Follow up uptake of signposted information and resources regarding mental health and wellbeing. Provide referral to local peer support or specialist service in area if required.
Reduce health inequalities by commissioning services which respond to local need set against clear outcome measures, empowering providers to make service improvements and monitoring progress regularly. Collaborate with relevant services to support the roll-out of continuity of carer models, those aimed at BAME and other vulnerable groups.
Follow up with women on their uptake of signposted information and resources regarding nutrition and folic acid supplements. Provide referral to local community delivered support group or specialist practitioner (i.e. dietitian) if required.
Deliver stop smoking intervention (see NSCST Standard Treatment Programme), receive feedback and discuss any referral outcomes. Provide weekly face to face sessions for at least 4 weeks, followed by ongoing sessions throughout pregnancy as required. Liaise and feedback with referring midwife throughout antenatal pathway. Re-referral to specialist stop smoking support if relapse.
Follow up uptake of signposted information, resources and support services regarding alcohol and drug use. Provide referral to local community delivered support group, i.e. AA, or specialist service for treatment.
Provide an accelerated course of hepatitis B vaccination (±HBIG) starting at birth for babies born to a mother infected with hepatitis B virus, or whose mother had acute hepatitis B in pregnancy. These must be given on time to prevent baby acquiring hepatitis B. Check screening results and offer (or signpost as necessary) doses of hep B vaccines as per the accelerated schedule.
Remember that timing of hepatitis B doses is critical to the success of this post-exposure vaccination treatment. The first three doses, given at birth, four and eight weeks are critical in preventing baby acquiring hepatitis B from its mother.
Promote good communication between hospital maternity services, health visiting services, general practice and child health informatics services are vital to ensuring baby receives all the necessary hepatitis B vaccines on time every time.
Babies born in areas that have high rates of TB infection, or who parents or grandparents were born in countries with high rates of TB should be offered BCG vaccine. Such babies will need to be identified and offer the vaccine.
Support families with identified risk factors are provided with strategies to support their child’s language development pathway with specific attention given to review of communication milestones. Signpost and refer to speech and language therapist guided groups (e.g. groups taking place in children’s centres, community settings, health clinics etc.), Hungry Little Minds and Tiny Happy People.
Collaborate with secondary care to undertake senior clinical review of policies that relate to the support of breastfeeding, ensure that signposting to local sources of feeding support are included, including:
Incorporate health visitor or local infant feeding support for families when faced with a clinical presentation that indicates feeding difficulties, dehydration, reflux or constipation; acute paediatric care may not be the most suitable care pathway.
Continuity of carer, to ensure safe care based on a relationship of mutual trust and respect in line with the woman’s decisions. Support honest discussion about domestic violence through a trauma informed framework.
Collaborate with relevant multi-agency parties to follow up safeguarding concerns from previous appointment. Discuss and implement next steps. Monitor and follow up with appropriate providers.
Encourage pelvic floor strengthening exercises during postnatally. Signpost to information and resources, including NHS Squeezy App and Tommy’s. Refer to relevant local services, including clinical pilates and women’s health physiotherapists if pelvic issues identified.
Identify women who have Long Term Conditions (i.e. epilepsy, diabetes, chronic obstructive pulmonary disease, arthritis and hypertension) and multi-morbidity, and develop an appropriate care plan using NHS’s House of Care NHS and social care long-term conditions framework.
Utilise NHS Long Term Conditions Year of Care Commissioning Programme Implementation Handbook to drive effective integrative care modelling services for Long Term Conditions in your area.