Preconception advice – Newcastle and North Tyneside Perinatal Community Team -NCCMH

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The Newcastle and North Tyneside Perinatal Community Team provides care for women aged 16 to 64 during the perinatal period who require or have had previous involvement with secondary mental health services. The women may have a range of diagnoses.

Co-Production

  • From start: No
  • During process: Yes
  • In evaluation: No

Evaluation

  • Peer: Yes
  • Academic: Yes
  • PP Collaborative: No

Find out more

Preconception advice – Newcastle and North Tyneside Perinatal Community Team

The Newcastle and North Tyneside Perinatal Community Team provides care for women aged 16 to 64 during the perinatal period who require or have had previous involvement with secondary mental health services. The women may have a range of diagnoses.

The service demonstrates positive practice in their delivery of care, in line with the Antenatal and Postnatal Mental Health NICE quality standard and Perinatal Mental Health Care Pathways. This includes:

  • meeting the recommended response time for Pathway 1, with at least 50% of women seen for preconception advice within 1 month of referral and 90% of women within 8 weeks.
  • offering women with a suspected perinatal mental health problem (during pregnancy or the postnatal period) a comprehensive mental health assessment, in line with NICE quality statement 5
  • preconception advice for women with a current or past severe mental health problems who are planning a pregnancy or are already pregnant, in line with NICE quality statement 3
  • asking women about their emotional wellbeing at each routine antenatal and postnatal check, in line with NICE quality statement 4.

Referrals

The service receives 632 referrals a year. Referrals are received from the following teams: GPs refer around 40%; midwives 20%; health visitors 20%; and other professions 20%.

Interventions

Women referred for preconception advice are offered face-to-face sessions with a consultant psychiatrist, either in the clinic or at home. Sessions typically last 60 to 90 minutes, and they cover:

  • current and past mental health problems (and their treatment)
  • the woman’s experience of her mental health problem
  • previous effective treatments, and available treatment options during pregnancy
  • diagnostic review
  • consideration of the effect of pregnancy and delivery on the woman’s mental health problem
  • treatment options (taking into account risks in pregnancy)
  • community psychiatric nurse monitoring and admission to a mother and baby unit if required
  • comprehensive review of past psychiatric records.

A verbal and written summary of the discussion, including information about prognosis and treatment, is typically given. Non-English language versions are also available, if appropriate. The GP, midwife, health visitor and obstetrician are copied in to the letter, if the woman agrees. The team also provides a follow-up appointment if requested by the woman.

Monitoring and measurement of outcomes

The Newcastle and North Tyneside Perinatal Community Team measures outcomes through the completion of Health of the Nation Outcome Scales (HoNOS). Women’s views and experiences are monitored and assessed through the Patient rated Outcome and Experience Measure (POEM).

Workforce and staff training

Workforce

(WTE hours and roles)

 This community-based team currently operates with the following staff:

·  consultant psychiatrist (0.5 WTE)

·  team manager (AfC band 7: 1 WTE)

·  community psychiatric nurses (AfC band 6: 4.8 WTE)

·  administrative staff (2.3 WTE)
Note: AfC = Agenda for Change; WTE = whole time equivalent.

 

The service offers general training for staff involved in the care of women who have or are at risk of developing a perinatal mental health problem. There are also plans to introduce a preconception counselling module to psychiatrists’ training.

Contact details

Provider: Northumberland, Tyne and Wear NHS Foundation Trust

Commissioner: North Tyneside CCG

 

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