The East London Mother and Baby Unit is a specialist inpatient service for women in South East of England, as well as receives and accepts referrals from secondary services from across England. The service is for women who have moderate to severe mental health problems during pregnancy or within the first year after childbirth. As well as accepting unplanned admissions, prophylactic and planned admissions are also accepted by the service for women from 32 weeks of pregnancy.
Inpatient care (mother and baby units) – East London Mother and Baby Unit
The East London Mother and Baby Unit is a specialist inpatient service for women in South East of England, as well as receives and accepts referrals from secondary services from across England. The service is for women who have moderate to severe mental health problems during pregnancy or within the first year after childbirth. As well as accepting unplanned admissions, prophylactic and planned admissions are also accepted by the service for women from 32 weeks of pregnancy.
meeting the recommended response time for Pathway 5 with at least 90% of women who need unplanned inpatient care should have access to a mother and baby unit within 24 hours of referral. This includes ensuring that the team accepts planned admissions for prophylactic management of high risk cases at the agreed date (subject to the availability of beds)
providing specialist multidisciplinary perinatal community services and inpatient psychiatric mother and baby units are available to support women with a mental health problem in pregnancy or the postnatal period, in line with NICE quality statement 7.
Referrals and assessment
Referrals to the East London and Inpatient Unit are accepted from services from across England. The inpatient unit receives referrals from community mental health teams, emergency departments, psychiatric liaison teams, acute mental health wards and home treatment teams. Where there are more complex needs, the team will come out to assess the woman, to determine the need for admission. The referral assessments are undertaken by senior members of the team (either an AfC band 6 nurse or above plus medical staff). Decisions about complex cases are made with the unit’s senior team in work hours, or with the duty senior nurse or on-call consultant out of hours.
Referrals can be made during the antenatal period from acute mental health wards (within and external to the trust), as well as community mental health teams.
Women are accepted to the inpatient unit from 32 weeks of pregnancy.
All referrers are asked to ensure that the family consents to the admission of the baby, and that every effort is made to ensure that children’s social care have been informed and are aware of plans for admission (instead of informing social services, the team will have a discussion with social care before making the decision to admit; social care are then notified)
Referrers are informed at the time of referral if the Unit is able to admit the woman, based on capacity. If the Unit lacks capacity, the woman is provided with the details of another mother and baby unit.
The outpatient teams accept referrals from primary care, GPs, health visitors, midwives and IAPT services.
Interventions
The facilities in the mother and baby unit have rooms that are suitable for mothers’ needs, including en-suite facilities, large family-oriented rooms, rooms suitable for women with twins and rooms adapted for women with a physical disability, mobility needs and those who use a wheelchair.
Other interventions include:
one-to-one time with a named nurse and nursery nurse, to develop individualised care plans
parent–infant psychotherapy
psychological therapy
sensory room to facilitate non-verbal communication
art therapy
dance movement psychotherapy
‘adjusting to motherhood’ group
gym visits
mindfulness sessions
baby massage
occupational therapy
one-to-one meetings with a pharmacist
health visiting and paediatric support for the infants
maternity and midwife care and treatment
sensory rooms for mothers and the baby, which fathers can also use.
The outpatient service provides a range of interventions, including:
care and planning for the perinatal period
specialist advice on the risks and benefits of medication in pregnancy and breastfeeding
community nurse visits
screening for cognitive behavioural therapy and short-term therapy may be offered
preconception counselling.
Monitoring and measurement of outcomes
The Margaret Oates Mother and Baby Unit monitors and records outcomes through HoNOS, and patient feedback is collected electronically, passed on to staff via ‘shared learning emails’ and analysed to inform future service delivery. The unit has close links with other perinatal teams from the East London NHS Foundation Trust and neighbouring mental health teams.
Workforce, reporting and staff training
Workforce
(WTE hours and roles)
The East London Mother and Baby Unit inpatient team is staffed by a team that consists of:
