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Maternity and Child Health

Photograph of mother and baby.Maternity and Child Health were key strands of the Transforming Your Care consultation process, and the Vision to Action Post Consultation Report set out how the key proposals would be delivered in each of the Health and Social Care (HSC) Trust areas.

In short, these focus on:

  • Promoting public health messages and preconception care to ensure that women are as healthy as possible before becoming pregnant;
  • A greater focus on continuity of care for women;
  • An increased focus on keeping pregnancy normal through midwives caring for women with straightforward pregnancies;
  • Freeing up obstetrician time to care for the growing number of women with complex pregnancies;
  • Developing regional plans for mothers with serious psychiatric conditions;
  • Promoting early direct contact with the midwife and bringing antenatal and postnatal visits into line with best practice;
  • Reducing the length of stay for mothers in hospital where appropriate;
  • Increasing the number of women having community based antenatal care; and
  • Improving antenatal education and early parenting to promote the good parent/child relationship in early years.

Maternity

The Maternity Strategy for Northern Ireland was published in July 2012 and sets out standards for maternity care in Northern Ireland from preconceptual care through to postnatal care.

It is outcomes-focused and intended to ensure:

  • every baby and family has the best start in life;
  • effective communication and high-quality maternity care;
  • healthier women at the start of pregnancy (preconception care);
  • effective, locally accessible, antenatal care and a positive experience for prospective parents;
  • safe labour and birth (intrapartum) care with improved experiences for mothers and babies; and
  • appropriate advice and support for parents and the baby after birth.

Within the document, 22 objectives have been identified which link to the six outcomes identified above.

Delivery of these objectives is being overseen by group which comprises senior representatives from Trust Maternity services, General Practice, Public Health Agency , the Health and Social Care Board  and Department of Health, Social Services and Public Safey

Some key areas of progress include:

  • the review of Antenatal Education;
  • the review of Community Maternity Care;
  • development of a Regional Service Model and Pathway for Multiple Pregnancy in line with NICE Clinical Guidelines;
  • ongoing work of the Maternity Quality Improvement Collaborative to reduce variation in intervention rates and improve the safety of care including the initiation of a regional maternity dashboard;
  • continuous improvement of the regional maternity information system NIMATs.

In the course of work already undertaken, there has been considerable service user engagement (1,130 women responded to an online survey about the review of Community Maternity Care).

Focus groups were conducted with service users for the Review of Antenatal Education and a significant number of responses from women who had used maternity services were received as part of the 10,000 Voices initiative.

There are also links with Trust Maternity Services Liaison Committees and plans for further user engagement are in development.

Child Health

Giving children the best start in life, prevention, and promoting their health and wellbeing are integral to Transforming Your Care.

In respect of Child Health, the key proposals from the Transforming Your Care consultation were the:

  • Development of childhood screening programmes;
  • Promotion of partnership working on children’s health and wellbeing matters with other government sectors;
  • Close working between hospital and community paediatricians through Integrated Care Partnerships;
  • Completion of a review of inpatient paediatric care;
  • Establishing formal partnerships for very specialist paediatric services;
  • To establish Family Nurse Partnership Programme pilots (initially in the Western, Southern and Belfast Trusts) to improve the health and wellbeing of children and families;
  • Providing prompt access to skilled staff when children need hospital care; and
  • Ensuring all children under 16 are admitted to appropriate paediatric settings.

Some good progress in this area has been made. For example:

The “Healthy Child, Healthy Future” (HCHF) programme has launched in 2010.

This aims to ensure that every family with children has universal access to immunisations, developmental reviews, screening, surveillance, information and guidance to support parenting and healthy choices.

The Child Health System records information on all children in Northern Ireland from birth to early adulthood and produces an annual report on the health of children in Northern Ireland. A copy of this information is available from the Public Health Agency website.

When children require hospital care they need prompt access to skilled staff. It is not possible to provide a full range of paediatric sub specialities for a population the size of Northern Ireland and some families have to access services in other parts of the UK when services are not available locally.

However, inpatient paediatric services are gradually increasing the upper age limit for paediatric services to 16 years and ensuring age appropriate paediatric settings are in place.

Likewise, Short Stay Paediatric Assessment Units (SSPAUs) are a model of care currently being established on all sites with in-patient units. These units allow an appropriate period of observation with investigations that can prevent the need for hospital admission in many cases.

In addition, two public consultations on paediatric services and paediatric palliative care have been completed and are currently being considered by the DHSSPSNI.

Useful links

Public Health Agency:  http://www.publichealth.hscni.net/
Maternity Strategy NI (2012-2018): http://www.dhsspsni.gov.uk/maternity-strategy.htm
Executive Summary: http://www.dhsspsni.gov.uk/maternityexesummary.pdf
Summary of responses to consultation: http://www.dhsspsni.gov.uk/maternityconresponse.pdf
Healthy Child, Health Future: http://www.dhsspsni.gov.uk/healthychildhealthyfuture.pdf
10,000 Voices: http://www.publichealth.hscni.net/publications/10000-voices-improving-patient-experience
Family Nurse Partnerships in NI: http://www.publichealth.hscni.net/directorate-public-health/health-and-social-wellbeing-improvement/family-nurse-partnership
DHSSPS Consultation on Paediatric Services: http://www.dhsspsni.gov.uk/p-consultation-document.pdf
DHSSPS Consultation on Paediatric Palliative Care:  http://www.dhsspsni.gov.uk/paediatric_palliative_and_end_of_life_care_review_-_consultation_document.pdf

Related web pages

Transforming Your Care consultation
Integrated Care Partnerships

 

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