Health: Supporting Women, Reducing Harm Short Life Working Group minutes - 17 October 2024

Attendees and apologies

Attendees

• Emma Cashmore-Gordon, Co-chair, Perinatal Services Manager, Aberlour
• Karis Deacon, SG, Secretariat
• Claudette Day, SG, official
• Carolyn Wilson, SG, official
• Anne McFadyen, SG, Perinatal and Infant Mental Health
• Marie-Claire Shankland, Programme Director, NHS Education for Scotland
• Shelley Arthur, Health Visiting Team Leader, NHS Forth Valley
• Roch Cantwell, SG, Perinatal and Infant Mental Health
• Sarah Zadik, Co-Founder & Head of Services, Amma Birth Companions
• Lynn Gillies, Service Manager, Children & Families, Social Work, Fife Council
• Jennifer Shields, Foetal Alcohol Advisory Support Training Team, Edinburgh
• Hazel Inglis, Specialist Midwife for Drugs and Alcohol, NHS Highland
• Samantha Stewart, Scottish Drug Forum (SDF)
• Jaki Lambert, Director for Scotland, Royal College of Midwifes
• Rowan Anderson, Programme Lead, CORRA Foundation

• Iona Duckett, Co-chair, Senior Midwife, NHS Tayside

Apologies

• Kirstie Campbell, SG, official
• Emily McLean, SG, official
• Carolyn Wales, SG, official
• Ruth Robin, Healthcare Improvement Scotland

Items and actions

Welcome and updates

The co-chairs welcomed group members to the seventh meeting and thanked everyone for attending. All members indicated they were content with the minutes of the previous meeting.

Lived and living experience (LLE) group

​​​​​​​The co-chair gave an overview of the previous session with the Lived and Living Experience Group, held on 3 October. They were asked specific questions around the draft guide of the Journey Through Care.

​​​​​​​The LLE group were asked if the list within the draft guide outlines the key stages of care and support, what gaps exist and where stigma and judgement exists in the process. The following key points were highlighted to the group:

• wraparound care for women and their families is fundamental to ensure positive outcomes in terms of recovery, self-worth and parenting
• trust in the social work process is required, particularly from the beginning of pregnancy
• improving the environment of capacity assessments, ensuring women feel safe to discuss traumatic and sensitive events, with proper follow-up support provided

• cross-functional collaboration and holistic workforce training and development, so women and their babies/infants receive comprehensive and consistent care through joined-up services that are both trauma informed and trauma skilled
• services should acknowledge the achievements women have made throughout their journeys, rather than focusing on perceived failures
• reasonable birth plans, including choice of place of birth, should be offered

​​​​​​​The LLE group also advised on what the good practice would look like if services were joined up:

• access to peer learning and having a support worker with lived and living experience to create a safe and comfortable environment, allowing honesty and real change to take place
• women being treated as the experts in their own lives
• coordination and connection around care planning, with stigma and shame removed

Good practice guide discussion

​​​​​​​Attendees were asked to address each of the four key questions related to the main areas of the draft guide and working towards planning integrated support to ensure person-centred and tailored care for women, babies, and families across services. In the discussion, the following key points were made:

• as a reflection of the practical challenges, internal information governance can sometimes feel obstructive and wieldy, slowing progress - despite strong buy in and support
• the Getting It Right For Every Child (GIRFEC) approach is designed to give nationwide continuity of approach, support and accessibility. It was noted if the principles were applied to unborn children, it would create a system that supports collaboration, addressing both the needs of the mother and the extended family in a more holistic way
• is the GIRFEC framework sufficient, or does it need to be strengthened?
• alternatively, should we consider implementing an additional framework that complements or can be stacked alongside GIRFEC to better address needs
• given that GIRFEC is almost 20 years old, it is important to ask whether the agreed process is still being coordinated as effectively as expected
• evaluating its implementation, considering nearly two decades of practice, could reveal areas that need refocusing and reinforcing, strengthening the aspects that have allowed co-production of working
• GIRFEC is effective in bringing a multitude of information together, and the request for assistance form is useful to weave in and access other services – such as neurodivergent support to address any unidentified needs in the parents that have contributed to the perpetuation of difficulties
• however, the levels of use are variable across Scotland and GIRFEC does differ from one locality to the other
• we need to ensure women and families affected by substance use have good  contraception advice alongside pregnancy planning care, ensuring women are supported in their choices, and this is included in the overall guidance
• making recommendations for a care coordination, someone who can work across services and not just within their own particular area. Advocacy and peer support must also become default
• mental health services and financial support/welfare advice should be added to the list of organisations within the guide as these are two drivers behind substance use

Actions and Close

• ​​​​​​working group will engage with the GIRFEC team for input
• ​​​​​​​the working group was asked to revisit the points circulated by Karis regarding the good practice guide, so that the remaining three key areas can be discussed at the next meeting

Date of next meeting: Thursday 7 November 2024, 11:00 – 12:00