Living in a care home can increase your risk of oral health problems. That's why knowing what questions to ask care staff about your oral health or loved ones can prevent problems from developing. This could be because you have a long-term condition like arthritis, which can make using a toothbrush more difficult. Or if you are living with dementia, dental appointments might be hard to get to and the care you do receive might not be tailored to your condition. Certain medications or treatments like chemotherapy can also cause poor oral health. If you are taking medicine which reduces the amount of saliva you’re producing, this can leave you with a dry mouth and increase your risk of tooth decay. People are also keeping their own teeth for longer, which can mean more complicated dental treatment than for people who have dentures. Because of this, people living in care homes may have difficulty eating, speaking or sleeping, which can affect their quality of life. Oral health assessments To help people living in care homes have healthy teeth and gums, all care home residents should have an oral health assessment when they get there. This is then recorded in their overall care plan. According to the National Institute for Health and Care Excellence (NICE)  quick guide , staff should start your assessment by asking you or a loved one these four questions: How do you usually manage your daily mouth care, and what help would you like? What dental aids do you currently use? For example, do you use a manual or electric toothbrush? Do you use mouthwash or floss? Do you have dentures, and if so, are they marked with your name? If not, would you like them to be marked? When did you last see the dentist? If you don’t have a dentist, would you like help to find one? Looking after your oral health After your oral health assessment, staff should know how to help you with your daily mouth care. This includes supporting you to: Brush your natural teeth at least twice a day with fluoride toothpaste. Use your choice of cleaning products for your dentures. Clean your dentures by brushing them, removing food debris and taking them out overnight. Use your own choice of toothbrush and mouth care products. For example, you might want to use a manual toothbrush and mouthwash. Read more Read the NICE guidelines in full to better understand the support care home services should offer to residents when it comes to their oral health.

Receiving a dementia diagnosis can be a life-changing event, but knowing what support is available to you and what steps to take next can help you or a loved one process the diagnosis and plan for the future. There are 944,000 people living with dementia in the UK. That's roughly 1 in 11 people over the age of 65 and 1 in 71 in the whole population of the UK.  As this number is set to increase with an ageing population understanding what support is available for you or a loved one following a Dementia diagnosis can make all the difference.  The essential information you should get After a dementia diagnosis, you should be made aware of the support available to you. This information should be explained to you and given to you in writing. You can also ask for it in a format you understand.  Your  type of dementia  and how it will affect you. Any further  tests, treatment, activities or therapies  that might help you. Who will provide your care, and how to contact them, including the  professional  who will coordinate your care. Support groups  and charities that can help you. How dementia can affect your  driving  and what you need to do. How your employer should support you if you  work  (or are looking for work). Any  research  studies you could take part in. If you don’t need this information straight away, you can ask for it later on. What else should you talk about with your GP?  Consent  - Do you agree to services sharing information about you? Who can they share information with, and what are you willing for them to share?  Information  - Do you know who to contact for more advice if your needs change?  Future contact  - You may not need any help or further appointments now. If that is the case, would you like to be contacted again and if so, when?  Next steps checklist It's not just health and care support you need to think about when diagnosed with dementia. To help you, Dementia UK has created a checklist to follow, which includes information on benefits and discussing plans and wishes with your family.  Planning your care Now After your diagnosis, your GP should direct you to services that can give you more information and support. You should also be given the name of a professional who will coordinate any care and support you might need. The future Thinking ahead can feel overwhelming, but planning care can help ensure people know your wishes for the future. When you're ready for this, you should be offered support and information to discuss your options. Support for carers Anyone with caring responsibilities for a person with dementia is entitled to a Carers' Assessment. Your local Authority will carry this out. The Assessment will look at the impact of caring for a person with dementia and what support is needed. Take a look at Dementia UK's guidance on  Carers' Assessments  for more information.  As a carer, it is essential to think about your health and wellbeing. It is a significant adjustment, so you should take a look at the options available to you. These can include: Training Support Advice More information If you want more information on what to do after a dementia diagnosis, what signs or symptoms you should look for to get a diagnosis or what support is available to you or a loved one, then these useful links are a great resource.  National Institute for Health and Care Excellence:  Dementia – discussing and planning support after diagnosis Dementia UK -  Get Support Alzheimer's UK -  Our Dementia Support services NHS -  Help and support for people with dementia Age UK -  Dementia Support

