New figures reveal smoking in pregnancy rates at all-time low in Greater Manchester
New NHS data shows the number of people smoking during pregnancy in GM has dropped to the lowest on record.
Smoking at the Time of Delivery (SATOD) rates have fallen by around a quarter in the past four years - down from 1 in 8 (12.6%) new mothers in 2017-18 to fewer than 1 in 10 (9.8%) in 2020-21[1], meaning 945 more babies were born smokefree.
It shows the success of the Greater Manchester Health and Social Care Partnership's Smokefree Pregnancy programme which was set up in 2018 and is recognised as best practice nationally.
In the 12 months between April 2020 and March 2021, the programme supported more than 1,700 people on their journey to stop smoking, including pregnant women and their partners, and saw a 65% successful quit rate.
The programme was created as part of efforts to give every baby the best start to life. NHS maternity staff in Greater Manchester are given comprehensive training to have open and honest conversations about the risks of smoking, use carbon monoxide (CO) screening to check for exposure to tobacco smoke and refer people who need help to a maternity-led stop smoking service.
Smoking during pregnancy or inhaling second-hand smoke from others (known as passive smoking), can raise levels of carbon monoxide (CO) within the body. This poisonous gas can restrict the essential oxygen supply to the baby and significantly increase the risk of complications such as miscarriage, premature birth, low birth weight and stillbirth.
During the pandemic, the number of women referring themselves to the stop smoking service increased, and personal carbon monoxide monitors were issued, allowing service users to complete CO screenings at home that linked through to a smartphone app which the specialist midwives could track to validate their quit journey.
Photo above right: Jane Coyne, Strategic Lead for the Making Smoking History and Smokefree Pregnancy Programmes
Long Term Plan Programme Implementation Advisor - Tobacco Dependence NHS England & NHS Improvement
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New report emphasises that pregnant and postnatal women with Covid-19 must receive the same standard of care as non-pregnant people |
Findings from the new MBRRACE-UK 2021 rapid report, Learning from SARS-CoV-2-related and associated maternal deaths in the UK June 2020-March 2021 , suggest there needs to be wider awareness of how best to treat pregnant and postnatal women with Covid-19.
Report authors reviewed the care of all pregnant and postnatal women who died with SARS-CoV-2 infection, and women who died and whose care or engagement with care was influenced by changes as a consequence of the pandemic between 1 June 2020 and 1 March this year.
Fourteen women died with SARS-CoV-2 infection, 10 from Covid-19 and four from other causes, three further women's deaths were influenced by changes as a consequence of the pandemic.
Only one out of 10 women who died from Covid-19 was treated in accordance with the evidence-based guidance developed by the Royal College of Obstetricians and Gynaecologists and Royal College of Midwives.
This comprehensive national guidance should be followed wherever pregnant or postpartum women are cared for. The report also highlights a need to ensure early senior involvement of the maternal medical team, understand the needs of the woman herself and avoid withholding treatment due to misplaced concerns over her pregnancy.
The report also noted ongoing indirect impacts such that women are fearful of seeking care and may delay presentation or not present at all. Other pregnancy complications remain many times more frequent than Covid-19 in pregnancy, and the need to ensure women are able to access the care they need is essential.
This includes making sure that women are confident about their safety in attending face to face visits, but also recognising situations in which remote consultations are inadequate. This may be for several reasons including language difficulties, lack of access to appropriate technology, repeated presentation, clinical complexity or potentially severe or high risk conditions.
MBRRACE Online Course 2021
MBRRACE will be running two free courses simultaneously over 6 weeks during September and October 2021.
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The MatNeoSIP delivery team at Health Innovation Manchester appreciate that maternity and neonatal units are under increased pressure at the moment and therefore will not be adding additional pressures by chasing those improvement teams who currently are unable to engage with regards to their MatNeoSIP improvement projects. We look forward to continuing supporting teams when it is safe and appropriate to do so.
Trust Improvement Teams have completed day three of the Patient Safety Improvement Practitioner Programme, the methodology on day three included measurement for improvement and PDSA cycles. Teams are now able to develop a measurement strategy and undertake small scale tests of change using PDSA cycles (when they have capacity to re-engage).
Following initial prototype testing, supported by the maternity team at Oldham, the new national MEWs tool has been finalised and is ready for the next phase of testing. We are currently awaiting further instruction from the national team regarding what specifically the next phase of testing looks like. We will likely call upon interested maternity units within our LMNS to support with this phase of testing.
We would like to thank Simon Meghan, Director of Midwifery, Karen Parks, Interim Labour Ward Lead Midwife and Karen Parks, Practice Educator at Oldham, for supporting us and the national team with the initial prototype testing process.
We are in process of engaging with the colleagues in the system regarding our delivery model for 2022/23 when we shift our focus to the optimisation workstream and look at preterm the optimisation pathway. We will undertake this engagement via HoMs and one to one meetings with the patient safety lead midwife.
Working collaboratively with the Greater Manchester Health and Social Care Partnership and smoke free specialist midwives from across the LMSN, we have developed a driver diagram with the aim being to increase CO monitoring at every contact in line with national standards. Over the coming months we will be working with specialist smoke free midwives at each maternity unit to undertake small scale tests change based on the change ideas identified in our driver diagram.
Our third Patient Safety Network Learning Event will take place on the on November 11 2021 and will be a joint event with the Strategic Clinical Networks (combining the Patient Safety Network Learning Event with the GMEC LNMS Patient Safety Showcase Event). The patient safety focus for this event will be on reducing inequalities. Further details regarding how to register for the event will be released in the coming weeks
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If you have any question regarding MatNeoSIP please contact Thomas.Openshaw@healthinnovationmanchester.com
Tom Openshaw Programme Development Lead Patient Safety Collaborative, Health Innovation Manchester.
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Greater Manchester and Eastern Cheshire Local Maternity System (GMEC LMS) was the only LMS involved in a recent pilot of the Peppy Baby app.
The lead maternity provider St Mary's Managed Clinical Service worked with stakeholders across Manchester, Trafford and Salford with support from the SCN Maternity team on the pilot of the Peppy Baby app.
This was for those in late pregnancy through to eight weeks post birth, providing additional free expert support including 1-2-1 text chat with perinatal practitioners, infant feeding consultations, mental health advice, tailored group webinar sessions on a wide range of topics, peer support group chat and more.
The external evaluation by Swansea University found positive outcomes for the support the app provided to parents as well as positive outcomes for infant feeding, mental wellbeing and parental confidence.
Some of the outcomes included:
- At eight weeks, 80% of women were breastfeeding, (this is higher than the average across Greater Manchester)
- 95% said Peppy helped them feel more knowledgeable about breastfeeding
- At eight weeks, 82% of parents were feeding their babies as they had planned (importance of this on parental wellbeing)
- Mental wellbeing improved during the pilot, with the percentage of mothers reporting normal or high wellbeing increasing from 69% at baseline to 89.9% at the end of the pilot. There was a particularly high increase in mental wellbeing at end of the pilot from those of Black, Asian or minority ethnic background
- 90.5% reported Peppy Baby gave them greater confidence in their parenting
- 92.8% said they would like to see Peppy Baby continue.
If you are interested in receiving the full evaluation report, once this has been released, please email Zoe.Neilson1@nhs.net.
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16th September 2021 HSIB National Investigation Conference via Zoom. To book a place follow link: Webinar Registration - Zoom
11th November 2021 LMS/HIM Safety Event via Teams 9.30-16.30 Further details from michelle.davies@nhs.net
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