4 December 2020

A new service being piloted in North West London next year, will help women who are experiencing psychological difficulties following pregnancy loss, still birth and neonatal loss, as well as birth trauma and women who have a fear of childbirth (tokophobia).

The NHS in North West London has been successful in its bid to develop and test a Maternal Mental Health Service (MMHS) as a pilot site during 2020-2021 and 2021-22 as part of implementation of the NHS Long Term Plan.

This MMHS is an innovative joint programme between two North West London NHS work programmes: Mental Health and Maternity – and this is  one of the few areas in the country to have been awarded the pilot funding.

Jointly led by Central and North West London NHS Foundation Trust (CNWL) and West London NHS Trust (WLT) and in partnership with the NW London Local Maternity System (LMS), the MMHS will help around 350 women each year access specialist support.

The service will offer women a combination of psychological therapy, specialist midwifery input and peer support. There will be a particular focus on women whose early life experiences make them more vulnerable to mental health difficulties.

More than £700,000 of funding from NHS England & NHS Improvement, will be invested by the NHS in North West London for this pilot; creating new posts including clinical psychologists, specialist midwives and peer support roles.

Around 1,500 women with serious and long-term mental health needs are seen in existing perinatal mental health services per year across both CNWL and WLT.

Around 2,145 women each year are provided with support through a combination of specialist midwifery, consultant midwifery, and obstetric led clinics in maternity services.

However, a significant number of women with psychological needs resulting from their maternity experience need more focused support, provided by specialists, in a timely manner. The development of Maternal Mental Health Services will address a long-standing gap in provision, which the NHS Long Term Plan seeks to fill across all areas of England by 2023/24. This gap exists between interventions offered in primary care and community perinatal mental health services.

A small joint pilot with CNWL and WLT and the maternity units at Chelsea & Westminster and West Middlesex Hospitals will begin in April 2021, during which the clinical model will be tested before being rolled out to the rest of North West London’s maternity services by the end of 2021/22.

CNWL’s Perinatal Service Lead Devina Vencatasawmy said: “This is fantastic news. For far too long a large number of women have not been able to access the help they needed in adequate time. While there is a long-standing and positive relationship between maternity and mental health services, there is a gap in care.”

“This proposed new service will build on the current offer and work towards reducing the impact of birth related trauma on women and their families.”

WLT’s Principal Clinical Psychologist for the Tri-Borough Perinatal Mental Health Service, Nic Horley said: “This is an exciting and innovative joint venture that will provide effective psychological therapies and psychologically informed midwifery care to women and families in North West London”

Pippa Nightingale, the SRO for the Local Maternity System (LMS), said: “I am delighted that NWL was successful in securing the bid. Maternity services in North West London have a long history of working collaboratively to ensure that women and their families have access to safe and high-quality care at the start of life. This project will enhance the package of care we provide across the sector”

Editors’ notes

The NHS in North West London is one of a number of pilot sites identified nationally who are going to develop and test this new service.

The service offer involves providing psychological therapy, maternity support and peer support to women with moderate-severe/complex mental ill health relating to the experience of loss or trauma in maternity/neonatal/perinatal contexts.

The patient cohort to be supported will focus on individuals with primary tokophobia (fear of childbirth) and birth trauma.

The NHS in North West London applied to be a Fast Follower pilot site, meaning it will launch next year.

Total funding:

  • 20/21 - £82,248.17
  • 21/22 - £633,785.04

Implementation will be phased with the first two sites able to access provision initially being West Middlesex Hospital and Chelsea and Westminster hospital in Q1 21/22 before expanding provision to other areas:

  • St Mary’s and Hillingdon Hospital NHS Foundation Trust in Q3 21/22
  • Northwick Park Hospital in Q4 21/22.

Women will be on the caseload for approximately 6-7 months – the duration of their pregnancy and until 6 weeks postnatal by the specialist midwife (typically over 8 appointments) and 6-9 months by the psychologist but with some flexibility for up to 12 months in a small proportion of cases (typically expected to be over 20 appointments).

This is an ICS collaboration involving and benefiting all ICS partners and service users.

We have worked with those with lived experience to inform the design and delivery of this project.