A new scheme could see women across England save hundreds of pounds a year on their Hormone Replacement Therapy with a prepayment certificate. What are Prepayment Certificates for Hormone Replacement Therapy?  The introduction of a Hormone Replacement Therapy (HRT) Prescription Prepayment Certificate by the Department of Health and Social Care (DHSC) will cap the cost of hormone replacement therapy at £20 a year.   According to DHSC, there has been a rapid increase in the number of women prescribed HRT in the past two years. Around 15% of women aged 45 to 64 in England are currently prescribed HRT. This is a jump from 11% just two years ago and is set to continue increasing.   The price cap will also increase access to HRT for women across England, as research shows that at least  one in ten  people are struggling to pay for prescriptions they rely on daily due to the rising cost of living This new certificate will make HRT more accessible than ever, helping around 400,000 women save hundreds of pounds a year. Steve Barclay, Health and Social Care Secretary How will HRT certificates affect me?  Women experiencing menopause can now access cheaper HRT prescriptions through a prescription prepayment certificate (PPC).  With a  HRT PPC , women across England who are prescribed HRT can access a year’s worth of treatment for as little as £19.30, the cost of two single prescriptions.  While the new HRT PPC  covers most HRT prescriptions , it does not cover them all. If your HRT isn’t covered under the new PPC scheme, you may still be able to cover the cost with an NHS Prepayment Prescription Certificate.   An  NHS PPC  covers all NHS prescriptions so, if you receive prescriptions for anything other than HRT, you could also save money on these each month. Making HRT more affordable will have a hugely beneficial impact on the lives of so many women. This prepayment certificate is a major step forward in prioritising the health and wellbeing of women. Dame Lesley Regan, Women’s Health Ambassador How do I get a prepayment certificate?   You can apply for your  HRT PPC  through the NHS Business Services Authority, which offers help with health costs.   Using their  eligibility checker , you can check to see if you are entitled to free NHS prescriptions and support with other health costs.   Apply for your Hormone Replacement Therapy Prepayment Prescription Certificate

We've launched a new project with the aim of improving access to mental health support for young people and their families, guardians and carers. The impact of COVID-19 on the mental health and wellbeing of children and young people has been well documented, and it is widely acknowledged that early access to the right support is crucial for recovery. However, research suggests that it’s not always easy for young people and their families to find out about or access the services and support they need. Through this new project, we are working with a group of young volunteers to investigate how accessible young people’s mental health support services are. We want to find out about people’s knowledge and experience of mental health and emotional wellbeing support, and we want to hear views and ideas for how access to support could be improved. We will share our findings and recommendations for change with Somerset’s Integrated Care Board in late summer 2023. This is a great opportunity to help shape young people’s mental health support in Somerset. You can share your experience and feedback by 4 June 2023, by completing our survey online  [now closed]  or get in touch to ask for a paper survey or to feedback over the phone: 0800 999 1286 (Freephone).

Our new report evaluates people’s experiences of being discharged from hospital to be cared for at home or in a residential or community care setting. In the report, we make several recommendations to improve people’s experience and the quality of care, mainly around the need for better communication, preparation, and support. We have shared the report with Somerset NHS and other organisations involved in the transfer to care process to inform their decisions about how to develop and improve. Since the report’s research was conducted, Musgrove Park Hospital in Taunton opened a new discharge lounge in May 2022, to make it easier for patients who no longer need hospital care to return home. And, in December 2022, Somerset NHS Foundation Trust introduced Ready to Go Units, focused on rehabilitation, to help patients get the best care for them according to their needs and reduce the risk of deconditioning caused by long stays in hospital. Read the full report to find out more about people’s stories and feedback, and to learn what Somerset NHS is doing to improve patient experience of hospital discharge and transfer to care. Announcing the report, Gill Keniston-Goble, Healthwatch Somerset Manager , acknowledged the dedication of health and social care professionals and the pressures they are under, while emphasising the value of learning from patient experience. “We are aware, from public feedback and our work with people and organisations working in health and care, that there is pressure on the delivery of NHS and adult social care services. Some of these pressures can be seen through long waits for hospital beds. Reasons for these waits include an increase in demand for hospital care and difficulties in discharging people who no longer require hospital care due to a lack of care home beds and/or services to provide care at home and in the community." “We wanted to explore the quality of the transfer of care process in Somerset and use the experiences of people who have been discharged from hospital to inform positive change. We are pleased that NHS Somerset has already made some progress to address people’s concerns and we will continue to support their development work by championing the views of local people.” Gill Keniston-Goble, Healthwatch Somerset Manager We will follow up on this report and the progress made by Somerset NHS Foundation Trust and Adult Social Care, when we investigate care in the community and intermediate care next year.

