20 November 2018

A NICE fellowship was an excellent opportunity to develop the PMH matrix Sarah Fishburn, quality improvement lead for perinatal mental health, Thames Valley Strategic Clinic

Sarah Fishburn, quality improvement for Thames Valley Strategic Clinical Network, discusses how postnatal mental health care can be improved



As a guideline committee member at NICE, I have been interested in improving women’s experience of pregnancy, birth and postnatal care for some time.  In this capacity I have contributed to a number of NICE guidelines and a quality standard on maternity topics.

I started a three year NICE fellowship with the goal of encouraging health services, clinicians, teams and people to use NICE guidance when mapping the options or making decisions in these areas.

During my fellowship, the opportunity arose to work on implementing the NICE quality standard on antenatal and postnatal mental health. Starting from there I have developed with Thames Valley Strategic Clinical Network at NHS England an on-line audit tool called the Perinatal Mental Health (PMH) matrix.

We know that one in five women is affected by mental health problems during or after pregnancy which can include low mood and depression. This can have a long-lasting impact on the woman, her family and relationship with her baby.

The tool audits the care provided by maternity, health visiting and community PMH services. It measures how well services meet the NICE quality standards on antenatal and postnatal mental health against the number of referrals to services and workforce staffing levels.  

The PMH matrix measures how readily postnatal women are offered treatment and how soon they are referred and start treatment, including the support offered by midwives during and after pregnancy. The PMH matrix can improve women’s care by identifying gaps in services provision. The tool presents the opportunity for clinicians and commissioners to work collaboratively to improve the quality of care.

It has been very rewarding to understand the complexity of translating NICE guidance into practice, and the passion with which clinicians embrace evidence-based opportunities to improve care for women. I’m delighted that the Perinatal Mental Health (PMH) matrix has been endorsed by NICE which supported the implementation workshops.

Find out more about being a NICE Fellow here.

Find out more about being a NICE Scholar here.

Tags: quality standards, guideline committee, NICE fellowship, antenatal and postnatal mental health, mental health, tools

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