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CHCP Small Grants Programme

Tue, 01 Feb 2011 11:17:00 +0000

CHCP Small Grants Programme

First Round of Grants have been Awarded:
We have awarded our first round of small grants to the following six voluntary and community organisations:

Looking Good Feeling Good in North Hull
Quaddy RG8 Football Team (North Hull)
Cottingham Fitmums and Friends (Hull and East Riding)
1st Hornsea Scout Group (East Riding)
Cruse Bereavement Care (Hull and East Riding)
Beverley Cornerstone (Hull and East Riding)
We have supported a wide variety of different types of activities across the communities of Hull and the East Riding and are looking forward to reporting on some of the impacts and results in due course.

Lessons Learnt:
There are a couple of key learning points from the assessments of the first applications that we would like to share for future potential applicants (these have been incorporated into the application form):

if your project is seeking a contribution towards a larger project or event then please clarify how much other money has been secured and what specifically the CHCP award would be used for
the timeframe for applications being submitted needs to be appropriate to the delivery timeframe for the project or event. As a general rule we would expect successful applicants to spend the award within 3 months of receipt
The aim of the CHCP small grants programme is to provide an opportunity for local voluntary and community organisations and/or other not-for-profit organisations to contribute towards the health and wellbeing of people living in Hull and the East Riding of Yorkshire.

The programme provides grants or donations of up to £500 maximum to carry out activities, projects or one-off events requiring an element of sponsorship.

Who Can Apply for a Small Grant/Donation?

In order to apply for a CHCP small grant or donation you must meet the following eligibility criteria:

A Not for Profit Organisation, Community or Voluntary Group
Have a written set of rules, governing document or constitution (copies should be submitted with your application)
The group or organisation needs to have been in existence for at least one year
Have an annual income of less than £30K
Work for the benefit of the local community in Hull and or the East Riding of Yorkshire.
The activity/event needs to be in relation to health or wellbeing. This could include dance/drama/football club. This could also include a health or wellbeing learning activity or event.
Needs to be led by volunteers
How the grants will be managed?
We will have four rounds of grants/donations per financial year in June, September, December and March.
Application will need to be in by the 1st day of June, September, December and March and groups/organisations will be notified by the last day of these months.
Decisions will be made by a Panel on meeting the criteria and resource available.
The Panel will be made up of a maximum of 6 staff from a cross section of CHCP service areas. Membership on the Panel will change on a rolling basis.
The monies available for each period/quarter will be £2,000.
Groups will only be allowed to apply once per financial year.
What do we require from you?
A completed application form with all information on.
The opportunity to publicise the activity or event.
After the event/activity a statement on what difference the contribution has made to your group or community.

For an application form and guidance notes please go to www.chcphull.nhs.uk/pages/small-grants--2

If you have any queries regarding the CHCP Small Grants programme then please e-mail: engagement@chcphull.nhs.uk

Enquiry into maternal obesity

Tue, 14 Dec 2010 09:23:00 +0000

CMACE release: National enquiry into maternal obesity – Implications for women, babies and the NHS. From the Royal College of Obstetricians and Gynaecologists. 8th December 2010.

The Centre for Maternal and Child Enquiries (CMACE) releases its report Maternal obesity in the UK: Findings from a national project today after its three-year UK-wide national enquiry into Obesity in Pregnancy.

This major national study, which collected information from every maternity unit in the UK, has revealed for the first time the prevalence of severe maternal obesity (body mass index 35+) in the UK. The report also details the complications and consequences of obesity during pregnancy, and outlines the implications for the care of obese pregnant women.

This study found that around 5% of the UK maternity population were severely obese. In real terms, this equates to around 38,478 (1 in 20) pregnant women each year, and, with growing levels of obesity in the general population, this number is expected to increase. Wales was found to have the highest rate (6.5%, 1 in every 15 pregnant women) of severe maternal obesity in the UK. In England, the region with the highest rate was East of England (6.2%, 1 in every 16 pregnant women), while London had the lowest rates (3.5%, 1 in every 29 pregnant women).

