Perinatal

Perinatal mental health problems are those which occur during pregnancy or in the first year following the birth of a child. Perinatal mental illness affects up to 20% of women, and covers a wide range of conditions. If left untreated, it can have significant and long lasting effects on the woman and her family.

Perinatal mental health problems can also have long-standing effects on children’s emotional, social and cognitive development.

NHS England has committed to fulfilling the ambition in the Five Year Forward View for Mental Health, so that by 2020/21 there will be increased access to specialist perinatal mental health support in all areas of England, allowing at least an additional 30,000 women each year to receive evidence-based treatment, closer to home, when they need it. This includes the right range of specialist community and inpatient care.

A phased, five-year transformation programme, backed by £365m in funding, is underway to build capacity and capability in specialist perinatal mental health services, focused on improving access to and experience of care, early diagnosis and intervention, and greater transparency and openness.

Preparation and planning

  • Developing and implementing evidence-based pathways – helping to deliver integrated services which incentivise early intervention and holistic approaches to care and recovery
  • Networks – being established in all regions, as recommended in NICE guidelines, to provide leadership and expertise in the development of local services and pathways.
  • Workforce development – working with partners to build the capacity and competency across the specialist workforce; to develop and deliver a workforce strategy as well as a multidisciplinary skills and competency framework.

Building capacity

  • Increasing Mother and Baby Unit (MBU) provision – including development of new MBUs in areas with significant access issues and increasing capacity in existing units, as needed.
  • Strategic collaborative commissioning models – develop and implement new commissioning models so that inpatient MBUs serve the needs of large populations and are closely integrated with specialised community perinatal mental health teams.

Securing transformation

  • Perinatal mental health community services development fund launched on 19 August to promote service development and quality improvement. Organisations invited to submit funding proposals for up to three years focused on expanding existing specialist community teams into a wider geography or resourcing small new teams with limited provision to meet the needs of local populations more comprehensively. Find out more and apply
  • Specialist community perinatal services  ensure these are available in each locality to deliver care as well as provide consultation and advice to maternity, mental health and community services; support this development with targeted investment through a community development fund over time before mainstreaming into CCG allocations.
  • Data, outcomes and incentives – collecting and publishing national and local data; developing standardised data and outcomes measures to measure and monitor improvement, activity and service provision, and reviewing levers to drive improvements.

Funding

Total additional funding is £365 million over the period. The funding increase each year, reaching £140m in 2020/21 as outlined in the Implementation Plan.

Funding will be a mixture of local funding (including through CCG baselines and targeted transformation monies for allocation) and national investment (including commissioning of MBUs through specialised commissioning, workforce development and regional perinatal MH networks).

National delivery

The transformation of perinatal mental health care is being led by a national transformation board, providing national collaboration and oversight and involving key partners, including the Department of Health, NHS Improvement, Health Education England, NHS Digital, Public Health England and the Maternal Mental Health Alliance.

This in turn reports to the cross-ALB Mental Health and Dementia Programme Board, chaired by Claire Murdoch, SRO for Mental Health. The Mental Health and Dementia Programme Board has overall accountability for delivering the NHS elements of all the Five Year Forward View for Mental Health recommendations.

NHS England has appointed two new Associate National Clinical Director to provide expert clinical guidance to the programme – Dr Giles Berrisford, the clinical lead at the Birmingham Perinatal Mental Health Service at Birmingham and Solihull Mental Health Foundation Trust, leading one of the largest inpatient Mother and Baby Units in the country, and Dr Jo Black, a consultant perinatal psychiatrist with Devon Partnership NHS Trust, where she leads an integrated community perinatal mental health service.