Recommendations for Setting Up a Successful PPC Service
Foster Supportive Leadership ‘Higher-Up’ at ICB and Trust-level Supportive leadership from both Commissioners and Trust managers is vital to mitigate barriers to setting up and maintaining a consistent service, and to ensure that the necessary resource and capacity is secured. It is important to demonstrate how essential a PPC service is via a strong business case to obtain leadership buy-in. This report aims to provide resource for the business case, and the companion report will be helpful in influencing policy makers. Services must be supported through effective commissioning and provider training to ensure all methods, including LARC, are available. 134 Establish a Contraceptive Champion within your Service Services should appoint a ‘Contraceptive Champion’ within their service who will hold oversee, monitor, and advocate for the provision of PPC on the maternity ward, as well as ongoing staff development to ensure all maternity staff are equipped to
deliver PPC. In many successful PPC services this is a midwife or nurse. Establish Nurse or Midwife as a Conduit for PPC Provision
A nurse or midwife should be the conduit for PPC provision. Due to their unique position, they can support women throughout their maternity journey, allowing opportunity to build trust, normalise discussion about contraceptive options and give pregnant people the space they need to consider what works best for them. Foster Collaboration and Support for PPC Across Disciplines Collaboration with colleagues across the pregnancy/maternity journey is essential, including obstetricians, GPs, SRH
professionals, sexual health services, health visitors, and community pharmacy. Standardise Contraceptive Counselling Before End of Pregnancy
Ensure that discussions of contraception become standard for all women during their pregnancy, reflecting women’s desire for these early discussions whilst allowing for post pregnancy discussions for those who prefer it. The timing of these discussions should be patient-led and sensitive to the individual’s needs. Contraceptive decisions should be recorded in a contraceptive plan prior to birth. Sands recommends that healthcare professionals should also arrange for a follow-up health check to take place, and
contraception could form part of this conversation. 135 Ongoing Workforce Training and Education
Ensure that all clinicians working with pregnant people in any setting receive adequate ongoing training and education development opportunities with respect to contraception knowledge and provision, including fitting of implants and intrauterine contraception where appropriate, and protect time within their clinical schedules for professional development. Ensure Access to Evidence-Based, Accurate Information on Contraception Access to accurate reliable information on contraception can facilitate women’s informed choice of method, dispel myths, and empower them to self advocate for improved health. Information should be available in different languages and formats and should be culturally sensitive. This report links to examples of information provision. Efficient Digital Infrastructure for Recording, Monitoring and Evaluating PPC Services Services should invest in and make use of digital technology, using shared electronic records to improve the patient experience and make it easier for staff. Patient satisfaction should be central to this and form a baseline for service improvement. • Services should consider using a contraceptive plan to record discussions, decisions and experiences of the patient to ensure continuity of service. • Services should embed robust monitoring, auditing and evaluation frameworks to ensure continuous improvement. Eliciting patient feedback should be routine and central part of service monitoring. • Ensure that staff and patients are aware of the NHS digital inclusion framework to ensure that all women can access digitally available information on contraception and book appointments via the NHS app. 136 To ease the women’s journey, the South Tees PPC service recommend a specific section within pregnancy notes to document discussion of contraception and the woman’s choices. This would then be obvious to the hospital midwives who would be able to ensure the contraception is provided without the woman having to remember to ask prior to discharge.
134 Reference: NHS England. Principles for commissioning abortion services.. 135 Further information on discussion contraception sensitively following pregnancy loss can be found in Appendix 3. 136 Inclusive digital healthcare: a framework for NHS action on digital inclusion.
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