Angus Midwifery Pilot
There was an agreement made between Public Health Tayside and midwifery colleagues in Angus to work in partnership with the Angus Council Welfare Rights Service to pilot a formal financial inclusion referral pathway. The pathway was set up to link pregnant women with a welfare adviser for financial inclusion support. The allocated Scottish Government monies was utilised to provide capacity within the Angus Welfare Rights Service to work through referrals and document outcomes for improvement purposes.
Objectives
The following objectives were agreed by stakeholders.
- Midwives routinely raise the issue of money worries with their service users.
- Establish a Financial Inclusion referral pathway established to link pregnant women and their families to Welfare Rights Services.
- Develop a standardised referral form for midwives to use to refer into Welfare Rights Service (Appendix 1).
- Parents will have better access to the benefits they are eligible to receive.
Training and support for midwives
A training programme for Angus midwives was put together on the referral process and how to raise the issue of money worries using the ‘CARE’ approach as recommended by NHS Scotland (Appendix 2). This resource was used to support the training sessions for midwives. Public Health Tayside shared the number of the referrals made and financial gains at both training sessions and team meetings. This was an opportunity for midwives to ask questions about financial inclusion and the referral process.
The original referral process was adapted towards the end of the pilot to move away from paper notes to an electronic form via Badgernet. Badgernet is a mobile app which is designed for women to view their maternity records securely and can be used to refer women to a range of services. The mobile phone app has simplified the referral process for midwifes by reducing the amount of time form filling and providing valuable data to the project.
Findings
In total 108 referrals were made by midwifes during Dec 2019/Jan 2021, with £326,338.52 generated for the pregnant women and their families during the time period. This averages at approximately £3,000 per person. The highest gains came from Universal Credit payments. One client in particular, received £16,791.43 in financial gains.
Jane's story
Jane was referred by a midwife for an entitlement check and advice regarding benefits. At time of referral Jane was less than 24 weeks pregnant, a single parent, living with her 3-year-old son in a council property. They were both in good health. Jane was also a carer for her disabled father. She received Carers Allowance, Universal Credit, Council Tax Reduction and Child Benefit for her son.
Angus Welfare Rights Service contacted the client and advised her Universal Credit would increase by £235.83 per month when the baby arrives, and her Child Benefit would increase by £13.95 per week. Jane was advised that she would qualify for a Best Start Grant (Pregnancy & Baby Payment) award of £300 when she reached 24 weeks and she would qualify for a Best Start Grant Early Learning Payment of £250 in respect of her 3 year old son. Jane was advised about the Best Food Vouchers amounting to £17 per four weeks that would increase to £34 per 4 weeks when baby was born up to age one, and £17 every 4 weeks from age 1 to 3. Jane was also advised that she would be entitled to free dental care until the baby turns one-year-old.
Evaluation
The evaluation for the midwifery staff was delivered through a Survey Monkey which was to be completed by midwives in Angus. The survey asked 17 closed questions using a Likert scale, and one open question. The survey drew on principles of the COM-B model (Michie, van Stralen & West 2011) which poses that a particular behaviour, in this case, when a midwife raises the issue of money with the pregnant women and refers them to welfare rights service. Overall, midwives believe they have the physical and psychological ability and skills to raise the topic of money, and refer to the Welfare Rights Service.
Recommendations
- Continue to provide midwives with training and support regarding raising the issue of money.
- Training for all new staff members.
- Continue to provide midwives with guidance and support regarding referral procedures.
Breast Buddies “Feeding your baby” Virtual Antenatal Classes
Due to the closure of all antenatal classes at the beginning of lockdown, Breast Buddies volunteers created a free, virtual antenatal breastfeeding class that all mothers and their partners/supporters were welcomed to. From March 2020 – May 2021, 84 women have had access to the antenatal class. Midwives, Health Visitors and Family Nurses refer women to sign up to the course, with many mothers also signing up via social media accounts. NHS Tayside Facebook page and the “Birth in Angus” Facebook groups also shared the details of upcoming classes and supported Breast Buddies Angus to encourage mothers to attend the classes.
A key success was that participants were given access to class PowerPoint so that they could go through it in their own time prior to the class.
This was a major benefit to local people as women were receiving timely breastfeeding peer support sooner after their baby’s birth. Before lockdown, they would initially see women when their babies were 10 days or older at groups. Most referrals to the project are now in the first few days after birth and if the mothers have attended the breastfeeding antenatal class they are usually communicating with them hours after their babies have been born. This allows a greater link in with hospital staff, particularly the Infant Feeding Team at Ninewells. Other benefits include:
- Breastfeeding support is more accessible as mothers that have had traumatic births, those that have had c sections and are unable to attend physical groups can still receive breastfeeding peer support.
- Mothers that would find attending face to face groups difficult and anxiety provoking can receive the materials and attend the classes with their videos and speakers off if that makes them more comfortable.
- After the classes, we invite participants to join a WhatsApp group for their class to help them to make friends and form a support network. This has been hugely successful and has allowed mothers to continue to make strong connections during lockdown. Please see link to video attached.
Feedback has included:
“I have breastfed before but only for a short time before moving to formula. I want to breastfeed for a longer period this time and after the BB meeting I already feel more informed than previous pregnancies”
“This is my first baby so I haven’t breastfed before. I feel like this class has absolutely helped me and I now feel more informed. I am certain I want to breastfeed my baby.” “They’ve been amazing and without them I think we would have given up and changed to formula feed but we’re still exclusively breastfeeding.”