The Five Year Forward View for Mental Health (FYFVMH, February 2016) reports that “NHS England should invest to ensure that by 2020/21, at least 30,000 more women each year access evidence-based specialist mental health care during the perinatal period, defined as the period during pregnancy and up to one year after delivery. Care should include access to psychological therapies.” The subsequent FYFV Implementation Plan states that “multi-disciplinary teams are vital for perinatal mental health (PNMH) and must be able to provide psychological and therapeutic support and interventions”. “To build perinatal mental health capacity, Health Education England (HEE) is leading work to develop a competency framework describing the skills needed in the workforce.” Variable outcomes and access to psychological therapies for women in the perinatal period have been identified as key issues for Improving Access to Psychological Therapy (IAPT) services.

The HEE Mandate (Mental Health Workforce Strategy, 2016) identifies work force transformation being required across the PNMH pathway. To date, the specialist PNMH workforce is very small. Nationally, a training programme is being rolled out to upskill 10 “super-specialist” clinical psychologists and 20 trainee clinical psychologists in PNMH in 2017/18, to expand in subsequent years. Extended training opportunities are available with the Royal College of Psychiatry to train more specialist perinatal psychiatrists. In the North West, scoping exercises have identified significant gaps in the current provision for PNMH care. A new Mother and Baby Unit is being commissioned in Lancashire and there are to be Specialist PNMH Community Teams within Mental Health Trusts. Training will be commissioned to upskill the workforce of these new services, as well as the wider workforce who come into contact with women during the perinatal period, such as in IAPT services. There are plans to deliver a series of PNMH masterclasses and conferences in the northwest.

HEE has commissioned a PNMH Competency Framework from the Tavistock and Portman NHS Foundation Trust, identifying the competencies required in PNMH care for the whole, multi-disciplinary workforce supporting women during the perinatal period. In the competency framework, there is a core domain, the ‘Perinatal Frame of Mind’, which is about bearing in mind the mother, infant and father/other caregivers at all times during care. There are nine other domains of competency:

  1. Knowledge of common emotional and physiological changes
  2. Understanding perinatal mental health conditions
  3. Having an open conversation about perinatal mental health
  4. Understanding the mother’s feelings about her baby
  5. Understanding the impact of pregnancy on others
  6. Understanding difference, stigma and barriers to care
  7. Understanding risk and protective factors
  8. Safeguarding vulnerable women and infants
  9. Understanding and valuing the multidisciplinary team and pathway.

 

The competency framework and an online feedback questionnaire are currently being piloted across geographical areas with a range of perinatal mental health services and training provision available. A wide variety of staff, in a range of services accessed by women during the perinatal period are being approached and the framework will to be used to highlight training needs. It is currently being piloted within the northwest, with support of the North West Coast Strategic Clinical Network and Health Education. Feedback from the nationwide pilots is being collated by HEE and the competency framework will be available later this year for use in services. We will keep you updated of further news and please contact us in the meantime for more information.

Dr Julia Boot
Project Manager - North West Psychological Professions Network
Health Education England working across the North West
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Libby Sedgley
Senior Programme Manager - Education Transformation and Commissioning
Health Education England working across the North West
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