1. Process for access to psychological therapies: For women presenting with a specific perinatal mental health issues Le. birth trauma, severe anxiety/depression (related to pregnancy), psychological therapy is accessed via the PRAMS generic assessment pathway I.e. women referred directly to PRAMS -seen for mental health needs assessment by a perinatal team clinicians (nurse/OT/psychiatrist) if psychological therapy is indicated internal referral to PRAMS clinical psychologist.

Where there is a need for psychological therapy but presenting difficulty is not perinatal specific i.e. presentations such as chronic/long term OCD, childhood trauma, part of a pre-existing severe mental illness women are signposted/referred to most appropriate existing service i.e. LPMHSS to access psychological based therapies. If mental health presentation requires referral to secondary MH services this will be facilitated by PRAMS following initial PRAMS assessment and a recommendation shared regarding need for psychological therapy.

2. The waiting time from internal referral (need for clinical psychology input being identified) to direct contact with PRAMS clinical psychologist approximately 8 weeks. Due to the limited resource and limited cross cover working arrangement within psychology waiting times are intermittently impacted by annual leave, training or sickness absence.

3. Current provision of clinical psychology inadequate to meet needs of current service and the guidance of CCQI standards. Further development work needed to clearly identify service needs and additional investment. Current provision is 0.2WTE band 8a clinical psychology (1 day per week across all 3 localities for approx 6000 live births).

4. Currently no specific clinical psychology input to group work due to limited resources and this being directed to individual therapy. Clinical psychologist has been involved in developing the group programmes which are delivered by PRAMS nurses/Occupational Therapists which does increase the scope of the service.

The Clinical Psychologist for PRAMS is currently providing the team with group reflective supervision and case discussion on a bi-monthly basis to support the development of the psychologically informed approaches within the service and provide direct case consultation.

I trust this information will assist but should you require any further information please do not hesitate to contact me.