Challenge
Birmingham and Solihull Mental Health NHS Foundation Trust needed to assess how well the service was meeting its population’s needs so that barriers to accessing services could be identified and overcome.
To achieve this, the Trust needed to address the following challenges:
- Assessing referral rates to target perinatal interventions.
- Identifying the number of births in different areas of the city to women of different demographic communities.
- Producing analysis at a geographic level suitable to guide improvements to services.
Solution
Anonymised information including age, home postcode and ethnicity for women referred over a 17-month period was extracted from the Trust’s database. Separate analysis was carried out for referrals to the community perinatal service and the inpatient unit using a combination of statistical and geospatial analysis.
The number of women of different ethnicities being seen in different geographic areas was compared with the estimated number of women requiring perinatal mental health care in those areas to assess whether need was being met. The analysis used a number of datasets from Ordnance Survey.
Result
- Integrated analysis identified a bias for referrals to Birmingham’s perinatal mental health service from the south of Birmingham, evident in community home visits and GP referral patterns.
- In contrast, there were fewer referrals from the central and northern areas. The central area of Birmingham is characterised by high social need, and a higher proportion of black and minority ethnic (BME) communities and a higher referral rate was predicted.
- Demographic analysis indicated that fewer women from Asian (especially Bangladeshi, Indian and Chinese) and black communities were being seen by the community perinatal teams than would be expected.
- The analysis identified geographic, ethnic and socio-demographic opportunities for improvements in the provision of community services.
- Outcomes from the analysis informed changes to perinatal care resulting in more women from BME communities being seen.
- The approach is recognised by Monitor (the sector regulator for health services in the UK) as an example of best practice.
"Using geographic information to understand perinatal referrals has enabled us to easily visualise where changes to perinatal care are needed... The approach is included as an example of best practice in Monitor’s online tool kit."