who undertake the delivery of pre-conception counselling or services.

Project leads

Pat Brydon, Specialist Midwife, Perinatal Institute.
Sally Clifford, Specialist Midwife, Perinatal Institute.

The aim of the field trial was to assess the ‘user friendliness’ of the notes and whether the notes fulfilled the role they were intended to, i.e. clear, logical documentation of pre-conceptual care.


The trial started in October 2011.

30 sets of notes were issued, 10 to each site. The notes were issued to women who had pre-existing diabetes. The initial pilot ran for 3 months to ensure the notes were used for more than one consultation.

Each unit was issued with a supply of evaluation forms for health professionals. The purpose of these forms was to ascertain feedback from clinicians on the layout, progression and usefulness of the document for recording the care provision. This enabled them to provide feedback and make suggestions about changes they would like to see made to the document.

Each set of notes included an evaluation form for the women to complete, to comment on the information included in the document.


a. Health Professionals

Feedback was received from Diabetologists, Obstetricians, Midwives, Dietitians, Diabetes Nurse Specialists and Specialist Midwives and all the units who took part in the trial provided comments. The majority of the feedback was positive, most staff felt the notes were clear, displayed logical progression and they felt that the information for women was appropriate.

There were comments about who would provide the service and where the booklet would be stored (primary or secondary care setting) following the episode of care.

There was a significant number of suggestions for inclusion into the document.

b. Women

We received feedback from women who had pre existing diabetes and women who developed gestational diabetes.

  • The age range of the respondents was: 29 years – 42 years

  • Two thirds of the women had previously experienced a pregnancy

  • Over 50% of the women were new to the pre-conception service

  • The women who responded to the evaluation were from a variety of ethnicities.

The majority of the women felt the notes helped them be more involved with planning their care. They felt the booklet was useful to understand how to manage their diabetes in preparation for pregnancy. They felt the information was relevant although there were some comments requesting more information. All of them had read some or all of the information.  All the women thought the notes were a good idea.


The field trial of the notes was successful. It allowed us to confirm that the notes will fulfil the role they are intended for. It gave invaluable feedback to develop and improve the notes further.


Firstly we would like to thank all the women who participated in the pilot and completed questionnaires.
We would also like to thank all the health professionals who took part in the field trial, not only using the notes to record the care they gave but also taking time to complete the evaluation forms.

Pat Brydon, Specialist Midwife, Perinatal Institute.

This Site is Maintained by the Perinatal Institute