CYPIC case study: NHS Lanarkshire

Case study: Lanarkshire Additional Midwifery Service (LAMS)

Source: Lorraine Farrow, Lanarkshire Additional Midwifery Team, NHS Lanarkshire, April 2017

The Lanarkshire Additional Midwifery Service (LAMS) was developed to work collaboratively to support pregnant women in Lanarkshire to recover from substance misuse.

It does this by improving women's engagement with antenatal care, providing support for their holistic needs and preparing them to care for their new-born. Using quality improvement methodology, through the Children and Young People Improvement Collaborative, LAMS tested, measured and implemented a number of systemic changes to the ways it delivers services.

These included improving screening and documentation of substance misuse, introducing psychosocial interventions to help pregnant women develop coping strategies and avoid relapse and, introducing initiatives to build parenting capacity, promote health and wellbeing and help tackle poverty.

The improvements resulted in many more pregnant women engaging with LAMS; increasing from 36 per cent in 2013 to over 85 per cent in 2015. There has been a significant reduction in families requiring social work interventions and an 86 per cent decrease in illicit substance misuse. More babies are being born at term and improvements in new born birth weights are being recorded. In addition, more women are taking up offers of advice on smoking cessation, breast feeding and welfare rights. And there is more uptake of Long Acting Reversible Contraception preventing future unplanned pregnancies.

Many families who engage with LAMS say that without this support they would not have been able to change their lifestyle and care for their child. LAMS midwives have produced a LAMS Recovery Action Plan that is now provided to all families they work with.

LAMS won the Royal College of Midwives President's Award in 2017 for Reducing Inequalities and was also shortlisted for a CYPIC Quality Improvement Award in 2016.