Smoking at Time of Delivery (SATOD) 2016/17 England North East - - PowerPoint PPT Presentation

Smoking at Time of Delivery (SATOD)

2016/17

England North East County Durham DDES North Durham 10.7% 16.1% 16.7% 19.1% 13.4%

5 10 15 20 25 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 SATOD (%) England North East County Durham 5 10 15 20 25 SATOD (%) England North East County Durham 5 10 15 20 25 SATOD (%) England North East County Durham 5 10 15 20 25 SATOD (%) England North East County Durham County Durham Target

2016/17

900 babies born to

mothers who smoke. If County Durham had the same % SATOD as England there would be around

340 less babies born to

smoking mothers. 2025/26

460 babies born to

mothers who smoke. If County Durham had the same % SATOD as England there would be around

180 less babies born to

smoking mothers. Let’s be ambitious… Less than 300 babies born to mothers who smoke in County Durham

SATOD by MSOA and deprivation

3 year pooled 2014/15 – 2016/17

5 10 15 20 25 30 35 40 10 20 30 40 50 60 % SATOD Deprivation Score (ID2015) Least deprived Most deprived

There are 66 MSOAs (middle super output areas) in County Durham with an average population of around 7,200.

SATOD by MSOA North Durham

3 year pooled 2014/15 – 2016/17

5 10 15 20 25 30 % SATOD North Durham North Durham +/- 20%

30% most deprived Not deprived

SATOD by MSOA DDES

3 year pooled 2014/15 – 2016/17

5 10 15 20 25 30 35 40 % SATOD DDES DDES +/- 20%

30% most deprived Not deprived

Smoking in Pregnancy incentive scheme DDES

Specific goals:

• To support pregnant smokers to set a quit date and achieve a CO

validated 4-week quit,

• To remain smokefree throughout the pregnancy and for 3-months

post-partum. Key elements:

• Enhanced cessation support
• A financial incentive/ reward for achieving and maintaining

smokefree status

• Support from a Significant Other (SOS)
• Taping. D, Bauld. L. Purves, D. et al, (2015) Financial incentives for smoking cessation in pregnancy: randomised controlled trial. BMJ 2015;350:h134 doi:

10.1136/bmj.h134

Criteria

Women are recruited via health professional referral based on the following criteria:

• Teen pregnancy
• Living in an area of deprivation/high smoking

prevalence

• Living with a smoker/s
• Smoked throughout previous pregnancy
• Judgement of the relevant health care

professional

Outcomes

• 122 women to go through the programme
• based on the success of previous

evaluation data, it is expected that 69% (n=84) women are quit at 4 weeks, and

• 71% (n=59) would still be quit at delivery

Recruitment as of Q2 (April –Sept)

Target 122: Recruited 92

• 36% (n=33) have identified a significant other.
• 64% (n=58) are participating in the scheme

unsupported by a significant other

• 40% of women unsupported by a significant other live

with a smoker. Within this cohort 47% were lost to follow-up or did not quit

• 14% (n=13) of those participating in the scheme are

teenagers

• 46% (n=42) are age 25yrs or above

Continued…

• 8% (n=44) participants have identified themselves as

never having worked or having been unemployed for

• ver a year
• 35% (n=32)as routine and manual workers
• Overall just under 84% are routine manual have never

worked or are long-term unemployed – These women would be classified as the most vulnerable

Great success once women engage with the Stop Smoking Service

Number referred to SSS Number setting a quit date Number quit Number quit with Midwife BI Total quit

920 211 117 66 183

2016/17

Q1 2016-17 Q1 2017-18 Total pregnancy referrals 217 331 Midwife referrals 193 309 Attended appointment 81 (37%) 136 (41%) Set a quit date 58 (72%) 59 Quit at 4 weeks 35 (60%) 40 (68%) CO validated quits 30 (86%) 34 (85%)

DDES North Durham DDES North Durham Set a quit date 33 23 41 18 Quit at 4 weeks 19 (58%) 16 (70%) 29 (73%) 11 (61%) CO validated quits 15 (79%) 15 (94%) 27 (93%) 7 (64%)

Q1 2016-17 Q1 2017-18

Quarter 1 service results

Quarter 2 service results

Q2 2016-17 Q2 2017-18

Healthwatch – Maternity Report

• Healthwatch County

Durham (HWCD) undertook engagement and research

• n to help ND and DDES

CCGs understand experiences of smoking during pregnancy

• Key Performance Indicator

(KPIs) for maternity services

– Women smoking at time of delivery (per 100 maternities)

Engagement and Research Undertaken

The approach was split into two areas of work:

• 1. Gathered the views and experiences of mothers

in County Durham in relation to their smoking behaviour whilst pregnant.

• 2. Contact demographically similar CCG areas

where they are higher achieving in relation to the performance indicator with a view to identify positive initiatives or/and best practice.

Key Themes / Feedback

• Early intervention is key
• Women do generally understand the risks to

themselves and their babies

• 97% of women surveyed felt had the information

provided to them on the effects of smoking on their unborn baby was helpful and easy to understand.

• 67% felt they were given support they needed to

stop smoking, however of those referred to the stop smoking scheme, 50% did not attend appointments and 40% did not want to go.

Recommendations from HWCD for consideration

• Methods adopted by similar CCGs – early intervention and

access to nicotine replacement therapy from the initial booking appointment

• Carbon monoxide level testing to be carried out at all

booking appointments and where there is a raised level is raised, an immediate referral made by midwife to the stop smoking services by telephone.

• Stop smoking support is maintained postnatally, at a time

when smoking is likely to re-commence.

• A ‘buddying’ network with non smoking family members and

friends who can offer support

• Enhanced support packages for higher deprivation and

rural communities