QOF Plus Year 1 - Imperial College London
QOF Plus Year 1 - Imperial College London QOF Plus Year 1 - Imperial College London
Priority and relevance to national policyThe importance of breastfeeding is highlighted in national policy including Choosing Health;Making Healthy Choices Easier (DoH, 2004) and the National Service Framework for Children andMaternity Services (DoH, 2004). Breastfeeding contributes to several Public Service Agreement(PSA) targets and NICE guidance on postnatal care (2006) has made recommendations that topromote breastfeeding, the UNICEF Baby Friendly Initiative should be implemented as routinepractice, the minimal standard across NHS Trusts in England. NICE has also published publichealth guidance on improving the nutrition of pregnant and breastfeeding mothers and childrenin low-income households (NICE, 2008).Prevalence of conditionUK breastfeeding rates are amongst the lowest in Europe. In the Office of Population CensusSurvey (Hamlyn et al., 2002) 71% of mothers across the UK initiated breastfeeding, and 86% ofmothers were from managerial and professional occupations compared to 60% of mothers fromroutine and manual occupations.The UK Infant Feeding Survey 2005 (2007) also found that 48% of all mothers in the UnitedKingdom were breastfeeding at six weeks, while 25% were still breastfeeding at six months. At sixweeks the rate of exclusive breastfeeding was 22% in England. In this survey, 84% of mothers saidthey were aware of the health benefits of breastfeeding. Three quarters of these mothers hadalso given their baby milk; which was not breast milk by the age of six weeks, an this percentagerose to 92% by six months.Associated morbidity and mortalityLow rates of breastfeeding are associated with increased incidence in the infant ofgastrointestinal, urinary, respiratory and middle ear infection (Aniansson et al. 1994; Howie et al.1990; Pisacane et al. 1992) and atopic disease, especially if there is a family history of this (Burr etal. 1989; Oddy et al. 1999). Breastfeeding may be protective against cardiovascular disease(Wilson et al. 1998}. Women who do not breastfeed may be at increase risk of certain forms ofcancer, including breast cancer (DoH, 1996).46
Local contextIn 2006/7, the percentage of mothers initiating breastfeeding within 48 hours was 79% (Zeuner,2008). The Food & Health Strategy developed by NHS Hammersmith and Fulham, in collaborationwith the London Borough of Hammersmith and Fulham, includes the following recommendationsfor infant care services:1 Promoting breastfeeding, especially to vulnerable young mothers, through Health Visitorante-natal support.2 Community breastfeeding support groups, run in conjunction with Children’s Centres byHealth Visitors, Midwives, Childcare Advisors and Family Support Workers.3 Breastfeeding advice and support given in child health clinics, post-natal/baby massagegroups, parenting groups, home visits and by telephone.4 Healthy weaning advice groups provided by Childcare Advisors to all parents and carersof babies from 17 weeks of age. Sessions also included in six-weekly parenting groupprogrammes. Support and information provided in Child Health Clinics, individual homevisits and by telephone.5 Training sessions on practical nutritional guidelines for people working with infants andyoung children.Review of evidence to support the proposed indicatorThe National Institute for Health and Clinical Excellence’s Public Health Briefing ‘Promotion ofBreastfeeding Initiation and Duration’ (2006) includes a comprehensive review of the currentevidence base for supporting the initiation and continuation of breastfeeding in the UK. ThePublic Health Briefing recommends that there should be provision of a ‘best package’ to suit localneeds that is informed by practitioners and service users and that targets areas where rates arelowest. It also recommends implementation of the UNICEF Baby Friendly Initiative in hospital andcommunity settings.The introduction of the Baby Friendly Initiative in the UK was launched in 1994. It provides aframework for both implementation and audit of best evidence based practice. It includes aSeven Point Community Plan which aims to promotes, protect and support breastfeeding incommunity health care settings. Facilities that meet the required standards can apply foraccreditation as Baby Friendly.47
- Page 15 and 16: Executive summaryIntroductionPrevio
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- Page 22 and 23: The quality and outcomes framework
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- Page 28 and 29: Doran T, Fullwood C, Kontopantelis
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- Page 47 and 48: QOF+ report on alcoholProposed indi
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- Page 53 and 54: QOF+ report on smokingProposed indi
- Page 55 and 56: Local context24% of adults (35,000)
- Page 57: ReferencesBritish Medical Associati
- Page 60 and 61: The NICE Clinical Guideline on Ante
- Page 62 and 63: Health impactThere are significant
- Page 65: QOF+ report on breastfeedingPropose
- Page 69 and 70: Degree of perceived professional co
- Page 71 and 72: QOF+ report on ethnicityProposed In
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- Page 85 and 86: QOF+ report on newpatient screening
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- Page 89 and 90: QOF+ report onpatient informationPr
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- Page 95 and 96: ReferencesCarpenter A and Mayers A
- Page 97 and 98: QOF+ report onpatient experiencePro
- Page 99 and 100: Rosen et al. (2001) categorised ini
- Page 101 and 102: The National 2007 Quality and Outco
- Page 103: ReferencesBaker, R (2007) Quality a
- Page 106 and 107: BackgroundThe United Nations Conven
- Page 108 and 109: In March 2008, a PCT audit of signi
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Priority and relevance to national policyThe importance of breastfeeding is highlighted in national policy including Choosing Health;Making Healthy Choices Easier (DoH, 2004) and the National Service Framework for Children andMaternity Services (DoH, 2004). Breastfeeding contributes to several Public Service Agreement(PSA) targets and NICE guidance on postnatal care (2006) has made recommendations that topromote breastfeeding, the UNICEF Baby Friendly Initiative should be implemented as routinepractice, the minimal standard across NHS Trusts in England. NICE has also published publichealth guidance on improving the nutrition of pregnant and breastfeeding mothers and childrenin low-income households (NICE, 2008).Prevalence of conditionUK breastfeeding rates are amongst the lowest in Europe. In the Office of Population CensusSurvey (Hamlyn et al., 2002) 71% of mothers across the UK initiated breastfeeding, and 86% ofmothers were from managerial and professional occupations compared to 60% of mothers fromroutine and manual occupations.The UK Infant Feeding Survey 2005 (2007) also found that 48% of all mothers in the UnitedKingdom were breastfeeding at six weeks, while 25% were still breastfeeding at six months. At sixweeks the rate of exclusive breastfeeding was 22% in England. In this survey, 84% of mothers saidthey were aware of the health benefits of breastfeeding. Three quarters of these mothers hadalso given their baby milk; which was not breast milk by the age of six weeks, an this percentagerose to 92% by six months.Associated morbidity and mortalityLow rates of breastfeeding are associated with increased incidence in the infant ofgastrointestinal, urinary, respiratory and middle ear infection (Aniansson et al. 1994; Howie et al.1990; Pisacane et al. 1992) and atopic disease, especially if there is a family history of this (Burr etal. 1989; Oddy et al. 1999). Breastfeeding may be protective against cardiovascular disease(Wilson et al. 1998}. Women who do not breastfeed may be at increase risk of certain forms ofcancer, including breast cancer (DoH, 1996).46
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