Graded Care Antenatal (GCP2A) assessment tool

About the tool

An evidence-based assessment tool to support expectant and new parents

The antenatal period and early years of a child’s life can have a profound impact on their future physical and emotional safety and wellbeing. It’s important that parents are given support to provide the best care for their developing baby and newborn infant¹.

Graded Care Profile 2 Antenatal (GCP2A) helps a range of professionals working with expectant parents to identify areas of strength and areas where they may benefit from support.

How it works

The tool is split into three sections. Each section uses a graded scale of 1 to 5 where 1 indicates no concerns and 5 indicates high concerns.

Sections 1 and 2 (Getting to know you and your pregnancy and Getting ready for baby) focus on the antenatal period, looking at the quality of consideration given to the developing baby. Section 3 (Now baby is here) is delivered during the postnatal period to review the quality of care in the early days of life.

The tool is based on Graded Care Profile 2 (GCP2) and includes areas of known risks that are linked to safeguarding concerns perinatally and in babies. It can help professionals build a picture to identify where concerns might emerge in relation to the impact on the developing baby. It can also be used as an indicator for potential safeguarding issues after birth.

Graded Care Profile 2 Antenatal has been piloted and tested for validity and inter-rater reliability. The results were positive so GCP2A can be used with confidence.

Ready to find out more?

If you would like to know more about Graded Care Profile 2 Antenatal, please email gcp2a@nspcc.org.uk.

Background and evidence

Graded Care Profile 2 Antenatal (GCP2A) builds on the GCP2 tool and was developed in response to requests from sites delivering GCP2 and Family Nurse Partnership (FNP) to develop an antenatal version of the tool. Our insights analysis also highlighted there was a gap in provision for an evidence-based tool for pregnancy and early years.

We designed the tool in collaboration with Dr Srivastava, who created the original GCP tool, and practitioners. We then worked with eight NHS trusts and local authorities to help us understand how effective the tool was.

Phase one: initial testing

Phase one aimed to find out how practitioners, parents, service leads and experts viewed and experienced the antenatal tool - and how we could improve it.

We approached practitioners and families for their views on the tool’s language, accessibility and usability. We asked how it impacted practitioners’ decision-making, how families found the process of being assessed, and how behaviour had changed as a result of the assessment. The findings from the phase one evaluation were reviewed in September 2022 and it was agreed the project should move to phase two.

Using the feedback from phase one and additional consultation with the practitioners, we developed an updated version of the tool for inter-rater reliability testing in phase two.

Phase two: inter-rater reliability

All tools should be exposed to inter-rater reliability testing. This tells us if the tool does what we want it to. It also demonstrates how close the results are when two individuals use the tool with the same family.

The validity and inter-rater reliability had positive results and GCP2A can be used with confidence by practitioners.

Read the report

> Read our report on the acceptability, validity and reliability of the GCP2A tool