Standing on the shoulders of giants


dsc_0049By Sally Hogg, Strategic Lead, Mums and Babies in Mind

On 28th November, NHS England announced the 20 areas of the UK that will be receiving the first phase of specialist perinatal mental health development funding. This funding is to support the creation or expansion of specialist perinatal mental health community teams.

This new funding is incredibly exciting: We’ve known for a long time that, while specialist services are critically important, there are huge gaps in provision. More than 40% of areas in England have no specialist community perinatal mental health team, and those that do often fail to reach accepted standards. In this tight financial climate, additional funding will be the enabler that many keen commissioners and providers need to close the gaps in provision.

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We are delighted that three of our Mums and Babies in Mind areas – Gloucestershire, Haringey and Southend – will receive funding for new services in this first phase, and we look forward to working with them as they establish their specialist teams.

Sadly there will be many areas of the country that do not receive funding in phase 1. However, with another phase of development funding in 2018/19, and funding in CCG baselines from 2019/20 – there will be opportunities for all areas to set up a new team in time. Those who submitted an unsuccessful bid this time, will receive feedback from NHS England to help them to refine their proposals and prepare to establish a new team in the coming years. Those areas who are not receiving funding in phase 1 still have important work to do in establishing partnerships; deepening local understanding of perinatal mental health and developing robust and evidence based plans for a new service so that they are ready to act when the funding arrives.

In physical healthcare, it has long been accepted that specialist services provide higher standards and quality of care. The same is true in perinatal mental health. Professionals working in general adult services are unlikely to see sufficient cases of severe perinatal mental illness to maintain the knowledge, experience and skills they need to provide high quality care. Specialist teams can develop this expertise. They also have the capacity to understand the social, emotional and physical changes associated with pregnancy, birth and new parenthood for the whole family, and the importance of working, not only with the mother, but also with the critically important mother-infant relationship. They can offer real prevention and early intervention: offering pre-conception and preventative care to women, and responding quickly if problems do occur.

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In October we brought leaders from the Mums and Babies in Mind sites together for a masterclass about developing specialist perinatal mental health community teams. This was the first of our Leaders’ Programme masterclasses, a programme of learning activities for leaders from a wide range of different services and professional backgrounds within the MABIM areas.

At the masterclass we were joined by fantastic clinicians from four existing specialist perinatal mental health community teams. They helped us to understand the challenges and opportunities in developing a specialist service and the common features of a successful team. Listening to the four speakers also highlighted the variations in the make-up and operation of different specialist teams, and the opportunities for commissioners and providers to design a service that works best for their local area and population. As Dr Jo Black told us, “No one has the final iteration of what good looks like”.

In the MABIM project, we are committed to sharing all our learning and resources with a wider network. We are particularly aware that all of the commissioners and providers who are receiving new funding from NHS England might benefit from the insights from our latest masterclass. In October we published a top tips report from the masterclass, and a ‘toolkit’ of slides and template resources, which are available on our website: www.maternalmentalhealthalliance.org/mumsandbabiesinmind/mabim-tools.

There is a lot of work involved in developing an effective specialist service, but it was clear from the masterclass speakers that it is achievable, and great things can be achieved in a relatively short time. There is a lot to learn from existing services, and we hope that the next phase of specialist teams will help to develop an even deeper and broader understanding of what good practice looks like. As Dr Alain Gregoire told us, “The UK has world leading perinatal mental health services. In developing your specialist perinatal mental health services, you are standing on the shoulders of giants.”

Mums and Babies in Mind supports local leaders in four areas of England to improve care and quality of life for mums with mental health problems during pregnancy and the first year of life, and their babies. MABIM

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