The report highlighted that pregnancy outcomes for severely obese women are poorer when compared to the general population. The study found that the stillbirth rate in women with a BMI 35+ (8.6 per 1000 singleton births) was twice as high as the overall national stillbirth rate (3.9/1000 singleton births), and that the risk of stillbirth increases with increasing obesity. Also, in women with a BMI 35+, stillbirths occurring during labour and birth were three times higher than the overall national rate in England, Wales and Northern Ireland.

The risks of obesity in pregnancy extend to the mother too. Pregnant women, and especially obese pregnant women, are more at risk of developing venous thromboembolism (VTE), which is a potentially fatal condition that involves a blood clot forming in a vein which may break away, travel through the circulatory system and obstruct a blood vessel. The CMACE study revealed how VTE risk was poorly documented for obese pregnant women at their first antenatal appointment and fewer than 50% of the women at moderate or high risk of VTE were offered treatment to prevent the condition. For those women who did receive treatment antenatally, the prescribed doses were considered to be insufficient for their body weight, according to current guidelines published by the Royal College of Obstetricians and Gynaecologists (RCOG). Similar findings were found for postnatal treatment for the prevention of VTE, with only 55% of eligible women being prescribed the appropriate medication. These findings highlight that improvements in this area are required to reduce the risk of VTE in obese women during and after pregnancy.

The CMACE report also revealed that obese women have an increased risk of medical conditions both before and during pregnancy. Thirty-eight per cent of women in the study had at least one medical condition diagnosed prior to and/or during pregnancy. The most common conditions were gestational diabetes and pregnancy induced hypertension, which affect 8-9% of women with a BMI 35+; these conditions affect approximately 2-2.5% of women in the general maternity population. The presence of medical conditions increases the risk of complications for both the mother and baby, and increased surveillance and medical intervention are therefore required.

Only 55% of women with a BMI 35+ gave birth naturally. The caesarean section rate for singleton babies was 37%, which is 1.5 times higher than the rate in the general maternity population. In addition, severely obese women were at least four times more likely to suffer from postpartum haemorrhage within 24 hours of birth than women in the general maternity population.

The CMACE study also identified gaps in anaesthetic care for obese women. According to current joint CMACE/RCOG guidance, women with a BMI ≥40 (morbidly obese) should receive an antenatal consultation with an obstetric anaesthetist so that potential problems can be identified and an anaesthetic management plan for labour and delivery can be made. Only 45% of eligible women had such a plan.

A set of ten key recommendations has been developed by CMACE in response to the findings in the report. The purpose of providing these recommendations is to highlight areas requiring better clinical practice. The general points are:

•   Better preconception care and advice is needed for women with overweight and obese BMIs. The joint CMACE/RCOG guideline on managing women with obesity in pregnancy, issued in March 2010, notes that women of childbearing age with a BMI 30+ should be provided with good information and advice on the risks of obesity during pregnancy and childbirth; and they should be supported to lose weight before conception and in the postnatal period. Pre-pregnancy counselling must also include taking an accurate height and weight measurement for a BMI calculation to identify women who may be at further risk or require additional services or care.
•   Women with obesity have an increased risk of pregnancy complications such as gestational diabetes and pre-eclampsia. CMACE recommends that surveillance and screening according to existing guidelines occur so that referrals for specialist care can be made early in pregnancy.
•   Women with a BMI 40+ should have a consultation with an obstetric anaesthetist, as recommended by the joint CMACE/RCOG guideline on obesity in pregnancy, so that potential problems such as venous access can be identified before the birth.

Professor James Walker, Chair of CMACE said, “The numbers of obese mothers are on the rise and this group of women require specialist care since they are more susceptible to illnesses and complications. So far, there hasn’t been a UK-wide study on the extent of the problem but we now have very good data on how these women are cared for and the areas where improvements are urgently needed”.

