Mental health professionals in Hampshire and Southampton found women were not getting advice, support and information early enough during pregnancy, resulting in crisis admissions to a specialist mental health unit.
Mental health nurses, nursery nurses, psychologists, psychiatrists and social workers in Hampshire and Southampton.
Local clinicians established a referral, advice, information and treatment service for women severely mentally ill during pregnancy or with a history of mental illness. Women are offered face-to-face assessment, information leaflets and group support. There is also a 24/7 telephone advice line for women and healthcare professionals. Primary care staff and midwives received training to help run antenatal and postnatal depression groups in children’s centres and GP practices, which are normal, non-stigmatising healthcare settings.
The team measured patient and referrer satisfaction. Feedback questionnaires were given to women, their partners and other professionals. Their responses identified where improvements could be made.
Patients views helped to design and pilot a national perinatal Patient Rated Outcome and Experience Measure (PROEM). The pilot results are being reviewed to enable changes in the perinatal PROEMs with a view to benchmarking of perinatal services nationally.
Co-produced Wellness recovery action plans (WRAP) were developed for mothers and their babies.
Occupied bed days across Hampshire reduced, from 98 per 1,000 births in 2011, to 75 per 1,000 in 2012. Patient and referrer satisfaction improved significantly. The service received an ‘Outstanding’ rating from the Care Quality Commission.
Team building, collaboration and peer support is essential to encourage quality improvement and reflective practice.