Nurturing innovation

across the UK

to improve patient safety

in maternity





simple solutions

for better care


Grunge Texture
Grunge Texture


no more swabs left behind

Imagine yourself as a young couple, expecting your second child. Your baby is born healthy by emergency caesarean section. You are happy. Everyone is happy. But the recovery at home is a difficult journey. Constant pain, endless visits to the GP but no clear diagnosis. This goes on for 11 years.

Then one day a scan identifies a suspicious mass in your abdomen. Is it cancer? No, it’s a surgical swab left behind during that caesarean section 11 years ago.


My name is Francesca and I am a risk management support midwife at Imperial College Healthcare NHS Trust. We call these incidents never events. As the name suggests, a never event should never happen in the first place.  But they do. Nearly 500 never events last year, of which 51 involving retained swabs. Last year alone, the NHS paid out 2.2 billion pounds to settle clinical negligence claims.


My project is a modified design surgical swab. All swabs come in packs of five. I have simply added an anchoring point linking the five swabs together, making it impossible to leave one behind. It is a simple no tech product. I am also working to ensure that the packaging is environmentally sustainable.

Its simplicity is its strength.

Watch the project video at: https://youtu.be/9iwNZTHe4n4

Watch the story video at: https://youtu.be/IstLooLRgfs

Read the article: https://doi.org/10.12968/bjom.2021.29.6.310

Attend the BJM Annual Conference 2022. Join on March 29th:


77.7% (n=103) of the respondents
to the 
questionnaire (https://forms.gle/wXYmiSqxHSmST9cd7)
would be
in their clinical practice



100% (n=100) of the clinicians
who tested the prototype 
in simulation settings

would be
in their clinical practice

BJM Conference
29th March 2022 at 10.40

presentation of the SIMPLE SWABS project
at: https://www.bjmconference.co.uk/

Missed the BJM Conference?
Here is the recording:




Midwife in a Van emerged from the NHS England Clinical Entrepreneur Programme and continues its development through the support of Imperial Health Charity and Imperial College Healthcare NHS Trust.

Midwife in a Van aims to promote simple solutions for better care and to inspire other midwives to develop and implement innovations to make care safer for all women and their babies.

Midwife in a Van is committed to working in an environmentally and sustainable way, promoting inclusion, equality and diversity in line with the NHS Long Term Plan.

And about myself ... My academic background in Philosophy and Mathematical Logic has shaped my critical thinking; my professional experience in the private sector has trained me to deliver the highest quality services on time and within budget limits. My clinical skills as a midwife complete this unusual professional profile.


From Handover

to Takeover

Communication breakdown is widely considered to be a significant factor contributing to poor patient outcomes, with handover being a major risk point.

Moving from handover to takeover - meaning that the incoming member of staff, who is rested and fresh, is leading the information transfer may enhance the quality of information transfer itself.  Fatigue and lack of concentration are not unusual at the end of a long shift and they are known to have a direct impact on the accuracy of the handover process. Furthermore, the incoming member of staff is from the point of handover onwards professionally and legally responsible and accountable for the care provided.  It is, therefore, important that this change in responsibility and accountability is reflected in the handover process in clinical practice.

From handover to takeover is therefore a new and innovative approach to handover. Historically, research on handover has concentrated on the quantity and quality of the information transferred, moving gradually towards assessing the impact on information transfer of other quantifiable factors – such as the medium used (e.g. verbal versus written) or the environment (e.g. number of disruptions, like telephone calls), and exploring the behaviour of the person receiving handover. The proposed takeover model takes a further step to reflect the shift in emphasis and leadership from outgoing to incoming members of staff.

The high frequency of clinical handover means that even a small improvement could result in a big impact on clinical care provided.

Its simplicity is its strength


Read the article at: https://doi.org/10.12968/bjom.2020.28.3.156


thank you