Director of Public Health Annual Report 2018: Healthy places
Update on recommendations from 2016 Director of Public Health Annual Report
Maternal health
Recommendation: Healthcare professionals in contact with pregnant women or new mothers should assess all the factors that could impact on the mother’s, baby’s and family’s health and offer advice, support and referral to appropriate services.
This includes lifestyle factors such as smoking, alcohol consumption, drug use, weight and healthy eating as well as mental health, exposure to domestic violence and other social factors. There is significant scope to increase referrals to support services to improve outcomes for babies, mothers and families.
Progress includes:
- Buckinghamshire CCG has commissioned a specialist Perinatal Mental Health service. This service has developed a perinatal mental health pathway in Buckinghamshire which is being promoted and embedded into everyday practice.
- The health visiting service has an infant feeding specialist now in post and the service is working towards UNICEF baby friendly status accreditation. Stage 1 of the process has been achieved and the service is currently being assessed for stage 2 accreditation.
- Buckinghamshire Healthcare Trust (BHT) have implemented a set of actions to improve the identification, recording and referral of pregnant women with high risk lifestyle behaviours, including:
- Midwives are being supported by the CCG and healthcare providers to develop skills in delivering holistic care, including identifying high risk women and referring to appropriate services.
- Pathways are being developed with new providers of lifestyle services to improve referral and care.
Supporting parents
Recommendation:
Buckinghamshire County Council (now Buckinghamshire Council) and partners should consider whether there is a need to develop and implement a new comprehensive strategy to support parents in Buckinghamshire.
Progress includes:
- A ‘Transition to Parenthood’ pathway (from ante-natal to post-natal care) has been developed and is being implemented. The pathway for vulnerable women is in development.
Referring families to other useful services
All professionals in contact with pregnant women and families with young children should encourage parents to access universal parenting advice via the:
- red book
- national start4life website
- Baby Buddy app
- Buckinghamshire Family Information Service
Progress includes:
- The Baby Buddy app has been commissioned in Bucks with the additional ability to adapt the platform to be more specific to Buckinghamshire.
- The app is promoted by maternity service and other stakeholders. Uptake and usage of the Baby Buddy app is regularly monitored and information is used to target its promotion in areas with higher need and poor uptake.
- Buckinghamshire Family Information Services provides national and local information and sources of support during maternity and parenthood is included.
- A local tool to support signposting to relevant information sources and services is being developed for non-healthcare staff and volunteers in contact with pregnant women and families with young children. This includes signposting for services relating to lifestyle factors, social issues, mental health concerns and domestic violence.
Improve data collection to help monitor progress
Recommendation: Commissioners and providers of maternity, early years, mental health and substance misuse services should enhance the data collected on the physical and mental health of mothers and babies, the prevalence of risk factors and referral to and outcomes of services. This should enable us to monitor progress and evaluate the impact of our services. Key data should be reported annually to the Health and Wellbeing Board.
Progress includes:
- BHT (now ICB) has reviewed the process of identifying and recording relevant information on pregnant women and has implemented a process to improve data accuracy and completeness.
- BHT (now ICB) is working with the new lifestyle service provider to improve data collection.
- The maternity and health visiting services have implemented a number of actions to improve the completeness and accuracy of data related to breastfeeding.
- Key indicators related to physical and mental health of mothers and babies are included in the Health and Wellbeing Board Performance Dashboard. These include indicators assessing:
- Maternal mood
- Smoking status at the time of delivery
- Low birth weight of term babies
- Infant mortality
Working with schools
Recommendations: Buckinghamshire County Council (now Buckinghamshire Council) should work closely with schools to explore how the new RSE/PSHE can prepare young people for a healthy and happy life and addresses emotional resilience, healthy relationships, sexual health and healthy lifestyles.
One of the future benefits of this should be healthier parents and babies and healthy, planned pregnancies.
Progress includes:
- A PSHE lead has been in post since December 2017. PSHE training sessions have been organised and delivered for primary and secondary PSHE school leads, and primary and secondary school PSHE forums (12 secondary and 20 primary leads plus other PSHE teachers have attended). These sessions have been facilitated by the PSHE lead and have resulted in increasing engagement from schools and improved sharing of practice and models. This will inform the report to be produced by the PSHE lead.
- A PSHE webpage has been set up which is available to all PSHE staff in schools. A termly newsletter is sent to schools to update them on the latest local and national updates.
- An increasing number of schools have joined the PSHE association which provides resources, tools and expert advice.
- A response to the Relationship and sex education consultation was made and the consultation was circulated to schools. The PSHE lead has encouraged schools and pupils to respond to the consultation.
Improve outcomes for babies, mothers and families
Recommendation:
Partners should consider how they can contribute to improving outcomes for babies, mothers and families in Buckinghamshire.
- The Health and Wellbeing Board hosted a workshop in October 2017 with over 50 delegates attending from a range of key organisations across Bucks including the councils, healthcare providers, healthcare commissioners and the voluntary and charitable sector. The workshop focussed on identifying activities that would improve outcomes for mothers, babies and families in Buckinghamshire with a particular focus on those with poorer outcomes.
- Individuals and organisations attending the workshop who were able to contribute to further developing and implementing activities and projects were identified and, where appropriate, engaged in the activities above.