Dr Imogen Stephens, CMACE Clinical Director said, “This CMACE report shows that much more needs to be done in the NHS to deal with the growing numbers of obese pregnant women. We have already shown in our previous survey how specialist equipment such as wheelchairs, trolleys and beds are needed to care for this unique group of women. The findings from this new study show that the risks of clinical intervention increase with increasing levels of obesity and that specialist obstetric care is needed. All this requires improved, and better integrated, care for these women”.

Dr Tony Falconer, President of the Royal College if Obstetricians and Gynaecologists (RCOG) said, “Pregnant women who are obese need to know about the associated risks for them and their baby and must be supported to lose weight before they embark on pregnancy. This will involve counselling and advice from a range of healthcare professionals including GPs, midwives, maternity support workers and nutritionists.

When a woman finds out she is pregnant, she tends to adopt positive behaviours to ensure that she is as healthy as she can possibly be and this includes sensible eating and lower alcohol consumption. However, we need to think about being more proactive by encouraging and enabling women to lead healthier lives before they fall pregnant and after giving birth so that they take a more long-term approach to being healthy”.

Professor Cathy Warwick, General Secretary of the Royal College of Midwives, said “Our own research backs up these recommendations. Women have told us that they are not getting the level of care that they should from maternity services.

“There is no doubt that being obese and pregnant can leave women open to more problems in pregnancy than non- obese women. However with high quality care these problems can be identified and treated and women can have a very positive experience of pregnancy and birth. It is therefore crucial that midwives and other health professionals work together to ensure that these women get the best possible care, support and advice. Many women have told the RCM that one of the big barriers to this is that there are simply not enough midwives to spend time with them especially in the antenatal period.

“There is also a much wider and long-term public health message here. There is a real need to reduce obesity in the population as a whole, tackling the issue before women become pregnant.”

Notes

The research lead for this project and author of the report is Dr Kate Fitzsimons (Senior Research Fellow, CMACE). The editor of the report is Professor Ian Greer (Executive Pro-Vice-Chancellor, Faculty of Health & Life Sciences, University of Liverpool; Chair of the National Advisory Committee for CMACE).

To view Maternal obesity in the UK: Findings from a national project, please click here. The launch of the report accompanies the CMACE conference ‘Obesity in Pregnancy: Improving care and effecting change’. To view the conference programme, click here.

This new report follows the publication of the CMACE survey on NHS maternity provision to obese women and the joint CMACE/RCOG clinical guideline ‘Management of Women with Obesity in Pregnancy’ in March this year.

Body mass index (BMI) offers a useful measure of obesity and is a simple index of weight-for-height used to classify underweight, overweight and obesity in adults. BMI is calculated by dividing a person’s weight in kilograms by the square of their height in metres (kg/m2). The table below shows a widely accepted classification published by both the World Health Organization and the National Institute for Health and Clinical Excellence (NICE). This report focused on women with a BMI 35+ (severely obese) in pregnancy. A woman with a height of 5ft 5” and a weight of 15 stone would have a BMI of 35.

BMI (kg/m2)   Classification
<18.5   Underweight
18.5-24.9   Normal/Healthy
25.0-29.9   Overweight
30.0-34.9   Obese I
35.0-39.9   Obese II
≥40   Obese III

Surveys and Survey Results

Wed, 15 Sep 2010 10:59:00 +0100

Hull Pride - 31st July 2010

The Sexual and Reproductive Healthcare Partnership for the second year was offering free and confidential HIV testing, support and advice at Hull Pride at West Park.

Just like last year, our aim was to promote HIV testing, increase uptake of testing and raise awareness of HIV and AIDS within the local LGBT community.

For the second time we increased uptake of HIV testing in the community and nearly doubled the numbers of tests undertaken in comparison to 2009.

The HIV testing was a simple and straightforward mouth swab with results being available up to 14 days after the test. Again, we had such a great respond from the LGBT community and we got 25 people tested on HIV during the day.

We are all pleased with the success of that day!

