Smoking cessation in secondary care: acute and maternity settings

Self-assessment framework for NHS acute trusts to develop local action to reduce smoking prevalence and the use of tobacco | Public health England

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The self-assessment tool breaks down the NICE guidance into 4 areas:

  • systems required to implement the guidance
  • communication required
  • training that will help staff to successfully implement the recommendations
  • treatments that should be available to support staff and service users

This self-assessment tool supports all of the recommendations applicable to acute services in the NICE guidelines on Smoking cessation in secondary care.

Please save the self-assessment file to your computer and click ‘enable editing’ before using it.

Public Health England has also developed a suite of resources including a self-assessment tool to support the implementation of NICE guidance in mental health settings.

View the full framework here

State of maternity services

The Royal College of Midwifery has published State of Maternity Services Report 2016.

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Image source: http://www.rcm.org.uk

The report examines emerging issues and trends in relation to maternity services.  It highlights that over a third of the UK’s NHS midwives are nearing retirement age; the increase in births to older mothers, who may require more care throughout their pregnancies;  and rates of obesity which are placing additional demands on maternity services.

Women’s experiences of maternity services

“Only 55% of women who made a decision about their birthplace achieved their choice” | The Women’s Institute

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Image source: The WI

This report presents the findings of the NFWI’s and NCT’s second survey of women’s experiences of maternity care, providing insights into key aspects of the experiences of 2,500 women who gave birth in England or Wales in 2014, 2015, and the first half of 2016. Since the publication of our last maternity services report in 2013, the maternity policy landscape has changed significantly. Most notably, the National Maternity Review report – Better Births – has recommended significant changes to how maternity services are organised.

Read the full overview here

Read the full report here

UK maternity care

MBRRACE-UK has published Saving Lives, Improving Mothers’ Care: Surveillance of maternal deaths in the UK 2012–14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14.

The report presents the findings of maternal mortality surveillance 2012 to 2014 in the UK and the lessons learned from the confidential enquiries into maternal deaths from cardiovascular causes, blood pressure disorders of pregnancy, early pregnancy causes together with messages for critical care.

MBRRACE-UK Maternal Report 2016 – Full Report

MBRRACE-UK Maternal Report 2016 – Lay Summary

Additional link: RCOG press release

Maternity transformation programme

NHS England has announced details of the seven local areas who will be taking forward the recommendations set out in its report Better Births.

The Early Adopter sites will test a range of new and innovative ways of working to help transform maternity services such as: using small teams of midwives to offer greater continuity of care to women; creating single points of access to a wider range of maternity services; making better use of electronic records to provide more joined up care; improving postnatal care and providing better personalised care planning.

Read more via NHS England

Health secretary promises to end maternity ‘blame culture’

National Health Executive | Published online: 17 October 2016

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Families who suffer problems during childbirth as a result of failings in care could claim compensation without legal proceedings under new proposals.

The DH said there is a danger that clinicians are being discouraged from speaking openly about mistakes which led to births going wrong, including children developing disabilities, out of fear of litigation.

It said it would open a consultation on introducing a rapid resolution and redress scheme, which would investigate incidents. Where harm was found to be avoidable, it could offer families regular financial support without the need for legal proceedings, as well as counselling, case management and legal advice.

Jeremy Hunt, the health secretary, said: “Our NHS maternity staff do a fantastic job under huge pressure. But even though we have made much progress, our stillbirth rates are still amongst the highest in Western Europe and many on the frontline say there is still too much of a blame culture when things go wrong – often caused by fear of litigation or worry about damage to reputation and careers.

“These comprehensive measures will give practical support to help trusts improve their approach to safety – and help to foster an open and transparent culture so that the courts become a last resort not an automatic first step. By learning from proven methods in countries like Sweden we hope to achieve a dramatic reduction in the number of tragedies where babies are lost or injured for life.”

Read the full story here

Maternity Care Failing Some Disabled Women

Hall, J. et al. | Published online: 15 September 2016

Research published  by Bournemouth University and commissioned by Birthrights highlights how maternity care may not be meeting the needs of some pregnant disabled women.

A survey of women with physical or sensory impairment or long term health conditions highlighted how  – despite most women rating the support they received from maternity health carers positively – only 19% of women thought that reasonable adjustments or accommodations had been made for them. Some found birth rooms, postnatal wards and their maternity notes and scans “completely inaccessible”,  while a quarter of women reported that they felt they were treated less favourably because of their disability. Most strikingly, more than half (56%) felt that health care providers did not have appropriate attitudes to disability.

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Image source: birthrights.org.uk

Just over half of the participants expressed dissatisfaction with one or more care providers, particularly their awareness of the impact of disability and their perception that their choices in pregnancy and birth were being reduced or overruled. One participant with a physical impairment and a long-term health condition stated, “No one understood my disability. No one knew how to help or who to send me to for support.” Another added, “I didn’t have any control or any choice. Everything was decided for me.” And one woman said, “They did not listen to me. I advised them on the unique way my body works. They did not listen to my advocates.”

Read the full report here

Read the full commentary here