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 rcantwell@nhs.net

Areas of activity Working in partnership Developing professional expertise Ensuring equity of care Delivering best outcomes

Communication strategy Informed by… Mapping and gapping Communication strategy

Mapping and gapping MMHA Turn the Map Green Campaign

Mapping and gapping NHS Board visits Visits undertaken to date Greater Glasgow and Clyde Borders Lothian Grampian Fife All completed by end 2018

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’

Mapping and gapping NHS Board visits How do we ensure the right people know about our visits?

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

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

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

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

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

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

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

Mapping and gapping Professionals / Women & families workshops Completed Midwifery Planned CPNs Health visiting Psychology 3rd sector Women & families

Communications strategy Website Social media presence Newsletters Annual network event 4th June 2018

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

Developing professional expertise Staff education and training survey Competencies for all staff in partnership with NES Training recommendations and resources matched to competencies

Developing professional expertise Should post-qualification PMH training be mandatory?

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

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

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

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

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?

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?

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?

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

Delivering best outcomes What other outcomes should we measure?

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?