Health: Supporting Women, Reducing Harm Short Life Working Group minutes - 25 April 2024

Attendees and apologies

Attendees

• Emma Cashmore-Gordon, Co-chair, Perinatal Services Manager, Aberlour
• Iona Duckett, Co-chair, Senior Midwife, NHS Tayside
• Anne McFadyen, SG, Perinatal and Infant Mental Health
• Roch Cantwell, SG, Perinatal and Infant Mental Health
• Jaki Lambert, Director for Scotland, Royal College of Midwifes
• Lesley Sharkey, Director of Midwifery, NHS Tayside
• Lynn Gillies, Service Manager, Children & Families, Social Work, Fife Council
• Maree Aldam, CEO, Birth Companions
• Marie Balment, Perinatal and Infant Mental Health Network Scotland
• Ruth Robin, Healthcare Improvement Scotland
• Shelley Arthur, Health Visiting Team Leader, NHS Forth Valley
• Jennifer Shields, Foetal Alcohol Advisory Support Training Team, Edinburgh
• Joanne Smith, Policy and Public Affairs Manager, NSPCC Scotland
• Rowan Anderson, Programme Lead, CORRA Foundation
• Karis Deacon, SG, Secretariat

Apologies

• Adam Burley, Trauma Services in Mental Health Lead, NHS Lothian
• Gavin Philipson, Perinatal and Infant Mental Health Network Scotland
• Fiona Miele, Family Nurse Partnership Lead, NHS Grampian
• Anna Clark, Consultant Obstetrician, Glasgow SNIPS
• Donatella Olisterno, Service Manager, Harper House
• Hazel Inglis, Specialist Midwife for Drugs and Alcohol, NHS Highland
• Linda Thompson, Head of Services, Women’s Support Project
• Kirsten Horsburgh, CEO, Scottish Drugs Forum
• Susanna Galea-Singer, Royal College of Psychiatrists in Scotland
• Kirstyn Brogan, Royal College of Obstetricians and Gynaecologists
• Lyndsey Turfus, Substance Use Sub-Group Chair, Social Work Scotland
• Maree Aldam, CEO, Birth Companions
• Carolyn Wales, SG, official
• Carolyn Wilson, SG, official
• Kirstie Campbell, SG, official
• Emily McLean, SG, official

Items and actions

Welcome and introductions 

The co-chairs welcomed group members to the second meeting and thanked everyone for attending.

Presentation on the Stepping Stones Study

Professor Helen Cheyne, Dr Lynne Gilmour and Louise Honeybul of the University of Stirling delivered a presentation on the Stepping Stones Study ‘Evaluating models of care: best practice and care pathways for women who are dependent on drugs and their infants from preconception to 18 months postnatal’. The aim of this study was to understand how health and social care providers can best meet the needs of women who use drugs and to understand the services and care pathways that are most acceptable and accessible, leading to the best outcomes for families.

The Stepping Stones Study included a review of clinical guidelines and existing interventions for this group of women and infants, and longitudinal interviews with women from 4 sites across England and Scotland who use drugs at multiple stages during the perinatal period.

36 women took part in the qualitative study, most of whom had a very complex history of mental illness, abuse, homelessness, offending, unemployment and severe poverty. The interviews found that when accessing services, these women often faced multiple issues including a hostile care environment, gaps in service provision and lack of person centred care and shared decision making. 12 focus groups were also held with staff from various services about their experiences of delivering care for this group.

The final report and full suite of evidence from the study has not yet been published, but these will be shared with this Group as soon as possible.

Following the presentation this was opened up to the group for a discussion. Points included:

• there is a need for improved care co-ordination for this group of women. There may be a new role here for a ‘care co-ordinator’ which would go beyond the existing role of the specialist midwife which is either vested in a person or an organisation
• relational based care is crucial during the antenatal period. The care co-ordinator could be someone who covers the whole period of 18 months, like a health visitor. This would overcome the disjointedness of the transition from midwife to health visitor
• when considering co-location, we must consider the full suite of services that would be helpful to women
• a key area of focus for this group should be support for women who have had children removed into care. The study highlighted very few examples of good practice in the postnatal period for this group of women, as care often follows the children
• vicarious trauma is prevalent in staff delivering care to women with multiple complex needs. Many staff report poor mental health, and the study highlighted there is a need for peer support or supervision to be built into services

The chair thanked Professor Helen Cheyne, Dr Lynne Gilmour and Louise Honeybul for their input.

Business planning

Iona Duckett highlighted the changes made to the terms of reference (ToR) following Meeting 1 and suggested that any further comments should be sent to the Secretariat, they will then be published on the Scottish Government website.

Iona Duckett noted that the Lived and Living Experience (LLE) Steering Group had not yet met due to recruitment issues, and steps were being taken to reach out to multiple services to find women who would be willing to take part.

​​​​​​​Iona Duckett provided an overview of the workplan for the Short Life Working Group (SLWG) and suggested that a small drafting group is established to deliver the good practice guide; this will  enable the wider group to utilise the monthly meetings to discuss existing good practice and dissemination. The following points were made by members:

• when considering how we can best engage people with lived and living experience, this group should be as creative as possible about the model of participation
• while some women will want to join the group, others may want to provide input via different methods and the group should be open to this
• monthly group meetings should be utilised to hear from services who are currently providing good practice across Scotland. Martha’s Mammies and Aberlour mother and baby recovery houses were highlighted as examples that the group would like to hear from
• there is a need to view this work through an equalities human rights lens, and link in with the Human Rights Charter

Actions and close

• the co-chairs noted that any members who would like to be part of the drafting group should contact the secretariat to discuss this further.
• ​​​​​​​members were also invited to contact the Secretariat if they have any women with lived and living experience of substance use during pregnancy within their services who would be willing to join the LLE Steering Group.
• ​​​​​​​the co-chairs thanked members for attending and for their valuable input and closed the meeting.

Date of next meeting: 30 May 2024 11:00 – 12:30