Agenda item

Purpose: To consider reports on maternal mental health in West Berkshire.

Liz Stead (Head of Midwifery, Maternity, Neonatal and Women’s Services, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) presented the report on maternal mental health.

During the presentation the following points were highlighted:

·         An overview of the importance of the perinatal period was given. One in five women experienced mental health issues in pregnancy or after the birth of their baby.

·         Pre-conception support for women with pre-existing mental health conditions was dependent on the level of need and could have been provided by GP’s, the Community Mental Health Team, Talking Therapies.

·         Routine screening of pregnant women was carried out by midwives at the first antenatal care appointment. When mental health concerns started during pregnancy and led to a pregnant woman becoming acutely unwell, the Berkshire Healthcare NHS Foundation Trust (BHFT) Perinatal Mental Health Service provided tailored care for women. This was a specialist service for women experiencing extreme or complex mental health conditions during pregnancy that could not be managed in other settings.

·         The Birth Trauma Pathway provided Cognitive Behavioural Therapy for women with perinatal post-traumatic stress disorder following a difficult or traumatic birth.

During the Committee’s discussion the following points were raised:

·         The national concerns of maternal mental health were noted as well as the importance of collaboration between GP’s, midwives and health visitors. It was noted that BHFT professionals used record keeping and verbal communication to work closely with colleagues. However, the Committee was advised that collaborative communication between health visitors and midwives could be improved particularly around the detail in care records.

·         It was confirmed that pregnant women saw midwives regularly despite the relative rurality of West Berkshire compared to other parts of Berkshire West. Teams worked well for services to be available and accessible. For those very unwell, there was specialist midwifery services at the Royal Berkshire Hospital. Midwives also did home visits if a woman was high risk.

·         Liz Stead advised that the main issue in Berkshire West was in the understanding of which cases needed to be referred to the specialist perinatal mental health service. They received inappropriate referrals, and there may not have been a robust enough safety net for women who were refused support from that service.

·         There were no areas of concern noted in West Berkshire specifically.

·         There was mandatory training in screening for perinatal mental health for all professionals likely to have contact with women during the perinatal period. The ICB collected data from BHFT and the acute trusts to monitor the levels of mandatory training compliance.

·         It was highlighted that relevant and accurate data was essential to ensure that inequalities could be addressed. There were two key pieces of work covering the BOB Equity Strategy, and work interrogating population data and checking for accuracy and consistency in records. It was important to make every contact count and to record the right data accurately.

·         It was noted that two inpatient provisions were available for the southeast of England (Winchester and Kent). It was advised they were very expensive provisions which were only used when critically necessary. Mothers were better supported at home and in the community.

Action: Liz Stead to share the Perinatal Equity Strategy.