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NHS specialist community perinatal services to be set up in all England regions

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Specialist community perinatal mental health services will be available in every part of the country by April next year, NHS England has said as it confirmed the roll-out of £23m of funding.

The funding is part of an overall investment of £365m in perinatal care, announced in 2016. 

“Following the bidding process, it has worked out that every CCG will now have funding to put a perinatal service in place”

NHS England spokesman

It follows the allocation of £40m in 2016 for 20 sites England to establish new specialist perinatal mental health services in the community, or expand existing provision – which has seen more than 7,000 new and expectant mums access care and treatment so far.

NHS England said services had already come a long way since 2014, when it was estimated that only 3% of the country had good access to perinatal mental health care.

However, recent research by the Maternal Mental Health Alliance campaign group suggests there is still some way to go before every woman requiring specialist care can access services.

According to the alliance, in 2017 more than half – 51% – of clinical commissioning groups (CCGs) in England had no specialist perinatal mental health services, which offer psychiatric and psychological assessments and care to women with complex or severe mental problems before, during and after birth. Across the UK as a whole, 25% of areas lacked services.

But NHS England has said the funding for community services confirmed today meant it was now on course to achieve “full geographical coverage” by April 2019.

“The £23m is for the second wave of work to put in place or expand services,” an NHS England spokesman told Nursing Times.

“Following the bidding process, it has worked out that every CCG will now have funding to put a perinatal service in place in either wave one or wave two,” he added.

The funding is part of a package of measures to improve perinatal health as promised in the Five Year Forward View for Mental Health and set out in an implementation plan published in July 2016.

This pledged a total of £365m by 2021, including about £60m for the development of community perinatal mental health services between 2016-17 to 2018-19.

“Evidence-based NHS services [are] growing in parts of the country where there used to be limited or no provision at all”

Claire Murdoch

NHS England said some areas were taking a “phased approach” to the development of services but confirmed the goal was “full provision” by 2021, meaning by that point services would be fully staffed and set up.

“By the end of April next year, no matter where a new or expectant mum lives, they will have access to a service,” said the NHS spokeswoman.

The implementation plan highlighted the need for a “significant expansion” in workforce to ensure adequate staffing levels, suggesting the potential challenge in recruiting enough nurses and others with the right skills to staff multi-disciplinary teams in inpatient and community services.

“These requirements will vary significantly across England depending on the starting position for local services. By 2020-21, all teams should be sufficiently staffed to meet the recommended levels,” said the plan.

As a rough guide, it stated staff numbers for a community team covering an area of 10,000-15,000 births, which will care for between 300 to 500 women, might typically be 23.5 whole-time equivalent members of staff.

The implementation plan promised nearly £60m for mother and baby units up to 2021, plus an additional £15m capital investment.

“These new, top-quality services have led directly to life-saving improvements in care for women and babies”

Alain Gregoire

NHS England also confirmed today that it was pushing ahead with plans to open four new, eight-bedded mother and baby units.

Claire Murdoch, national mental health director for NHS England, said a key factor in ensuring services improved was that women who had experienced perinatal mental health issues were playing an integral role.

“Women with lived in experience can play a pivotal role when it comes to shaping the services for others and influencing how we plan and deliver care effectively as possible,” she said.

“What we are now starting to see is evidence-based NHS services growing in parts of the country where there used to be limited or no provision at all,” she added.

Meanwhile, Dr Alain Gregoire, chair of the Maternal Mental Health Alliance, said the latest developments looked set to “eliminate a long-standing and serious postcode lottery”.

“In over 30 years working for the NHS I have never seen any national programme produce such a rapid, effective and widespread transformation in services,” he said.

“These new, top-quality services have led directly to life-saving improvements in care for women and babies that will hugely reduce immediate and long term suffering,” he added.

“This vital investment will make an enormous difference to so many families who desperately need it”

Sean Duggan

As part of the programme to improve perinatal mental health services, new practical guidance has been developed by the Royal College of Psychiatrists on behalf of NHS England.

This includes a self-assessment tool that all community perinatal mental health services will be expected to use to check their performance.

Sean Duggan, chief executive of the Mental Health Network, which is part of the NHS Confederation, said: “A fifth of new and expectant mums experience perinatal mental health issues and without effective treatment they can have devastating long-term effects on entire families, so this vital investment will make an enormous difference to so many families who desperately need it.

“The Five Year Forward View for Mental Health targeted at least 30,000 more women would be able to receive evidence-based treatment closer to home by 2021 and today’s announcement moves us closer to being able to provide that vital outstanding care for even more women up and down the country,” he said.

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