Agenda item

Report of the Director of Public Health and Secondary School Representative for the Health and Wellbeing Board

The Portfolio Holder for Children and Young People introduced Board members to the report which aims to facilitate meaningful discussion regarding Pregnancy and Early Years priorities as identified in the Joint Local Health and Wellbeing Strategy.

The report is intended to support a deep dive review into the thematic priority of pregnancy and early years, with a focus on:

a)      Agreed priorities

b)      Related performance indicators

c)      Health inequalities

d)      Stakeholder engagement

e)      Key actions taken and / or planned

f)       Issues of concern or risk

g)      Ask(s) of Health and Wellbeing Board partners

Officers highlighted the ambitions of the report and gave thanks to those who were involved in its production.  Data on smoking in early pregnancy was presented to Board members with Darlington tending more positively than other North East regions but similar to national averages.

Board members were provided with a presentation covering the various areas of the deep dive, which included:

·         The reasons why smoking during pregnancy is an important public health issue, such as lower birth weights and miscarriages and sudden infant death being 3 times more likely to occur.

·         The drivers and results so far, including 727 fewer antenatal complications, 154 fewer missed appointments and 109 fewer non-scheduled overnight stays in hospitals.

·         The actions of CDDFT to reduce smoking in pregnancy

·         The focusses of the 0-19 service

·         Delivery rates at Darlington Memorial Hospital by ward – showing a synergy with the deprivation map

·         Age group analysis and variations

·         Inequalities

·         Tobacco dependency treatment service referrals

·         Opportunities available, including closer working with partner organisations and stop smoking support before pregnancy

Discussions took place including the Chair highlighting that pinpointing inequalities remains the first step in an effective strategy and praising officers on the work conducted and data gathered thus far.

Further discussions included how to progress from this point – with officers informing Board members that they are currently utilising data to share across the trust and working with sexual health teams.  In terms of using data effectively, targeting specific patient groups is taking place, such as diabetic women.  “Listening events” focussed on areas with highest tobacco dependency will now take place in Darlington

A Board member informed those present that the “Bump, Baby and Beyond” scheme is present and would be willing to collaborate.

Questions were raised with a member stating that 10% smoking while pregnant is still too high and asking what approaches are being taken in clinics with the response that huge variations can be present as smoking is an addiction not simply a change of lifestyle alongside many pregnancies being unplanned.  Smoking wasn’t managed as a clinical pathway in the past (like e.g. diabetes).  Incentive Schemes are now established and numbers are shown to be reducing.  Although officers agree that 10% of pregnant women being smokers is still too high, they are confident it can be reduced.

It was asked as to whether data on the impact of vaping is available with the response that vaping is promoted to smokers and that data is being collected on those who have only ever vaped (without smoking) but is hard to track due to the nature of patient record collation.

A Board member asked as to whether smoking data is tracked following the birth date to determine what percentage of women return to smoking for example.  Officers responded that initiatives are in place to try and prevent women from returning to smoking, including gathering data on household members with incentive schemes which also cover partners with everyone in the home being offered CO monitoring.  The overall goal is for women to be non-smokers at the start of the their next pregnancy should this occur.

It was asked whether alcohol and drugs are also a focus and it was confirmed that a multi-agency approach is present to ensure this.  In addition, a Chair for the Tobacco Alliance is currently being recruited with the establishment of the group.

AGREED – Board members noted the content of the update, and the work carried out in the production of the deep dive, offering praise to those involved for the quality of the work produced.  Member organisations agree to consider actions that could be taken to better support health during pregnancy and identify opportunities to develop partnership work.