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v2 IAPT Data Set – Guidance for identifying and submitting data on individuals in the perinatal period

This guidance outlines the benefits of identifying individuals in the perinatal period within Improving Access to Psychological Therapies (IAPT) services and how to accurately submit data on this cohort to v2 of the IAPT data set.

The intention is to support the availability of robust local and national data to inform service development in line with guidance for this cohort in the IAPT manual. The IAPT manual recommends that women in the perinatal period are prioritised for assessment within 2 weeks of referral and commence treatment within 4 weeks.


Perinatal mental health

For the purpose of this guidance, individuals are considered to be in the perinatal period for 33 months, which includes the 9 months of pregnancy and 24 months post birth. This aligns with NHS Long Term Plan ambitions for specialist Perinatal Mental Health Services.

Suicide is a leading cause of maternal death in the first 12 months after birth1. 

Between 10–20% of women develop a mental illness during pregnancy or in the first year after delivering their baby2.

Perinatal mental ill-health includes a wide range of disorders, with post-natal depression affecting 10–15% of women after birth3.  

Women with a history of mental health illness are at significant risk of relapse during pregnancy and the first 12 months after birth4.

Partners/carers of women experiencing severe mental illness during the perinatal period may be at an increased risk of developing mental ill-health.5


The role of IAPT

Depression and anxiety are the most common mental health problems during the perinatal period. Depression and anxiety affect 15‑20% of women in the first year after childbirth as well as during pregnancy in some cases6

During pregnancy and the postnatal period, anxiety disorders, including panic disorder, generalised anxiety disorder (GAD), obsessive‑compulsive disorder (OCD), post‑traumatic stress disorder (PTSD) and tokophobia (an extreme fear of childbirth), can occur on their own or can coexist with depression.

A large proportion of women who experience common mental illness, such as depression and/or anxiety for the first time, or see a deterioration in an existing condition, during the perinatal period are appropriate for treatment in IAPT.

As stated in the IAPT Manual, the Antenatal and Postnatal Mental Health NICE guideline recognises the serious impact of undiagnosed depression and anxiety disorders on the health and wellbeing of the mother and baby during pregnancy and the postnatal period. Therefore, NICE recommend that women in the perinatal period are prioritised for assessment within 2 weeks of referral and commence treatment within 4 weeks.


Capturing perinatal mental health information

IAPT services should continue to capture information in relation to perinatal mental health in line with local clinical practice, however the following questions can be used at the point of referral.

The resultant findings must be recorded locally using SNOMED CT clinical terms. SNOMED CT is the terminology mandated for the recording of clinical terms within all electronic communications by April 2020.

Pregnancy

Question SNOMED CT Concept Description SNOMED CT Concept ID
Are you pregnant? Pregnant (finding) 77386006
Is your partner pregnant? Partner pregnant (situation) 704502000

It is recognised that not all expectant/new parents will be biological. Provider feedback will be used to assess whether this is a requirement for the data set. A SNOMED item to accommodate pregnancy where individuals are not biological parents i.e. surrogacy could be added at a future date.

Children 

Question SNOMED CT Concept Design SNOMED CT Concept ID
Do you have a child under 12 months old? Family with child under one year (finding) 224123004
Do you have a child under 12 months old? Family with children under one year (finding) 224122009
Do you have a child under 24 months old Family with child under two years (finding) 1128911000000100
Do you have a child under 24 months old Family with children under two years (finding) 1127321000000108

 


Primary uses local reporting

Supporting good clinical practice

Identifying individuals in the perinatal period or the partner of someone that is, at the point of referral ensures IAPT services are able to provide the most appropriate clinical response, such as:

  • prioritised assessment
  • commencing treatment within 4 weeks
  • alocation of the most relevant practitioner (e.g. PWP perinatal champion)

Meeting the needs of the local community

Commissioners and providers must fully understand demographic profiles and epidemiological data for their local community in order to provide appropriate IAPT services for the whole population including individuals in the perinatal period or the partner of someone that is.


Secondary uses IAPT Data Set

An Information Standards Notice (ISN) has already been issued for the IAPT Data Set (DCB1520) and all IAPT services are mandated to submit monthly data as part of this. This includes any clinical findings recorded for the patient during their referral for care.

Ensuring the flow of relevant perinatal mental health information in the IAPT Data Set will vastly improve the availability and quality of data that providers and commissioners can use to evidence services are meeting the needs of individuals in the perinatal period in their community, and directly support service development and quality improvement.

Whilst the data linkage between the IAPT and Maternity Data Sets can help to identify the number of women entering treatment, data only becomes available retrospectively. Locally this data linkage is not useful to enable services to use local data analysis to guide delivery at the immediate point of care.

The IAPT v2.0 Data Set provide multiple areas for these clinical findings to be recorded, depending on the way in which the data is captured locally:

A. IDS011 Social and Personal Circumstance – Where the finding has been made outside of an appointment (e.g. via a self-referral form, GP referral, online assessment..)

B. IDS202 Care Activity – Where the finding has been made as part of a direct contact with the patient (e.g. a face to face assessment)

A. IDS011 Social and Personal Circumstance data group

Read more about IDS011 Social and Personal Circumstance data group

Data item

LOCAL PATIENT IDENTIFIER (EXTENDED)

Purpose

The LPI for the patient, to link back to the patient entry in the IDS001MPI table.

Data item

SOCIAL AND PERSONAL CIRCUMSTANCE (SNOMED CT)

Purpose

The SNOMED CT Concept ID for the clinical finding.

For example  ‘77386006’ (pregnant)

Data item

SOCIAL AND PERSONAL CIRCUMSTANCE RECORDED DATE

Purpose

The date associated with the clinical finding.

This is not a mandatory field but should be populated where known.

 


B: IDS202 Care Activity data group

Read more about B: IDS202 Care Activity data group

Data item

IDS201 Care Contact to be populated in usual manner, including Care Contact Date, Appointment Type and Consultation Medium Used among other items.

Data item

CARE ACTIVITY IDENTIFIER

Purpose

To link the IDS202 record back to the associated IDS201 Care Contact.

Data item

FINDING SCHEME IN USE

Purpose

Set to ‘04’ to indicate a SNOMED CT code is being submitted.

Data item

CODED FINDING (CODED CLINICAL ENTRY)

Purpose

The SNOMED CT Concept ID for the clinical finding.

For example. ‘77386006’ (pregnant)

Footnotes

1. Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (EMBRRACE -UK), Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2015-17

2. LSE and Centre for Mental Health, The cost of perinatal mental health problems, 2014.

3. LSE and Centre for Mental Health, The cost of perinatal mental health problems, 2014.

4.The British Psychological Society and The Royal College of Psychiatrists, Antenatal and postnatal mental health, the NICE guideline- Clinical management and service guidance, updated edition, 2007.

5. Reid, H., et al., The Experiences of Fathers When Their Partners are Admitted with Their Infants to a Psychiatric Mother and Baby Unit. Clinical Psychology & Psychotherapy, 2017. 24(4): p. 919-931.

Ruffell, B., D.M. Smith, and A. Wittkowski, The experiences of male partners of women with postnatal mental health problems: A systematic review and thematic synthesis. Journal of Reproductive & Infant Psychology, 2019: p. 1-17.

6. [1] LSE and Centre for Mental Health, The cost of perinatal mental health problems, 2014

Last edited: 14 May 2024 1:21 pm