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Strengths and Weaknesses of SATOD as a measure of success

Strengths and Weaknesses of SATOD as a measure of success. The Blackpool Experience. Using SATOD as a measure…. Blackpool 33.6%. Middlesbrough 27.2%. Kensington & Chelsea 3.1%. Westminster 3%. % SATOD. Current SATOD for Blackpool. Years.

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Strengths and Weaknesses of SATOD as a measure of success

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  1. Strengths and Weaknesses of SATOD as a measure of success The Blackpool Experience

  2. Using SATOD as a measure… Blackpool 33.6% Middlesbrough 27.2% Kensington & Chelsea 3.1% Westminster 3%

  3. % SATOD Current SATOD for Blackpool Years Data Source: Health Improvement Analytical Team (HIAT)

  4. STATISTICS!!! ‘Trusted and reliable statistics form one of the foundations of an effective democracy. Official statistics are also a building block for open and transparent government, effective public administration, and efficient operation of the economy and society. They provide everyone in the wider community with the statistical information, analysis and advice they need to improve decision making, inform debate and stimulate research.’ (ONS 2011)

  5. SATOD The Scientific Committee on Tobacco and Health (SCOTH), which advises Government on smoking and health and tobacco control issues, said in its 1998 Report: ‘Smoking in pregnancy causes adverse outcomes, notably an increased risk of miscarriage, reduced birth weight and perinatal death’. The Smoking Kills White Paper (published December 1998) outlined a series of measures to tackle this issue, and contained a key target for reducing the proportion of women who smoke during pregnancy. This was ‘to reduce the percentage of women who smoke during pregnancy from 23% to 15% by the year 2010, with a fall to 18% by the year 2005’. In March 2011 the new coalition government announced a national aspiration of 11% SATOD by 2015.

  6. Governing strategies and reports

  7. Percentages into numbers 2010-2011 2889 Maternities in 2010-2011 1228 Smoked 12 months prior to becoming pregnant 42.51% (337 Unknown) 845 Smoked at time of booking 29.25% (23 unknown) 778 Smoked at time of delivery 26.93% (2 Unknown) Data taken from BFW Hospitals NHS Foundation Trust patient administration system Data Source: Health Improvement Analytical Team (HIAT) & Information Department BFW Hospitals NHS Foundation Trust

  8. Bank staff Blackpool quarterly data: Q1 2004/05 to Q4 2010/11 % SATOD Quarter by year Trend line shows an increase in Blackpool’s SATOD Data Source: Health Improvement Analytical Team (HIAT)

  9. Blackpool quarterly data ‘cleaned’: Q1 2004/05 to Q4 2010/11 % SATOD Quarter by year Trend line shows an decrease in Blackpool’s SATOD Data Source: Health Improvement Analytical Team (HIAT)

  10. SATOD and deprivation Tobacco smoking in pregnancy remains one of the few preventable factors associated with complications in pregnancy, low birthweight, preterm birth and has serious long-term health implications for women and babies. Smoking in pregnancy is decreasing in high-income countries and increasing in low- to middle-income countries and is strongly associated with poverty, low educational attainment, poor social support and psychological illness. Ref: Interventions for promoting smoking cessation during pregnancy (Review) 2009 Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L

  11. DH mapping SATOD

  12. Smoking in pregnancy and deprivation

  13. So far… • Checking the Blackpool data ironed out some inaccuracies • Research suggests that you could map SiP against IMD… ………lets try it…..

  14. The five most deprived LA areas (IMD average score) 2010/11 SATOD rate SATOD 2010/11 Top 5 Local Authority areas (IMD by average score Data Source: Health Improvement Analytical Team (HIAT) & Information Department BFW Hospitals NHS Foundation Trust

  15. The bottom five lowest SATOD areas and IMD rank SATOD 2010/10 Richmond & Lambeth Brent Kensington & Westminster Twickenham (29) (35) Chelsea (103) (87) (285) Data Source: Health Improvement Analytical Team (HIAT) & Information Department BFW Hospitals NHS Foundation Trust

  16. Scrutinising local data using the reward scheme 18 women, supported by the reward scheme, successfully quit during their pregnancy (all these women were CO validated). Of these 18 women who had quit, 53% had their smoking status incorrectly recorded in the birth register and in EuroKing. After double checking the data with the women, 35% were still recorded incorrectly.

  17. The affect of this inaccuracy. Data Source: Health Improvement Analytical Team (HIAT) & Information Department BFW Hospitals NHS Foundation Trust

  18. Key points arising from investigation • Some midwives referred only to the booking notes for smoking status at time of delivery • Some staff have a relationship with tobacco, are unable to override this and consequently cannot work to guidelines and hospital policy

  19. Blackpool staff member quote May 2010 “..Well, if you are disabled you get a ramp, if you’re a heroin addict you get methadone, if you are a smoker you get put outside in the rain.”

  20. On further investigation…. • Explored problems in the initial recording of SATOD • Checked against indices of deprivation • Drilled down into the data to check against verified pregnant women we know have quit and found an error rate of 35% • Explored staff attitudes towards smoking

  21. Check! 2010-2011 % women % women 13.26% women quit smoking 12 prior to booking 2.32% women quit smoking between booking and delivery Data Source: Health Improvement Analytical Team (HIAT) & Information Department BFW Hospitals NHS Foundation Trust

  22. Check! Mean average quit rate before booking 13.26% Mean average quit during pregnancy 2.32% Blackpool SATOD for 2010 – 2011 33.60% Total % of fertile woman in Blackpool who smoke 49.18% Average Blackpool smoking prevalence in whole population is 33% Information Department BFW Hospitals NHS Foundation Trust

  23. 0.9% women were not coded Exploring the validity of the data

  24. What does the data tell us? 5.44% of women reported as smoking at time of delivery were recorded as not smoking at time of booking. Information Department BFW Hospitals NHS Foundation Trust

  25. What does the data tell us? • In August it was recorded that no women quit smoking between booking and delivery -However 3 of the women who sustained their quit with the support of the Reward programme delivered their babies in August…….

  26. Now we know • The data is incorrect • The data does not match against research • I don’t know where the data is wrong • The data is only as reliable as the person who inputs it • Only 2.32% pregnant women quit smoking after booking and before delivery • We are unable to use this data to support service investment/development • We don’t know what works.

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