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Roch Cantwell Lead Clinician, PMHN Scotland rcantwell@nhs.net
Perinatal Mental Health Network Scotland National Managed Clinical Network 2018 Update Roch Cantwell Lead Clinician, PMHN Scotland
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Areas of activity Working in partnership
Developing professional expertise Ensuring equity of care Delivering best outcomes
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Communication strategy
Informed by… Mapping and gapping Communication strategy
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Mapping and gapping MMHA Turn the Map Green Campaign
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Mapping and gapping NHS Board visits
Visits undertaken to date Greater Glasgow and Clyde Borders Lothian Grampian Fife All completed by end 2018
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Mapping and gapping NHS Board visits
Methodology Letter to senior management (Board COO, HSCP COO, Nurse Director, Medical Director Key individual(s) notified Cascade information Not always effective Key individuals missed Groups missed ‘Workers’ or ‘Managers’
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Mapping and gapping NHS Board visits
How do we ensure the right people know about our visits?
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Mapping and gapping NHS Board visits
Results/Common themes Contribution of 3rd sector Lack of awareness of training opportunities Limited preventative interventions Difficulty sustaining services Very limited CAMHS infant mental health provision Areas of good practice and innovation
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Mapping and gapping NHS Board visits – 3rd sector contributors to date
NSPCC Scotland Barnardos Crossreach Aberlour Mellow Parenting Stork Café Paisley Abbey PND Homestart Nurture PND Borders
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Mapping and gapping NHS Board visits
Results/Common themes Contribution of 3rd sector Lack of awareness of training opportunities Limited preventative interventions Difficulty sustaining services Very limited CAMHS infant mental health provision Areas of good practice and innovation
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Mapping and gapping NHS Board visits
Results/Common themes Contribution of 3rd sector Lack of awareness of training opportunities Limited preventative interventions Difficulty sustaining services Very limited CAMHS infant mental health provision Areas of good practice and innovation
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Mapping and gapping NHS Board visits
Results/Common themes Contribution of 3rd sector Lack of awareness of training opportunities Limited preventative interventions Difficulty sustaining services Very limited CAMHS infant mental health provision Areas of good practice and innovation
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Mapping and gapping NHS Board visits
Results/Common themes Contribution of 3rd sector Lack of awareness of training opportunities Limited preventative interventions Difficulty sustaining services Very limited CAMHS infant mental health provision Areas of good practice and innovation
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Mapping and gapping NHS Board visits
Results/Common themes Contribution of 3rd sector Lack of awareness of training opportunities Limited preventative interventions Difficulty sustaining services Very limited CAMHS infant mental health provision Areas of good practice and innovation
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Mapping and gapping Professionals / Women & families workshops
Completed Midwifery Planned CPNs Health visiting Psychology 3rd sector Women & families
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Communications strategy
Website Social media presence Newsletters Annual network event 4th June 2018
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Working in partnership
Women & families Expert by experience group established National survey of women’s views Charter of Women’s & Families’ Rights Interdisciplinary working Learning from and promoting development of regional networks
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Developing professional expertise
Staff education and training survey Competencies for all staff in partnership with NES Training recommendations and resources matched to competencies
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Developing professional expertise
Should post-qualification PMH training be mandatory?
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Ensuring equity of care
Database of all postnatal admissions in Scotland to identify pathways into care (with ISD; MWC) Models of service provision for Scotland
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Ensuring equity of care Scenario 1 - high birth numbers
Stand-alone specialist PMH team Staffing includes psychiatrists, CPNs, clinical psychology, nursery nursing, social work, occupational therapy Other members of the core team may include e.g., specialist midwives Ability to case manage
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Ensuring equity of care Scenario 2 – low birth numbers
Dispersed specialist PMH team Consultant psychiatrist with ring-fenced specialist time CPNs in CMHTs with ring-fenced specialist time Face to face team meetings Access to e.g., clinical psychology, nursery nursing, social work, occupational therapy Ability to case manage all, or more complex, presentations
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Ensuring equity of care Scenario 3 – very low birth numbers
Regional specialist PMH provision Consultant psychiatrist with ring-fenced specialist time to provide advice and support for staff working in CMHTs Additional generic staff training Case management by CMHT
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Ensuring equity of care Low birth numbers areas
How do we design services for low birth numbers / sparsely populated areas? Examples of existing models for other services? Access to MBU beds?
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Ensuring equity of care Infant mental health
Models of care across all tiers Importance of 3rd sector Development of evidence base of recommended interventions NES work on Early Intervention Framework Efficacious and effective Where is specialist provision located?
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Ensuring equity of care Infant mental health
How do we ensure access to infant mental health services across spectrum of need? 3rd sector? CAMHS v embedded within PMHS?
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Delivering best outcomes
Network outcomes Internal governance Service delivery outcomes Access to MBU beds Clinical outcomes Core data set with outcome measures and patient feedback
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Delivering best outcomes
What other outcomes should we measure?
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Questions for you (the network)
How do we ensure the right people know about our visits? Should post-qualification PMH training be mandatory? How do we design services for low birth numbers / sparsely populated areas? How do we ensure access to infant mental health services across spectrum of need? What other outcomes should we measure?
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