1. BREAKOUT 2: TAKING ACTION TO CLOSE THE GAP (11:10 - 12:25)

2. WORKSHOP OBJECTIVES Presenter builds on break out 1, but then takes the gap and describes their action plan to refine their work, expand their projects, and close the gap Using the Closing the Gap Action Planning form, participants are invited to create a plan for closing the gap that they identified in Day One Have fun!

3. SOME IMPORTANT NOTES Our discussions today are about learning, not about performance, so… sharing your challenges and failures can be just as important as sharing your wins and successes.

4. MEETING NORMS REFRESH Suspend judgment as best you can. Respect one another. Seek to understand rather than persuade. Invite and honour diverse opinions. Speak what has personal heart and meaning. Go for honesty without going on and on and on.

5. Site Sharing: Reflecting on Our Work to Date “There is a clear correlation between poorer pregnancy outcomes... in women who book later for antenatal care, attended infrequently or never attend for care. At present in Scotland, women and babies who are at the greatest risk of poor health outcomes are the least likely to access and/or benefit from the antenatal health care that they need.” (A Refreshed Framework for Maternity services 2011). Ensure that women experience positive pregnancies which result in the birth of more healthy babies as evidenced by a reduction of 15% in the rates of: stillbirths (from 4.9 per 1000 births in 2010 to 4.3 per 1000 births in 2015) infant mortality (from 3.7 per 1000 live births in 2010 to 3.1 per 1000 live births in 2015)

6. PROJECT GAPS Promote enhanced interactions between parents and their unborn baby, resulting in improved attachment as well as strengthening engagement with maternity services. *Resulting in a decrease in Do Not Attend rates at antenatal appointments in the Wishaw locality by March 2015. *Resulting in a increase in attendance at antenatal appointments in the Wishaw locality by March 2015.

7. REVISED DRIVER DIAGRAM Decrease in Do Not Attend rates at antenatal appointments in the Wishaw locality by March 2015. Primary drivers Secondary drivers Awareness of impact of lifestyle on unborn baby resulting in positive choices/changes Willingness to attend Engagement with Maternity Services Understanding value of services provided Available information Cultural Norms Ability to attend (organisational skills) Specific Change Ideas Focused Improvement Concepts Ideas: 1)Ante natal text prompt reminder with date and time. 2)Provide information on what to expect at appointment. 3)Promoting positive messages during pregnancy. Increase Uptake with texting service Guidance Engagement Relationship with staff and service Promote enhanced interactions between parents and their unborn baby, resulting in improved attachment as well as strengthening engagement with maternity services. Aim

8. Impact of the intervention I have developed my sense of smell; can hear more and I am also beginning to remember things. I am getting to know and I am soothed by my family’s voices. I like when you talk, sing and play music and respond to my movements. 01698354966 29 weeks Examples of Texts sent Keep us both healthy – you should have an appointment with your midwife around now. I have now grown to around 42cm long and can react to light. Why not try shining a torch over your tummy, play music or read me stories and see how I respond? 01698354966 Between 31-32 Weeks Appointment (Prim)

9. Data Feedback from mothers Like the baby development messages. The text messages would encourage me to talk to my baby. Liked all the messages I have received, I would recommend the service. I especially liked the baby development messages. I would recommend the texting service. I really like receiving the messages as I have a 1 year child, so don't always have time to read or refer to my book

10. Data

11. Learning for improvement Challenges around E-Health / IT – 11 page information governance form to send a text message! Uptake of text message service is high – seen as a normal way to engage with a service provider Impact on clinic time by discussing sign up Scaling up could be challenging

12. Table Reflection and Discussion part one Using the action planning form – sketch out milestones, next actions, and structural things they need to do to move their dots and close their gap – 20 minutes Action planning questions on next slide

13. Table Reflection and Discussion 1.What's the next action or task for each to move them forward. 2.What assets can we draw upon within our partners or the community to move this work forward? 3.Who needs to be involved? 4.What do you need for others? 5.What are predicted barriers and what are your ideas for overcoming them?

14. Discussing as a table, participants are invited to share their action plans What were common theses about your next actions to move things forward? What can you do in the next 2 weeks to move existing projects forward and start new ones? Where do you need help or support? Table Reflection and Discussion part two – 20 minutes

15. What did you discover in your action planning? What surprised you? What ideas are you taking home from your table discussions? For all of us as leaders are there leadership issues to consider? – Or leadership issues we need to escalate? REPORT OUT

16. PLEASE INSERT HERE (DURING SESSION): – Top 5 emerging themes based upon facilitator themes from tables. THEMES FROM THE ROOM

17. Parting Thoughts Today was about closing the gap Take your plans to CPP action planning, to close the gap you’ve identified Head into the action period with clarity about what you need to do!

18. Thanks for a great session!