A smokefree pregnancy: the role of PHE Professor Viv Bennett Chief Nurse December 2017

PHE Aims and Actions in Maternal and Child Health System and programme leadership Best Start Programme and Maternity Transformation Programme: prevention stream Supporting local authority commissioners with information, evidence, resources Professional leadership and guidance to public health and public health nursing workforce ‘Lifecourse’ public health Place based community and service development Direct to public campaigns ‘Healthy Pregnancy’ Ready to Learn at 2 Ready for School at 5 Building Resilience Wellbeing 5-24 Reducing Childhood Obesity Oral health

Towards a smokefree generation Reduce smoking rates from 15.5% down to 12% or less. Reduce the prevalence of 15 year olds who regularly smoke from 8% to 3% or less.  Reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less. Reduce the inequality gap in smoking prevalence between those in routine and manual occupations and the general population. PHE have supported the plan throughout its development. Within days of his appointment, the Public Health Minister made a commitment on the floor of the house, for the plan to be published before recess. A new Government Tobacco Control Plan for England was published on 18th July 2017

Maternity Transformation Plan Improving Prevention work stream: Supporting women to be ‘Fit for and during pregnancy’ Embedding a holistic approach to prevention to improve women’s health before and during pregnancy will: Give every child the best start in life Reduce health inequalities Improve choice and personalisation Achieve safer outcomes for all mothers and babies. Programme priority areas 2017/18: Reduce the burden of perinatal mental illness Increase the number of women having a smokefree pregnancy Increase the number of babies breastfed at 6 months Embed public health and prevention across the maternity pathway PHE is providing support to local maternity systems to promote a whole systems, holistic approach to prevention both to build healthy places to have and raise families, and through supporting women and their partners Interdependencies with other maternity transformation workstreams: MTP WS1: Supporting Local Transformation MTP WS4: Improving access to perinatal mental health services MTP WS5: Transforming the workforce MTP WS7: Harnessing digital technology Health Visitor and School Nursing networking and learning events: protecting and promoting the health and wellbeing of children and families 2

Linking action on prevention and smokefree pregnancy across the MTP Working across the programme to ensure key principles are embedded, messaging is consistent and collaboration between work streams

PHE actions PHE had a key role in supporting DH with the development of the Tobacco Control Plan. Now working in collaboration on a more detailed delivery plan Developing a joint PHE/NHS E Smokefree pregnancy ‘action plan’ to reflect activities already underway through the tobacco control programme, MTP, care bundle and work with the SiP Challenge Group. Leading work on SF pregnancy across the MTP: Implementing NICE guidance, workforce development, improving data and providing new data tools, integrating SF pregnancy action in maternity safety activity e.g. Care Bundle & Clinical Excellence Working with the Smoking in Pregnancy Challenge Group – collaborating on new resources, animations and infographics in development, review of recommendations in Smokefree Skills report . Further work with Health Visitors and Practice Nurses – project initiated to support training and engagement of these groups in addressing smoking before, during and after pregnancy. PHE Centres – all prioritising action on smoking in pregnancy. Supporting networks, holding regional events and engaging with Local Maternity Systems where possible.

Summary Smoking in pregnancy remains the main modifiable risk factor for a range of poor pregnancy outcomes. The challenge is how to ensure action takes place systematically and sustainably across the WHOLE system. The new Tobacco Control Plan for England and Maternity Transformation Programme provide an opportunity to progress cross-agency working Everyone in the maternity team has a role to play in addressing smoking – needs to become embedded into routine practice Stop smoking interventions saves lives (and money) in the short, medium and longer term. Partnership is key to effective and sustainable action

Professor Viv Bennett Chief Nurse Viv.Bennett@phe.gov.uk @VivJBennett