SPSP Perinatal and Paediatric Programmes National Learning Session: October 2024
Perinatal breakout session overview
Focus on tobacco dependency in pregnancy
Aims
- Consider the impact of tobacco dependency on health outcomes for women and babies
- Hear a local example of smoking cessation quality improvement activity
- Discuss and share successes and challenges with tobacco dependency in pregnancy
Why we should care about treating tobacco dependency in pregnancy, presented by Sonya Scott, Public Health Consultant from Public Health Scotland.
NHS Highland smoke-free pregnancy service, presented by Cat Clark and Lorna MacKenzie, Smoking Cessation Midwives from NHS Highland.
Discussion summary
Delegates shared feedback on four questions before the session. Their responses are themed below.
Attendees discussed three areas of improvement to reduce tobacco dependency in pregnancy, exploring successes, challenges and opportunities for each area.
1. Carbon Monoxide (CO) monitoring at booking and 36 weeks
What are you doing well and can share?
- High CO monitoring booking rates in some boards
- Mandatory field on TrakCare, a healthcare information system
- Education with community midwives
- Good smoking cessation teams
- Documentation completion on Badger
- Regular reporting
What challenges are you facing?
- Availability of / faulty equipment
- Financial constraints / ordering process
- Some boards do not offer at 6 weeks
- Staffing / time pressures / funding
- Environmental factors
- Staff education / engagement
- Making it routine part of antenatal check
How might you overcome those challenges?
- Explore why CO monitoring is not happening at 36 weeks of gestation
- Involve Public Health team
- Combine CO monitoring with wellbeing appointment
- Education for midwives and obstetricians
- Availability of specialist roles
- Make CO monitoring a priority
- Ensure every community midwife has a CO monitor
2. Opt-out referrals
What are you doing well and can share?
- Good referral system – NHS Lothian
- Trak auto referral
- Financial incentive works well in NHS Greater Glasgow and Clyde
- ‘Quit Your Way’ – NHS Grampian
What challenges are you facing?
- Non-attendance
- Lack of awareness of financial incentive
- Not all smokers referred at booking
- Unsure regarding data sharing / GDPR
- Paper referral system
How might you overcome those challenges?
- Offer other methods of contact
- Improve process / cut down steps
- Implement automatic referral
- Involve service users
- Avoid person dependency
3. Offer of referral for significant others
What are you doing well and can share?
- Referrals to Smokefree Mailbox – NHS Lothian
- GDPR: consent to contact
- Offered to woman and partner – NHS Forth Valley
What challenges are you facing?
- Poor process for offering referral
- Difficulty in obtaining partner details
- Midwifery services ask partners to contact GP
- Anti-smoking fatigue
- No partner offers
How might you overcome those challenges?
- Improve communication between services
- Involve service users