Mother and Baby Unit (MBU) capacity increase options: consultation

Section A: Background

Scottish Government Consultation Process

Consultation is an essential part of the policymaking process. It gives us the opportunity to consider your opinion and expertise on a proposed area of work.

You can find all our consultations online. Each consultation details the issues under consideration, as well as a way for you to give us your views, either online or by email.

Responses will be analysed and used as part of the decision making process, along with a range of other available information and evidence. We will publish a report of this analysis for every consultation. Depending on the nature of the consultation exercise the responses received may:

• indicate the need for policy development or review
• inform the development of a particular policy
• help decisions to be made between alternative policy proposals
• be used to finalise legislation before it is implemented

While details of particular circumstances described in a response to a consultation exercise may usefully inform the policy process, consultation exercises cannot address individual concerns and comments, which should be directed to the relevant public body.

Currently, there are two regional Mother and Baby Units in Scotland. These are at St John's Hospital, Livingston hosted by NHS Lothian and Leverndale Hospital, Glasgow hosted by NHS Greater Glasgow and Clyde. Each Mother and Baby Unit can take up to six women and their babies.

Information from the existing Mother and Baby Units and data linkage show that, over the five years 2016-2020, there were an average of 115 Mother and Baby Unit admissions per year. However, there were a further 125 admissions per year of women within 12 months of childbirth to other inpatient mental health beds.

The data also indicate that in all health board areas, except NHS Lothian and NHS Greater Glasgow and Clyde, women were more likely to be admitted to a non-Mother and Baby Unit setting than to a Mother and Baby Unit if they require inpatient mental health treatment. NHS Lothian and NHS Greater Glasgow and Clyde are the host boards for the two Mother and Baby Units.

It is likely that some of the women and their infants admitted to non-Mother and Baby Unit settings would have benefitted from Mother and Baby Unit admission. However, we do not currently have the data to tell us why women were admitted to non-Mother and Baby Unit beds. There are a number of possible reasons ranging from not being the primary caregiver or the patient preferring to be treated away from their baby to lack of available of beds in Mother and Baby Units or the patient not wishing to travel away from their local area.

Delivering Effective Services: Perinatal mental health services: needs assessment and recommendations (2019) draws on the findings of the Perinatal Mental Health Network's NHS board visits, professionals' workshops and online survey of women's views, conducted in 2017-18, and the existing evidence base on service provision. The report makes recommendations on what services Scotland should develop to meet the needs of mothers with mental ill health, their infants, partners and families.

The Scottish Government established the Perinatal and Infant Mental Health Programme Board in April 2019. The Programme Board oversee a programme of investment, provides strategic leadership and have overall management of the delivery of improved perinatal and infant mental health services. Since its establishment, the Programme Board has been working to take forward the recommendations from Delivering Effective Services (2019).

Delivering Effective Services (2019) recommended that Scotland could benefit from an additional four Mother and Baby Unit beds. These additional beds could be created by expanding one or other of the existing Mother and Baby Units, or through creating a new, third, Mother and Baby Unit in the north of Scotland.

Delivering Effective Services suggested that an options appraisal should be carried out to determine where the additional beds should be sited. We are currently seeking views to help us understand the needs of women and families in Scotland. This will help to inform the options appraisal. The options appraisal will evaluate potential options on the basis of equity of access, cost, and the safety and sustainability of the service.

Why your views matter

To help ensure that the right services are available at the right time, and in the right way for those who need them we are aware that we need to hear the views from people across Scotland. Your views will help us in determining the most effective way forward in developing inpatient services which meet the recommendations outlined in Delivering Effective Services.

What we will do with the responses we receive

We will use this data to inform the final draft of the options appraisal and to support future decisions in this area. The views of people across Scotland are highly valued and as such we would also seek to incorporate these into other future policy developments. This would involve discussing and sharing the analysis of the consultation with Scottish Government policy areas and stakeholders involved in Mother and Baby Unit provision. The information shared at this point would be from the final consultation analysis and would take into account the context and approach of the consultation itself.

The consultation will conclude on 31st May 2022. We will then carry out further engagement with any groups underrepresented in consultation responses. All consultation responses will be analysed.

We will publish the results of the consultation Summer 2022.

The following questions are designed to be deliberately open to allow you to share your thoughts. If there is not a specific question focusing on an area/issue you feel strongly about, please add it to the final comments section.

You may not have any thoughts about some of the questions or there may only be a specific area you are interested in commenting on; we would still appreciate your thoughts. If you do not have an answer for a question, just skip it and move onto the next.

You can choose for your response to be published with your name, be published without your name, or for your response not to be published. If you choose for your response not to be published, we will still consider your views and response as part of the decision making process. We will redact personal and identifying details from any published responses. However, please be mindful of the personal information that you are sharing when responding to the questions.

We understand that this can be a difficult subject to talk about. Please see below for a places you can find support.

• Breathing Space - Breathing Space is Scotland's mental health helpline for individuals experiencing symptoms of low mood, depression, or anxiety, and offers free and confidential advice for individuals over the age of 18. They can be contacted on 0800 83 85 87, 6pm to 2am Monday to Thursday; and from 6pm Friday throughout the weekend to 6am Monday.
• Samaritans – Samaritans provide confidential non-judgemental emotional support 24 hours a day for people who are experiencing feelings of distress or despair. You can contact Samaritans free on short code 116 123.
• NHS24 - If you're feeling overwhelmed or need support you can call NHS 24 on 111. The Mental Health Hub is open 24/7.
• NHS Inform - NHS inform has a lot of resources to help with your mental health, whether you're looking for advice, information, local support, or ideas for improving your wellbeing.
• Clear Your Head – Clear Your Head provides practical advice on how to stay active, keep connected with friends and family, and create healthy routines to support your mental health and wellbeing.