Genital Care Leaflet - 'Tips for your Bits'

This leaflet was developed by one of our Genitourinary Consultants to provide the local population with advice and information on how to care for the skin around the genital area. The leaflet is aimed at males and females of all ages.

When developing the leaflet, we consulted with users of the service as well as non-users regarding the wording of the leaflet, the content of the leaflet (whether there was more information that needed to be included), the layout of the information and the name of the leaflet.

We consulted with 109 people of ranging from 15 - 77 years old. The results showed:

- 97% of those consulted understood all the information in the leaflet
- 74% thought that they got all the information they needed
- 82% felt that it would help them to improve their personal care
- 93% understood all of the words

The preferred name for the leaflet was 'Tips for your Bits'. Other options were 'Personal Care Leaflet' and 'Hints for Healthy Genitals'.

Other feedback asked for a bit more explanation in the leaflet and less repetition.

As a result of the consultation more explanation was added into the introduction, amendments were made to some of the words used and changed the layout of the information to include a General Advice section, Information for Females and Information for Males.

CASPHER Texting Service

The Chlamydia Awareness Screening Programme for Hull and East Riding Team currently use text messaging to inform those who have been tested of their results. Young people are responding well to this service and we thought it would be a good opportunity to promote the Chlamydia Screening Programme and remind people to undertake a further chlamydia test.

This service is aimed at males and females aged between 14 - 24 years old who live in Hull and the East Riding of Yorkshire.

We consulted with 44 people aged 13 - 25 years old:

- To investigate whether the texts are a good idea
- To establish what the text should say
- To establish if this service should be opt in or opt out
- To find out how people like to be tested
- To find out how many times a person changes their mobile phone number

The results are as follows:

39 people thought this would be a good service
30 people would not object to an annual reminder
24 people thought that this would need to be an 'opt-in' service, therefore, they would need to give permission to receive the text
21 people preferred this wording: 'Hi CASPHER team here, just reminding you its been a year! Please pick up a test from ur nearest site'
33 people told us they had changed their phone number in the last year
23 people said they would prefer to get their test kit from their local clinic

Outcome

Although we are now unable to develop this texting service at this present time, the results will help us in the future when we consider developing this service again.

Photographs

We wanted to update the artwork on the walls within Conifer house, the main clinic sexual health and reproductive clinic in Hull and East Riding of Yorkshire.

We had tasteful pictures of different forms of contraception taken and asked staff and service users which pictures they liked and for further comments.

Results

Respondents requested more explanation on the pictures
Respondents liked the intrauterine device next to the 20 pence to show how small it is
Some of the text was confusing/innaccurate
Some pictures showed contraception that was not available anymore

Outcome
Text was removed or amended to reflect the feedback given by staff (e.g. 'you do not need to know how it works' removed from the picture of the intrauterine device)
The picture of the intrauterine device with the coil was not used
Only used images of contraception that was still available

Genitourinary Medicine (GUM) User Satisfaction SUrvey

We ran a survey throughout May 2010 throughout our GUM service usersto establish levels of satisfaction regarding different aspects of the service.

The survey was completed by service users as soon as they had completed an episode of care within one of our clinics and asked about the following areas:

Reason for visit.
Why choose the GUM service over their GP surgery or pharmacy.
How users heard about us.
Were service users advised to come here.
Length of wait.
How long users were willing to wait.
General satisfaction about aspects of the consulation e.g. whether users felt they were valued and treated with respect, got all the information they needed, whether they were confident their informaiton would be kept confidential, whether they were given enough time, if they were made to feel comfortable and if they felt the consultation was worth the wait.

Results

Overall we received 195 responses, equating to about 9% of the total number of people accessing the service throughout May 2010.

The main reasons for visiting a GUM clinic rather than a GP or pharmacy accross all three locations was for confidentiality and because there was no need for an appointment.

Friends and family, GP surgeries and websites were the main ways in which people heard about our service.

Most people accessing our services did so without being referred here by someone else or being told to come by friends or family.

'Sexual health check' was the main reason people attended the GUM clinics accross all three sites.

