presented by dr zelda mathewson and dr elizabeth magee ...dr zelda mathewson, dr elizabeth magee, dr...
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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
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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
Dr. Zelda Mathewson, Ms Sandra Murray: Copyright © 2009 Tayside Health Board. All rights reserved
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)
Dr. Zelda Mathewson, Ms Sandra Murray: Copyright © 2009 Tayside Health Board. All rights reserved
Young person issuesg pSocial/Environmental issuesFamily CircumstancesServicesACTIONS
Sub-population: young mothers with learning disabilities (n = 5)
Dr. Zelda Mathewson, Ms Sandra Murray: Copyright © 2009 Tayside Health Board. All rights reserved
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)
Dr. Zelda Mathewson, Ms Sandra Murray: Copyright © 2009 Tayside Health Board. All rights reserved
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.