1. Working in Partnership to Reduce Smoking throughout Pregnancy
Tackling smoking in pregnancy to reduce health inequalities and infant mortality
Wednesday 15th March 2017
Better Start Bradford
Working in Partnership to Reduce Smoking throughout Pregnancy

2. Every Baby Matters in Bradford District
Joanne Nykol
Public Health, Tobacco Lead

3. Every baby Matters in Bradford District
Smoking in pregnancy is the single most modifiable risk factor for pregnancy and pregnancy outcomes
Today is about a call to action because if we are going to make a difference to health inequalities and infant mortality we have to tackle smoking in pregnancy

4. Welcome Set out the rationale for action and the evidence base
What we have already achieved
What we plan to do
Increase knowledge, identify opportunities for partnership working, gaps, recommendations
Welcome we would like to share with you the work achieved and the work in progress sit back, relax – engage and participate

5. Smoking at time of delivery (SATOD) by CCG 2015/16 (source HSCIC)
15% for the district as a whole England 10.6% - target % or less

6. Where are they smoking?
Source: Public Health Analysis team, CBMDC 2014

7. Bradford driving force ~
Every Baby Matters Strategy and Action Plan recommendations to improve maternal and infant health and reduce infant mortality rates
Every Baby Matters (EBM) - Steering Group
Smoking In Pregnancy Action Plan
Every Baby Matters (EBM) leads on reducing infant mortality rates.
Steering Group - key partners to identify the actions required –
The Health and Wellbeing Board, Children’s Trust Board and Integrated Early Years Strategy Steering Group will monitor progress on the Every Baby Matters Action Plan and progress in reducing infant mortality rates as well as the Health and Social Care Overview and Scrutiny Committee.
The infant mortality rates for Bradford district is now the lowest rate over the last decade and has reduced year on year for the last six years.

8. Collaborative commissioning
Bradford Council
Bradford Districts CCG
Bradford City CCG
Public Health England
Reducing smoking in pregnancy everybody's business
This is a challenge that can not be achieved in isolation Reducing health inequalities and infant mortality is a local authority priority it is also a priority for our CCG partners . The work started with an opportunity to come together and co fund babyclear here in Bradford to achieve consistent intervention and messages across the antenatal care pathway

9. Working together…our partners
Commissioned Specialist Midwife
Better intelligence
Planning Services
Children’s Centres
Front line services
Health Visitors
Referrals

10. Working together…our partners
Commissioned Specialist Midwife
Better intelligence
Planning Services
Children’s Centres
Front line services
Health Visitors
Referrals
Smoking is an addiction that often starts in childhood – it is not a lifestyle choice – women don’t start smoking in pregnancy – partnership working to achieve a consistent, evidence based intervention. 4 x more successful with support and medication – ensure smokers get the best chance of quitting

11. Hilary Warring and Lisa Fendall has been on this journey with us right from the beginning

12. Lisa Fendall…..where it all began
“There are a lot of common misconceptions out there and it may be surprising but often women continue to smoke because
they don’t really understand the impact this can have on their babies”
Lisa Fendall - Specialist Midwife

13. Every Baby Matters in Bradford District
Carolyn Sadler – Public Health Stop Smoking Specialist, Pregnancy Lead

14. Our Key Message….. MAKING EVERY CONTACT COUNT
Following the NICE guidance (PH26)
Collaborative working with:-
Midwives
Health Visitors
Children’s Centres
Better Start Bradford
MAKING EVERY CONTACT COUNT

15. Progress so far Stop Smoking Specialist Midwife commissioned BTHFT
All Ante-natal Midwives babyClear trained
Midwifery staff provided with CO monitor and consumables
Integration into antenatal care pathway
Referral process that ensures referrals are received by the Stop Smoking Service within 24 – 48 hours of CO screening
Quarterly reporting
Ensure those responsible for providing health and support services understand why and how to identify those who smoke and refer to the Stop Smoking Service

16. Source: HSCIC, 2016

18. Next steps Risk perception implementation. 36 week CO readings.
Support for antenatal admissions – rapid access to NRT

19. Further Training http://elearning.ncsct.co.uk/vba-launch 19

21. Bradford Stop Smoking Service - 01274 437700
Resources available from : Health Promotion Library & resources At Lynfield Mount Hospital
Bradford Tobacco Health Needs Assessment available online at:-

22. References BMA (2007) Breaking the cycle of exposure to tobacco smoke
Royal College of Physicians: Passive Smoking and Children. A report of the Tobacco Advisory Group of the Royal College of Physicians. London, RCP(2010)
Bradford Joint Strategic Needs Assessment, 2014
NICE (PH26), 2010 Smoking: stopping in pregnancy and after childbirth
Smoking Cessation in Pregnancy: A call to action (2013)
Nicotine Addiction in Britain (Royal College of Physicians, 2000)
Action on smoking and health (various facts sheets available)
Bradford Tobacco Health Needs Assessment availble online at:-