1. Raising sensitive issues with pregnant women Training for maternity settings 2011 NICE clinical guideline CG110

2. Introduction The purpose of this session is help health and social care professionals to: Develop their skills and competencies in raising sensitive issues. Reflect on current practice. Generate ideas for improving practice and encourage further development. Promote and support discussion between management and front-line staff to improve practice and the experience of service users.

3. Session format Experiential learning approach Simulated patient (SP) Ground rules Time out.

4. Learning needs What groups of pregnant women are likely to be vulnerable to experiencing complex social factors? Why are pregnant women with complex social factors discouraged from using antenatal services? How can these problems be addressed? What skills and knowledge would you like to gain from this training session?

5. Rules of feedback Be constructive and specific What went well and why? 1.Learner first 2.Check with simulated patient 3.Ideas from the group What could be done differently and how? 1.Learner first 2.Check with simulated patient 3.Ideas from the group 4.Re-run a section if appropriate

6. Case scenario Sharon McCoughlin, aged 36, teacher, unmarried, no children. Peter Sharp, aged 48, police officer, divorced father of two.

7. Domestic abuse Learning points Routine enquiry Raising sensitive issues generally

8. Action planning What skills have you developed? Where can you access additional support for you and pregnant women experiencing domestic abuse? What changes will you make as a result of this session? How can the skills developed in this session be applied to other case scenarios?

9. Raising sensitive issues Preparation Pick up clues Listen to concerns Be sensitive Empathy Avoid making assumptions Confidentiality Summarise Future plans Offer availability

10. Further information Antenatal care (NICE clinical guideline 62) Department of Health (2005) Responding to domestic abuse. A handbook for healthcare professionals. London: Department of Health Department of Health (2010) Responding to violence against women and children – the role of the NHS. London: Department of Health

11. Further information Women’s Aid The Hideout Refuge Respect Broken Rainbow