Presented by Dr Zelda Mathewson and Dr Elizabeth Magee ...Dr Zelda Mathewson, Dr Elizabeth Magee, Dr Rosemary Millar and Ms Shiona Tasker. Background. Method – Tayside SOS forms

Presented by Dr Zelda Mathewson and Dr Elizabeth Magee, NHS Tayside

Tayside Suite of Summaries (SOS) –an innovative structured approach toan innovative structured approach to

information

Dr Zelda Mathewson, Dr Elizabeth Magee, Dr Rosemary Millar and Ms Shiona Tasker

Background

Method – Tayside SOS forms

Population Demographics Spring 2015

Number of Practitioners 19

Population Demographics, Spring 2015

Pregnant women 71

Young mothers with children 199

Pre school children (includes twins) 200Pre-school children (includes twins) 200

H L liti fPregnant women Young mothers

Home Localities of women

Angus 15 45Dundee City 39 130Perth & Kinross 17 24

Total 71 199

Obj tiObjectivesP fili• Profiling− Individual− Population

- including sub-populationsincluding sub populations• Identification of potential vulnerability

M i d d• Mapping need and resource

FindingsPregnant woman Case 1, age 18Mother issues Unborn baby

issuesSocial/environmentalissues

Family issues Services Actions

Unsupported in pregnancy

Unborn baby protocol

Inadequate housing Potential parenting capacity issues

Other NHS involvement – not specified

Supported programme

Level of education Homeless/temporary Relevant bereavement Social Work Follow up/reviewattainment accommodation/roofless

Previous miscarriage Recent change of address/frequent moves

Significant adult 1 with mental health/ illness /condition, learning difficulties and substance misuse

Perinatal depression Low income Significant adult 2 withPerinatal depression Low income Significant adult 2 with mental health/illness/condition, substance misuse and domestic abuse

Mental illness Prolonged unemployment

Physical disability Long term poverty/deprivation

Substance misuse Further advice on finances including benefits

Smoking

Person Information Panel (PiP): Pregnant woman age

Person Information Panel (PiP): Pregnant woman

Person Information Panel (PiP): Pregnant woman, age 18, Case 1

Person Information Panel (PiP): Pregnant woman

Mother Issues

Unborn baby issues

Social/Environmental issues

Case 1 Family Circumstances

Services

Case 1

0 5 10 15 20 25 30 35Number of issues

ACTIONS

Dr. Zelda Mathewson, Ms Sandra Murray: Copyright © 2009 Tayside Health Board. All rights reserved

P t 18 C 1 d t il f iion

ion

Pregnant woman, age 18: Case 1 detail of issues

NCESan

cy tta

inmen

tign

ifican

t fac

tors)

scarri

age

LLBEIN

Gisk

iden

tified

llness

iden

tified

SABIL

ITY

CTIO

N CO

NCER

NMS

TANC

ESmm

odati

on/R

oofle

ss

ess/f

reque

nt m

oves

ment priva

tion

nces

incl.

bene

fits

CES apac

ity iss

ues

t /OTH

ERS

ental

healt

h/illn

ess/c

ondit

io

rning

diffi

cultie

s

bsta

nce m

isuse

ental

healt

h/illn

ess/c

ondit

io

bsta

nce m

isuse

mesti

c Abu

sent me

nt

MOT

HER C

IRCUM

STAN

C

Unsu

ppor

ted in

preg

nan

Leve

l of e

duca

tiona

l atta

OBST

ETRIC

HIST

ORY (

sig

Prev

ious/r

ecur

ring m

isc

MEN

TAL H

EALT

H/WE

LLB

Perin

atal d

epres

sion ri

s

Perin

atal d

epres

sion il

ln

Men

tal ill

ness

MED

ICAL H

ISTOR

Y/DI

SA

Physi

cal d

isabil

ity

LIFES

TYLE

ISSUE

S

Subs

tanc

e Misu

se

Smok

ingUN

BORN

BABY

PROT

ECT

Unbo

rn Ba

by Pr

otoco

l

POOR

SOCIA

L CIRC

UMST

Inade

quate

hous

ing

Home

less/T

emp a

ccomm

Rece

nt ch

ange

of ad

dre

FINAN

CIAL IS

SUES

Low

incom

ePr

olong

ed un

emplo

yme

Long

term

pove

rty/d

epr

Furth

er ad

vice o

n fina

nc

FAMI

LY CI

RCUM

STAN

CE

(Poten

tial) p

arent

ing ca

p

Relev

ant b

erea

veme

nt

SIGNI

FICAN

T ADU

LTS/

O

Signif

icant

Adult

1 M

en

Signif

icant

Adult

1 Le

arn

Signif

icant

Adult

1 Su

bs

Signif

icant

Adult

2 M

en

Signif

icant

Adult

2 Su

bs

Signif

icant

Adult

2 D

om

Moth

er ‐ S

ervice

s

Othe

r NHS

invo

lveme

nt

Othe

r Age

ncy I

nvolv

eme

Socia

l Work

ACTIO

NSSu

ppor

tFo

llow

up/re

view

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Mother Issues


Unborn baby issuesSocial/Environmental issuesFamily CircumstancesServicesACTIONS

SOS form versions updated 26th January 2015 . Dr. Zelda Mathewson & Ms Sandra Murray . Copyright © 2009. Tayside Health Board. All rights reserved

