Agenda item

The Board received a report and presentation from Natasha Moody and Nicola Bromage on the Health in Early Life Priority Progress Update.

The HWBB strategy had a priority for ‘Health in Early Life’ which sought to improve health in pregnancy and infancy with a focus on reducing infant mortality.

The presentation noted the local picture of Infant Mortality, both at Staffordshire, Stoke-on-Trent and the West Midlands. It was noted that Stoke-on-Trent had the highest infant mortality rate in England, whilst Staffordshire was rated 25^th highest. Neonatal and Post-Natal mortality rates were shown to the Board.

The slides further showed the rates across the districts and boroughs within Staffordshire. The Board were informed that whilst there is a lag in the published data, the latest available being from 2021, the 2023 provisional data was promising in a reduction in rates of Infant Mortality.

The Board were shown modifiable factors which would impact on infant mortality cases in Staffordshire. This included:

-      Smoking during pregnancy

-      Poor nutrition

-      Pre-term and low birth weight of babies

-      Access to support from GPs, Midwives, Health Visitors and other key workers

Smoking in pregnancy was highlighted as the top risk factor in infant mortality. The County Council had commissioned a stop smoking in pregnancy service for several years which offered a 12 week behavioural support and NRT therapy to pregnant women who smoke, post-natal support for up to six months and a preventative offer to support Staffordshire Schools.

In a step to overcome infant mortality, a parent education programme, called ICON helped to aim prevent abusive head trauma and help people who care for babies cope with crying. ICON served to show that:

-      Infant crying is normal

-      Comforting methods can help

-      It’s OK to walk away

-      Never, ever shake a baby.

A co-ordinated whole system approach Staffordshire and Stoke-on-Trent was also in place to support breastfeeding. An infant feeding survey aimed at families was carried out to understand experiences and help inform future planning. A total of 752 responses were received. An action plan was in development following the analysis of the survey which had three key priorities:

-      Improve the awareness of and benefits of breastfeeding within the community and for parents

-      Increase the support to breastfeed particularly the first 10 days following birth

-      Embed infant feeding pathway so more people know and access timely help and support.

The Board were further informed of a whole family support system, called the Families’ Health and Wellbeing Service (0-19). This offered holistic support to the entire family with a number of mandated checks.

The Strengthening Families Team work with pregnant and post-natal people and provided more targeted support for children known to services. They provide a named health worker for each eligible family and focus on achieving high quality outcomes.

It was noted by the Board that whilst there was significant work underway to address varying modifying factors of infant mortality, the approach was somewhat fragmented and lacked clear overall ownership. It was demonstrated that there were approximately 16 strategic and partnership/working groups who had reducing infant mortality as a priority focus. Moving forward, one system wide group had been established which would drive forward improvement, currently reporting into the SSCB and HWBB.

Garry Jones queried whether circumstances of the birth itself were included in the modifiable factors, and whether evidence of inequalities were linked to protected characteristics. Natasha responded to say that evidence and research suggested that certain cohorts of people were more likely to experience infant mortality. Nicola Bromage would take away the first point regarding modifiable factors.

Councillor Sutton questioned the age of data available and asked why there was such a lag, and whether there was any way of getting more up to date data. Natasha was not able to confirm why there was a lag in the data from the ONS, however, comparable data from Child Death Overview Panel showed similarities in the data between the two sources. Richard Harling highlighted that a local system could be established for the overall data, but with a deeper dive into the causes.

Natasha also highlighted the Child Death Overview Panel which runs across Staffordshire and Stoke-on-Trent and discusses deaths of every single child. This panel is used to inform the work that is then undertaken.

Baz Tameez informed the Board of higher rates of infant mortality across BAME communities, and offered to bring data and deep dive findings back to a future meeting.

Tim Clegg observed that similar cohorts of people exhibiting similar health concerns are becoming apparent with each priority update to the Board and commented on the need to co-ordinate interventions across the system.

Councillor Jessel noted that the Board did not want to lose focus on infant mortality and questioned the prevalence of smoking and whether alcohol and drug use was an emerging factor. In response, Natasha confirmed that the data wasn’t showing drug and alcohol use as a major factor currently and would also consider the points raised by Tim and include more data sets where appropriate.

Councillor Sutton highlighted the governance surrounding the work on infant mortality and stressed the importance of all Boards having the same information presented to them, and co-ordination between what each Panel/Board are doing.

Resolved – that the Board (a) note the progress being made by partners in Staffordshire regarding Healthy Start in Life;

(b) Support the widening of the focus on children and young people beyond infant mortality to encompass the work we are doing on the wider determinants of health to improve outcomes for Children and Young People;

(c) Endorse the CYP Framework which has been developed by the Programme Board delivering on behalf of the Integrated Care System;

(d) Endorse the Co-Production Promise as a critical way in which we plan to work with CYP&F and consideration of its use across the broader partnership;

(e) Acknowledge the planned work across the partnership and continue to support the development of these programme of work over the coming year; and

(f) Work towards enhanced and timely data of infant mortality and more joined up working between the various governance structures.