National paediatric complex care governance institute

Advancing Excellence in Children's Complex Care

A national institute providing paediatric-specific governance, standards, and system leadership to strengthen the safety, quality, and accountability of children's complex care.

Focus Children's complex health needs
Scope Home, school, hospice, respite & community
Launch National rollout from 2026
Our mission

Why the Marula Institute exists

The Marula Institute exists to ensure that every child with complex health needs receives safe, consistent, clinically governed and compassionate care across every environment in which they live, learn, and receive support.

We are committed to reducing variation, strengthening governance, and embedding standards that advance excellence in children's complex care.

Why we exist

Addressing variation and gaps in care

Across the UK, children with complex medical needs often encounter:

  • highly variable standards of care
  • inconsistent governance between providers
  • gaps in paediatric-specific competence
  • fragmented communication and documentation
  • limited emotional safety for families and staff

Existing national guidance provides essential elements of commissioning and service design, but there is no single, unified, paediatric-specific practice standard that sets expectations for day-to-day complex care across home, school, hospice, respite and community settings.

The Marula Institute was established to fill this gap by providing a coherent, evidence-based benchmark that complements national frameworks and strengthens the entire system of care.

The Marula Standard®

A 10-component benchmark of excellence

The Marula Standard® integrates clinical governance, relational practice, staff development, safeguarding, and system accountability into one cohesive framework:

  • Paediatric clinical governance & transparent decision-making
  • Workforce training & competency development
  • Safeguarding excellence
  • Reflective supervision & psychological safety for staff
  • Documentation, record-keeping & risk assessment
  • Family partnership, communication & shared decision-making
  • Leadership, accountability & organisational culture
  • Care planning & consistent multi-setting delivery
  • Incident learning, audit & continuous improvement
  • Equity, dignity & child-centred practice

This Standard supports commissioners, NHS providers, schools, hospices and homecare organisations to deliver safe, skilled, relationally intelligent and consistently governed care.

What we offer

Practical support for systems, services and families

The Marula Institute partners with commissioners, providers, professionals and families to embed The Marula Standard® into everyday practice.

Governance Framework Consultation

Supporting organisations to understand, adopt, and embed The Marula Standard® across their services.

Leadership & Implementation Support

Helping systems strengthen oversight, accountability, quality assurance and organisational culture.

Workforce Competency & Development

Creating paediatric-specific training, competency frameworks, and emotionally safe supervision models.

Family Partnership & Co-Production

Embedding family voice into governance, planning and evaluation, including parent representation at board level.

Research, Evaluation & System Learning

Generating evidence, reflective learning, and continuous improvement across multi-agency children's care.

Our leadership & advisory board

Clinically led, multi-disciplinary, shaped by lived experience

The Marula Institute is clinically led and supported by a Board of Expert Advisors comprising:

  • senior paediatric clinicians
  • safeguarding and governance specialists
  • educators and researchers
  • leaders in system improvement
  • parent representatives (currently being appointed)

This multi-disciplinary advisory structure ensures that our work remains clinically robust, academically grounded, ethically sound, and shaped by lived experience.

Our vision

A national expectation of excellence

We envision a UK where every child with complex medical needs experiences:

  • safety through clear governance
  • competence through trained and confident staff
  • dignity through relationally attuned practice
  • equity regardless of geography or provider
  • partnership through genuine family inclusion
  • consistency across all care environments

The Marula Institute positions excellence in complex care not as an aspiration - but as a national expectation.

Connect with us

Partner with the Marula Institute

We welcome partnership with commissioners, providers, professionals, researchers, families, and all those invested in improving children's complex care.

Follow our launch journey and join our growing network. Together, we can advance excellence in children's complex care across the UK.

Commissioners & system leaders
NHS & independent providers
Schools, hospices & community teams
Researchers & educators
Parents & family advocates

Email: info@marulainstitute.org

Phone: +44 (0)777 245 7744

For formal enquiries, partnership discussions or to express interest in The Marula Standard®, please contact us via email in the first instance.