Improving Services for Young Children by Anning Angela;Ball Mog; & Mog Ball

Author:Anning, Angela;Ball, Mog; & Mog Ball
Language: eng
Format: epub
ISBN: 537747
Publisher: SAGE Publications, Limited
Published: 2008-05-30T00:00:00+00:00

A disadvantage was a perceived unfairness to families just outside SSLP boundaries not entitled to enhanced services (although in practice many SSLPs regularly allowed families from the surrounding non-Sure Start area to use their services).

Multi-disciplinary and multi-agency working

There has always been rivalry, and relatively little contact, between midwives and health visitors, with a handover at approximately 10–14 days after birth. In SSLPs midwives and health visitors were working as part of an integrated team. This collaboration resulted in significant improvements in continuity of care between the antenatal and postnatal periods, with joint visits, efficient handovers and follow-up. The integrated nature of SSLPs teams enabled midwives and health visitors to co-work with nursery nurses, family support workers, outreach workers, healthcare assistants, home visitors, bilingual link workers, community dietitians and community psychiatric nurses. A key enabler was sharing a common base at the Sure Start centre. Co-location gave maternity and other staff informal opportunities to share knowledge and refer clients to each other. Where SSLPs delivered maternity services at satellite venues SSLP staff informally attended the clinics or groups, co-facilitated groups or led particular sessions.

To provide comprehensive maternity care, most SSLPs brought in expertise from local statutory and voluntary agencies outside the Sure Start team. Experts were invited to antenatal and postnatal groups to offer information and support on topics such as healthy eating, welfare benefits, maternal mental health, the emotional aspects of having a baby and relationships. Some SSLPs funded voluntary organisations to provide a specific service for Sure Start women, such as befriending or breast-feeding counselling.

Some SSLPs used paraprofessional maternity care assistants to provide elements of services, such as breast-feeding support, freeing up midwifery or health visitor time to concentrate on specialist services. For example, one SSLP used maternity care assistants to provide practical and social support at home to women for six weeks after birth. Some professionals had difficulties adjusting to paraprofessionals, reflecting a debate going on more widely in children’s services; for example, some midwives expressed concern that their role was being eroded.

Multi-agency teamwork resulted in improved referral links. The SSLP maternity staff worked with city- or county-wide services and the voluntary sector to arrange clear and efficient referrals to mainstream services for Sure Start women who needed additional support, especially on issues such as smoking cessation, domestic violence and support for women with postnatal depression.

Extra time allocated to maternity practitioners for non-clinical work enabled some to take the lead on a key maternity issue, particularly breast-feeding or postnatal depression. It allowed them to build comprehensive partnerships with all the relevant stakeholders to transform services beyond the SLLP. One SSLP created a partnership with the PCT, mental health services, social services, the acute trust, the health visiting service, and local parents to develop an integrated care pathway on postnatal depression that included training for staff, screening of women, listening visits, support groups and clearer referral paths.

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