Berni Lee introduced this item providing a
presentation in addition to the circulated report. The presentation
covered the following areas:
- Smoking and birth outcomes
- Estimated costs
- Context for the smoking in pregnancy (SiP) review
- Recent trends in
performance, highlighting the challenges in the north Warwickshire
- Objectives and
overview of the SiP review
- Review findings, showing the higher
numbers in the north of the county
- Characteristics of smokers vs
- Access to smoking cessation services
– showing that only 20% ceased smoking
- A slide disaggregated this by
- Smoking at the time of delivery,
also disaggregated by area and the number that ceased smoking
during the course of their pregnancy
- Engagement and responses from staff
surveys including key messages
- Compliance with NICE guidance
- What needs to change? This was based
on the review findings
- What does the evidence say?
- Key recommendations
- Warwickshire smoking estimates
The Coventry and Warwickshire SiP review was commissioned by the local maternity and neonatal
system (LMNS) board in order to provide a detailed picture of
the women who smoked during pregnancy, the support they had
received and to identify any further measures that could be taken
to enable them to stop smoking.
The report set out sources of insight,
differences in the midwifery workforce at the three acute hospital
trusts, changes to commissioning arrangements and key issues and
findings under the headings of:
- Scale of the problem
- Failure to meet targets
- Access to specialist support
- Compliance with guidance
- Staff engagement
Key areas to be addressed and a number of key
review recommendations were provided. There were financial
implications associated with the need to identify a resource to
support dedicated strategic lead(s) for the Smoking in Pregnancy and Tobacco Control/Smoke-free
2030 initiative across Coventry and Warwickshire
A discussion took place on the following
- A request for the presentation
slides to be circulated.
- Dame Stella Manzie noted the
progress made and resources in place at SWFT. The use of
transformation funds to contribute towards posts at GEH and UHCW
was welcomed. Whilst she couldn’t give a commitment to
funding at this meeting, it would be taken back to UHCW and she
agreed that a strategic smoke free lead across the system made a
lot of sense. The Chair agreed that one post on a partnership basis
- Councillor Humphreys agreed that a
lead was needed who could give time and advice.
- Sharon Beamish saw this as a
priority area and would refer it back to the Warwickshire North
- Councillor Sally Bragg voiced
concerns about vaping and e-cigarettes. The report only referenced
smoking and she was concerned about the impact of vaping on both
children and expectant mothers.
- Berni Lee responded to the points
raised. On funding, she referred to the transformational monies
which may be allocated to the three trusts. At the LMS board, she
had questioned whether some could be earmarked to fund the
coordinated approach. She acknowledged
Councillor Bragg’s points about e-cigarettes. They did
contain nicotine, but not carbon monoxide, which was the
significant cause of harm. As such they could be viewed as a
temporary step towards total cessation.
- Councillor Falp stated not only the
health benefits for expectant mothers and their families, but also
the financial benefits.
That the Health and Wellbeing Board:
the adoption of a Tobacco Control/Smokefree 2030 programme of work
including smoking cessation in pregnancy and supports the use of
resources to address this priority.
the adoption of a place-based, system-wide approach that addresses
the inequalities and social norms that result in higher smoking in
pregnancy rates in some areas of Warwickshire (e.g. Nuneaton), as
compared to others.
the co-production of a new model for specialist smoking in
pregnancy services, embedded within maternity services, that
provide rapid access to specialist advice and NRT.
Identifies potential funding sources for a
strategic LMS Smokefree Pregnancy Lead / Programme Manager to plan
and drive the implementation of a system-wide approach to tackling
SiP across Coventry and Warwickshire.