Meeting of the SMART Group – Scion House, Stirling

Present: Helen Bryers (HB), Helen Cheyne (HC), Emma Coles (EC), Ruth Deery (RD), Tracy Humphrey (TH), Caroline Hollins-Martin (CHM), Ann Holmes (AH), Mary Renfew (MR), Andrew Symon (AS), Heather Whitford (HW).
Apologies: Rhona McInnes (RM), Jean Rankin (JR).

In attendance: John Bowers (JB).

Introductions

HC introduced new members Mary Renfrew and Caroline Hollins-Martin.


Aims/purpose of SMART Group and future directions

HC revisited the original purpose and aims of the group from when it was set up in 2012. Now that the 3 projects are up and running, and in acknowledgement of the changing landscape, it was agreed it may be time to broaden or even alter the role and remit of the group, as it continues to evolve with the addition of new members. This may involve: taking a more strategic direction, contributing to the policy agenda, garnering intelligence and becoming a united voice for the midwifery profession, and supporting research capacity and clinical/academic career development. The website (see 5) will be used as a platform to make the group more visible, showcase its members and provide a cohesive message. AH suggested that the group should consider ways to publicise their work and keep policy-makers updated on midwifery in Scotland, perhaps in the form of a concise email with a link to the website that can be circulated.


Project updates

Alcopreg (AS): Four researchers are employed, two in each site (Fife and Ayrshire). Recruitment, at the mid-pregnancy scan, has been very positive (one in two of eligible women) and the project is ahead of schedule. Emerging data about drinking patterns is complex. Focus groups are planned, and results will be fed back to participants and midwives. It is hoped that another UK university will replicate the study.

Mode of birth after caesarean – predictive scoring model/decision-making support (TH): Two midwives are employed as research fellows in RGU. The project is multi- disciplinary, with the involvement of JR, HW and HC, as well as Mairead Black and statisticians from the University of Aberdeen. Routine data from the last 10 years from women who fit the criteria has been gathered, is currently being cleaned, and final analysis will take 6-8 weeks. TH has submitted a grant proposal to work the scoring model into clinical interventions; the plan is then to submit a proposal to CSO for a multi-site RCT.

Early years interventions to improve child wellbeing and reduce inequalities (HC): The realist review, the first stage of the three-stage project, is underway, with a scoping exercise and consultation with experts (Scottish Government/third sector) undertaken. Brigid Daniel, University of Stirling, is collaborator on the project; the group will be named as collaborators on project outputs. A protocol paper has been submitted to Systematic Reviews and is likely to be published shortly subject to revisions made following peer review.


Review of maternity services

AH briefed the group about the review of maternity and neonatal services. It is anticipated that the review will start in June and be completed by Spring 2016. It was suggested that group prepare evidence so it can feed into the review as soon as possible (AH will contact the SMART group as soon as the review group is set up and terms of reference set). This may be in the form of a series of short papers on problems (e.g. medicalisation, continuity of care(r), models of care, risk assessment, inequalities) and evidence-based solutions. Suggestions included: producing a table populated with evidence, taking an assets-based approach, using the Lancet Series as a framework. There is a need to take this forward in a timely manner; it was agreed that some work towards this will be done via email before the next meeting.


Website

Fiona Dawson of Unavoided web design showed the group four potential logos along with various colours. Two of the designs (hands and curves) were popular, although it was suggested that the hands design could be reworked with the hands made more prominent. Alternative colours were suggested, including blue-green. Fiona will send out the reworked designs electronically so they can be viewed on screen.


Continuity of care project

HC introduced Professor John Bowers, School of Management, with whom she is collaborating on the continuity of care project. Group involvement in the project is invited. JB outlined the stages of the project and the research plan (identify and categorise aspects of the pathway where continuity of care is important; identify and model management options to improve continuity of care; set targets and measure progress; produce recommendations). The group discussed various issues raised by the project. Next steps: the ‘Enhancing Maternity Continuity of Care’ paper and a revised research proposal will be circulated; the group will work towards identifying the key questions and priorities. This work will link in with the continuity of care aspect of the review of maternity services.