Most of the respondents waiting between 0-30 minutes to be seen, however it was noted that at Conifer House, some had waited between 60-90 minutes to be seen.

Most people thought that waiting between 0-30 minutes was acceptable, however, at Conifer house, respondents were prepared to wait between 60-90 minutes.

Most respondents Strongly agreed or Agreed that they were valued and treated with respect, got all the information they needed, they were confident their informaiton would be kept confidential, they were given enough time, they were made to feel comfortable and they felt the consultation was worth the wait.

Those that expressed dissatisfaction with the with the service waiting times as the reason for this.

Outcomes

The staff working within the GUM service are completing an action plan to say what they will be doing with the results.

We have already started to include information about waiting times on the whiteboards in the waiting areas to ensure that people are aware of how long they will be waiting, We are also reviewing our triage systemto make this more efficient, ensure that staff time is used more effectively and, omst importantly , to ensure service users are seen as quickly as possible.

World first in sexual health as My Contraception Tool launched

Wed, 07 Jul 2010 14:32:00 +0100

Sexual health charities Brook and FPA today launched My Contraception Tool (v1.0) a unique, evidence-based web tool designed to support people's contraceptive choices by evaluating their preferences and priorities as well as their physical needs. This new web tool is expected to fundamentally change contraceptive consultations - empowering people's choice and giving invaluable support to busy health professionals.

Eighteen months in development, and launched simultaneously on both organisations' websites, the tool combines specialist software1, research2, expertise in decision making3 and sexual health and months of user involvement and consultation. Using the latest research into every method of contraception, the circumstances, medical history and personal preferences are input by the user online. These data are then processed and each contraceptive method is ranked in order to suit individual needs.

Simon Blake, Brook's National Director, said:
"We wanted to help young people think about the kind of things they need to take into account when it comes to making contraceptive choices and this tool supports them in doing that. We hope it will give young people the confidence to have conversations with health professionals about the range of contraceptive choices available to them as well as beginning to understand the importance of making informed decisions."

Julie Bentley, chief executive of FPA, added:
"There are many medical and lifestyle considerations to think about when choosing a contraceptive method. And everybody benefits from having the most up to date information at their fingertips. My Contraception Tool is quick and easy to use. It will open up the range of options to women of all ages and give health professionals another facility to use during contraceptive consultations."

The tool is designed for use by men and women of any age who want to use contraception and is linked to further information about each contraceptive method as well as a wealth of information on other aspects of sexual health.

People can log on to My Contraception Tool at www.brook.org.uk/mycontraceptiontool or www.fpa.org.uk/mycontraceptiontool
and answer questions about their lifestyle, medical history and their priorities in terms of contraception.

As the tool provides a hierarchy of methods based upon the preferences of the user the results can be printed and taken to help initiate conversations with a healthcare professional.

Health professionals can use the tool either by going through the surveys with people during consultations, talking through the options and discussing their advantages. Alternatively, the result sheet can be printed out by the person at home and used to form the basis of a contraceptive consultation.

My Contraception Tool is backed by some of the country's leading professional health representative organisations.

Dr Peter Carter, Chief Executive & General Secretary of the Royal College of Nursing commented:

"We are delighted to see Brook and FPA launch such an easy-to-use, invaluable resource which will quickly and easily help people to make informed decisions about their sexual health. It is important that people are aware of the wide range of choice there is about contraception so they can find a method which best suits their needs."

Dr Ewen Stewart from the Royal College of General Practitioners' Sex, Drugs and HIV Group said:

"Discussing sexuality and contraception with patients can sometimes be uncomfortable for healthcare professionals. My Contraception Tool acts as a conversation starter that will help GPs and Practice Nurses to discuss contraceptive choice, allowing people to make the right choice of method for themselves."

My Contraception Tool was developed by a team of specialists from Brook, FPA, Maldaba Ltd. (www.maldaba.co.uk), and the London School of Hygiene and Tropical Medicine (www.lshtm.ac.uk).