Potential Vulnerability grid: Pregnant women (n = 71)Ordered from largest number of issues to smallest (actions not counted)

Population Information Panel (PoP): Pregnant women (n = 71)

Mother Issues

Unborn baby issues

195 41 158 98 101 93

Social/Environmental issues

Family Circumstances

Services

ACTIONS

0 100 200 300 400 500 600 700 800

Number of issues/actions

SOS form versions updated 26 January 2015. Dr. Zelda Mathewson & Ms Sandra Murray. Copyright © 2009. Tayside Health Board. All rights reserved

S b l ti th h lf h ( 9)Sub-population: young mothers who self-harm (n = 9)


Young person issuesg pSocial/Environmental issuesFamily CircumstancesServicesACTIONS

Sub-population: young mothers with learning disabilities (n = 5)


Young person issuesSocial/Environmental issuesFamily CircumstancesServicesACTIONS

Sub-population: young mothers who are homeless or in temporarySub population: young mothers who are homeless or in temporary accommodation/roofless (n = 17)


Young person issuesS i l/E i t l iSocial/Environmental issuesFamily CircumstancesServicesACTIONS

250

Mapping of need and resource - pregnant women, young mothers and children caseloads:number of identified issues by Practitioners (n = 19)

04

03

02

01

71 pregnant womenn = 2

n = 25

n = 11

n = 4

10

n = 6

n = 2

n = 0

07

06

05

04 71 pregnant womenFamily data:199 Young mothers200 children

Mother and child n =

n 2

n = 2

n = 10n = 10

n = 15

n = 4

n = 8

n = 3

10

09

08

titio

ners

refers to n mothers with n children except *, which includes twins

n 4n = 20

*n = 18/n = 19n = 24

n = 0

n = 0

n = 0

13

12

11

Prac

t

n = 4

n = 7

n = 10

n = 7

n = 5n = 6

17

16

15

14

n = 6n = 8

n = 4

n = 10n = 6

n = 8

n = 8

n = 7

-150 -100 -50 0 50 100 150 200 250 300 350

19

18

17

50

n = 4

n = 0

100150

n = 8n = 0

n = 8

n = 2

SOS form versions updated 26 January 2015. Dr. Zelda Mathewson & Ms Sandra Murray. Copyright © 2009. Tayside Health Board. All rights reserved

-150 -100 -50 0 50 100 150 200 250 300 350

Total number of identified issues50100150

Pregnant Mother and child

Conclusions – the Tayside SOS:• Provides an innovative structured approach to information• Provides a simple complete pictorial approach - ‘at a glance’• Allows key relevant information to be summarised in a structured way by• Allows key relevant information to be summarised in a structured way by

frontline staff• Person-centred approach throughout the lifecourse (pre-birth to older

person) supports the Integration agendaperson) supports the Integration agenda• Identifies all key issues at individual/population level – pregnant woman,

mother, unborn baby, environment, social, family, service involvement• Summary of all key issues in line with GIRFECSu a y o a ey ssues e G C• Supports clinician/professional in decision making and identification of

potential vulnerability• Allows easier navigation through information ++g g• Supports mapping need and resource• Supports identification of training needs and caseload management• Identification of potential health inequalitiesIdentification of potential health inequalities• Consistent standardisation of definitions (within NHS and with partners)• Whole systems approach• Consistent mechanism to assist in undertaking audit monitoring and• Consistent mechanism to assist in undertaking audit, monitoring and

evaluation, outcomes and routine reporting

AcknowledgementsOur thanks go to child health and nursing colleagues including frontline service and administrative staff and public health colleagues. Particular thanks go to Ms Sandra Murray, Mrs Joan Wilson (Chief Nurse –Children and Families), Mrs Debbie Balshaw (Lead Nurse - Early Years) and Mrs Gillian Robertson (Public Health administrative support).

References• Mathewson Z and Murray S. Tayside Maternal and Child Health Suite of Summaries (SOS) Report NHS

Tayside: December 2012.• Mathewson Z, Alexander J, Millar R et al. National Maternal and Child Health Information: Scoping Exercise.

Report to the Scottish Government; May 2015.Report to the Scottish Government; May 2015.• Magee E, MacLeod D and Mathewson Z. Getting Information Right in the Early Years- evaluation of an

information framework to capture the 'mother-child' journey. In: Faculty of Public Health Annual Public Health Conference Peebles 5th November 2015; Peebles. Abstract number: B6: http://www.fphscotconf.co.uk/abstracts.

• Miller R, Magee E, Balshaw D and Mathewson Z. Getting Information Right for the Named Person - Suite of Summaries (SOS) Chronologies In: Faculty of Public Health Annual Public Health Conference: 6th NovemberSummaries (SOS) Chronologies. In: Faculty of Public Health Annual Public Health Conference: 6th November 2015; Peebles. Abstract number 12: http://www.fphscotconf.co.uk/posters.

Documents

Presented by Dr Zelda Mathewson and Dr Elizabeth Magee ...Dr Zelda Mathewson, Dr Elizabeth Magee, Dr Rosemary Millar and Ms Shiona Tasker. Background. Method – Tayside SOS forms