Sharon Humberstone from NHS North East Lincolnshire CCG is a Specialist Nurse for Safeguarding Adults and Children, helping practitioners working on safeguarding issues such as gender-based violence, the Prevent counter-terrorism strategy and modern slavery. She also supports the Commissioner for Women and Children working on perinatal mental health and co-ordinates iHV Champions training. Recently she has used the Pathway Assessment Tool to identify gaps in services and improve the experience of women experiencing perinatal mental illness.
We asked Sharon how the Pathway Assessment Tool worked for her.
Why did you decide to use the Pathway Assessment Tool?
The Clinical Commissioning Group (CCG) decided that we needed to undertake a mapping exercise to look at our existing services and to identify where the gaps are. On recommendation from a colleague at the NSPCC we decided to use the MABIM Pathway Assessment Tool.. We also took the opportunity to re-brand our ‘task and finish’ group as the North East Lincolnshire steering group. This gave us a chance to re-visit the membership and ensure that all partners were included. Our new steering group has representation from the CCG, maternity, health visiting, primary care, CAMHS, IAPT services, NSPCC, children’s social care, service users and adult mental health.
How do you engage users?
We have found this difficult at times. We have one fantastic service user representative but we are aware that we need more, so that the work can be shared a little more evenly. We started by running drop-in sessions for women and their families to come and talk to us about perinatal mental health services. We have also dropped in on mother and baby and antenatal groups and sent out a questionnaire to gain feedback. This has given us very useful comments, but we’re aware that we need to do more work to engage service users.
The work has been initiated by the CCG because PNMH was identified as an area that would benefit from more cohesive service provision. North East Lincs is a small county with a higher than average level of deprivation. It is also very rural with a lack of public transport infrastructure in some areas making it difficult for women and families to attend appointments in other localities. The services may be limited but the professionals involved are enthusiastic and committed – a good point to start from.
How have you filled gaps in your service?
We completed the Pathway Assessment Tool at the inaugural meeting of the steering group. We sent the tool out to all of the members prior to the meeting and we worked through the responses, collating and scoring the information as we went along. We were then able to draw up an action plan based on the gaps in service, which we discuss at each monthly meeting. We have identified members who will address specific issues which need a multi-agency response – such as having the same screening tools across different services.
What has been the effect so far?
The overall effect has been really positive. It has given us areas to focus on and means that we are starting to make some real progress on joining up some of the services and raising awareness of perinatal mental health issues in general. It has also meant that work that was already underway such as ‘cascade’ training from the iHV (Institute of Health Visiting) PNMH Champions training is now being overseen by our steering group rather than it being a separate entity.
What specific changes to services have you made as a result of using the Pathway Assessment Tool?
We’ve co-ordinated cascade training and are aiming to make this mandatory for local authority staff who work with children. We’re also working towards ensuring the consistency of screening tools used by health visitors, midwives and IAPT services and consolidating our links with the regional Mother and Baby Unit.
The Northern Lincolnshire and Goole Hospitals have appointed a PNMH midwife, and the Pathway Assessment Tool has helped our steering group direct her so she can focus on the gaps in service.
What have been some of the challenges?
The challenges are much the same as the challenges for our other projects – time and resources! We have had the additional challenge of co-ordinating the number of meetings for PNMH and ensuring that pieces of work are only undertaken once.
Do you have any advice for other teams wanting to use the Pathway Assessment Tool?
Just do it! There are enthusiastic and passionate individuals in every locality and it is possible to start with a small number. Others will join in once they realise that PNMH has an impact on all services. There are also lots of people, like ourselves, who are willing to help, advise and give support as we want all women with PNMH issues to be able to access services and lessen the impact of illness on themselves, their baby and their family. By sharing our own journey we can hopefully improve the experience of not only our local women but those across the country too.
How do you want to move this work forward in the future?
We want to continue to build on the services that we already have and develop a multi-agency pathway so that all providers know where to signpost and refer women who are suffering from any perinatal mental illness. We’d like to strengthen links with other areas and draw from their experiences and expertise. We are also aware that we need to encourage more service users to take part in groups and to give feedback so that any new provision is co-developed with the families that will be using them.
When this blog was written the Pathway Assessment Tool was known as the Mapping Tool. References to the tool were amended when the name of the tool was changed.