Perinatal Equity and Anti-Discrimination Programme Evaluation

What is the Perinatal Equity and Anti-Discrimination Programme?

The Perinatal Equity and Anti-Discrimination Programme (PEADP) is an NHS leadership programme to tackle racism and discrimination in maternity and neonatal services. The programme is designed to help service leaders identify, understand and challenge racism, discrimination and cultural bias – both in daily interactions between people and in the way that organisational processes, procedures and ways of working can disadvantage certain racial groups. The PEADP involves different types of activities such as:

• reviewing of patient data to understand differences and inequalities in care;

• listening to the experiences of staff, families and communities;

• anti-racism training to develop the knowledge, confidence and skills to act;

• support to implement changes into practice.

Ultimately, the PEADP aims to address racial inequities in maternity and neonatal care and to improve the experiences of racially minoritised women, families and staff. It is developed and delivered by NHS England in partnership with the NHS Race and Health Observatory, Advancing Quality Alliance (Aqua), Inspiring Hope and White Ribbon Alliance UK. It is being rolled-out nationally to NHS Trusts in England between March 2026 and September 2027 (expected).

How is the evaluation structured?

This is a mixed-methods rapid evaluation with four work packages.

Work package 1: Scoping

Scoping work was completed between March and June 2026. It involved 15 interviews, 3 workshops and multiple co-design activities with NHS England, PEADP implementation partners, NHS staff and patient advocates. It also involved a rapid review of academic literature to learn about other anti-racist leadership programmes. Scoping work helped us to understand the PEADP and how it is expected to work. It informed what questions this evaluation will focus on and how the evaluation will be carried out. The literature review will continue beyond the scoping phase.

Work package 2: Case study work

This evaluation aims to find out how the PEADP works in different types of NHS Trusts, including how the PEADP is delivered in different Trusts and how it is experienced by NHS staff and patient advocates. In our case study work, we will collect data in three NHS Trusts.

We will organise focus groups, or group discussions, with the PEADP implementation partners. We will also organise interviews and focus groups with NHS leaders who take part in the PEADP; with other NHS staff working in maternity and neonatal services; and with patient advocates who work with women and families in the community. Finally, we will send a survey to NHS leaders and other maternity and neonatal service staff to capture a wide range of perspectives and experiences.

Work package 3: Equity and inclusion

We will seek input, advice and guidance to put the priorities, experiences and wellbeing of families and staff with lived experience of racism and discrimination at the centre of this evaluation. We will seek support from different groups and individuals, including Cysters. Cysters is a charity committed to breaking down the barriers that create menstrual, mental, maternal, and menopausal health inequalities. Our partnership with Cysters will help put the interests of families and communities central throughout the full evaluation.

We will also organise quarterly meetings with two advisory groups. The service user advisory group consists of mothers who recently used maternity services and patient advocates helping families to use these services. The professional advisory group consists of people with professional experience in maternity and neonatal care, workforce advocacy, community advocacy, and research on racism and discrimination.

Finally, we will organise quarterly workshops with the evaluation team to reflect on diversity, inclusion, and equity within the evaluation. This work is guided by the NIHR Research Support Service (RSS) Research Inclusion Toolkit and the Health Inequities Assessment Toolkit.

Work package 4: Analysis and shared learning

Analysis of the data we collect across NHS Trusts is an ongoing process that is refined over time. For each NHS Trust, we will compare and combine insights from different groups (service leaders, other NHS staff, and patient advocates). We will then compare insights between NHS Trusts. We will share and discuss early insights with our advisory groups, the national PEADP team, implementation partners, and NHS sites. Shared learning early on can help us to strengthen evaluation findings and outputs. It can also help policymakers and NHS staff to make informed decisions about the future of the PEADP and similar anti-racism programmes.

Why does this evaluation matter?

Evidence from MBRRACE-UK shows that the experiences of maternity and neonatal care are not equal across women and babies with different ethnic backgrounds. In fact, babies and mothers of Black, Asian, or mixed-ethnicity are about twice more likely to die during pregnancy or birth than White mothers and babies. These inequities are driven by institutional racism and discrimination – which the Baroness Amos' review (2026) identified is a critical safety issue in maternity and neonatal care. The PEADP aims to address these issues through leadership. However, there is limited evidence on how anti-racist leadership programmes, like the PEADP, should be delivered to achieve positive effects both in the short and longer-term. This evaluation focuses on the delivery and early experiences of the PEADP while it is being rolled out to NHS Trusts in England. These insights could inform time-critical decisions about the future delivery of the PEADP and similar anti-racism programmes in the NHS.

Who is leading the evaluation?

• Study co-leads: Dr Beck Taylor and Dr Michelle Fisher

They are both experienced maternity and inequalities researchers with roles in the NIHR Maternity Disparities Consortium

• Community lead: Neelam Heera-Shergill

She is CEO of Cysters, a grassroots charity that tackles menstrual, mental, maternal, and menopausal health inequalities.

• Evaluation team: Dr Sophie Spitters (project manager) Fifi Olumogba (research analyst), and Helen Dent (administrator)

 Findings and outputs

Final findings will be published in a summary report (monograph) at the end of the evaluation and shared with policymakers and practitioners in perinatal care.

Early findings will be shared with our advisory groups, the national PEADP team, implementation partners, and NHS case study sites via webinars and slide deck before the final report is published.

Additional outputs will be agreed with our advisory groups and may include a summary report for women and families, infographic, conference presentations, and academic publications.

Project duration

The main evaluation will run for 12 months, from August 2026 to June 2027, following a four-month scoping phase completed between March and June 2026.