As Healthwatch marks its tenth anniversary this week, Healthwatch Somerset joins the 152 local Healthwatch across England to appeal for more people to feedback on NHS care. People are nearly four times more likely to share their thoughts on a dinner out or takeaway than on NHS services, according to a new survey. National research highlights how widespread the culture of reviewing products and services is now in England. When polled, 84% of adults said they would likely leave a review if they had a positive or negative experience. The top five areas where people typically post reviews are: Going out for a meal or drink, or getting a takeaway (41%) Experience of ordering products online (28%) A hotel stay (25%) A visit to a tourist attraction (23%) A book they have recently read (15%) On average, the respondents said they would spend eight to ten minutes sharing these reviews. Online review forums and product websites are the most likely ways people would share their views. Yet when asked if they had or would provide feedback after visiting their doctor, nurse or another healthcare professional - just one in ten (11%) people said yes. Patient feedback can enable the NHS to spot issues and identify where services may need more resource or other support. It can also help address inequalities in access to care, the extent of which has been laid bare by the pandemic. With NHS and social care services under pressure, Healthwatch is calling on more people to tell the NHS when they are doing a good job and when services can be improved. Healthwatch Somerset Manager, Gill Keniston-Goble, said: "The Healthwatch Somerset Board Members and staff celebrated our 10-year anniversary this week. We took the chance to review the journey we have been on to become a trusted champion within the health and social care system, and to look forward to the work we will be doing to ensure that the experiences of our local communities are heard." "Here in Somerset last year over 630 people shared their experiences of health and social care with us. That’s great but we would love that number to be even higher so that we can tell local service leaders what things are working well and highlight where there needs to be improvement. Everybody's story matters and you can share your experience with us - good or bad – online or Freephone 0800 999 1286." Pictured right: Healthwatch Somerset Board members and staff celebrate 10 years of listening to local people and championing their views to help improve health and social care. (L-R) Back: Gill Keniston-Goble; Jennie Flory; Helen Webb; Bob Champion; Sandra Wilson; Judith Goodchild; Sue Thomas; Gill Waldron; Tony Robinson. Front: Karen Ball and Tanya Camberwell. Commenting, Louise Ansari, National Director of Healthwatch England, said:   "There has been a massive rise in 'review culture', which, if harnessed, could make a real difference to local NHS and social care services. Feedback about what is and isn’t working plays a crucial role in helping care services spot issues and understand how they can improve quality, safety, and efficiency. With doctors and nurses hard-pressed, positive feedback can be a real boost for morale.  So next time you use a health or care service, take a moment to share your experience. It won't take long and could make a real difference in making care better for you and your community." The research also found that health and care services could generate more public feedback by clarifying that any shared experience is welcome and won't negatively impact people's care. When asked what the most significant barriers were that stopped people from sharing feedback on health and social care services, the most popular reasons were:  Being worried it would harm the quality of their care (20%) Not wanting to cause problems for health and care workers (20%) Not knowing how to feedback (18%) The research comes as the Healthwatch network of 152 services marks its tenth anniversary. The public health and care champion is celebrating its anniversary across the country by thanking everyone who has shared their care experiences, and the professionals who have acted on feedback since Healthwatch started work in 2013.

Our new community project asks people in Bridgwater to get involved to improve the health and wellbeing of those living with Chronic Obstructive Pulmonary Disease. Evolving Communities and Healthwatch Somerset have launched a new community engagement project to improve the health and wellbeing of people living with Chronic Obstructive Pulmonary Disease (COPD) in Bridgwater, and we are looking for local people to get involved. Respiratory diseases cause more deaths in Somerset than any other type of condition apart from cancers and circulatory diseases. Bridgwater has a relatively high level of COPD, with 2.3% prevalence in the population and 3.3% in more deprived areas. However, less than 50% of people in these areas have had an annual review with their GP, meaning many are not receiving support or have not been diagnosed with COPD. Through the project, we aim to reach and represent people in Bridgwater who are living with diagnosed chronic respiratory disease as well as those with undiagnosed breathing difficulties. We want to build and share understanding of their health and care needs and find out how to improve community support to help them access health and care services and inspire them to take positive action to live well. To do this, we want to work with people in Bridgwater who have COPD, as well as their families, friends, carers and supporters, and we are now recruiting a team of local volunteer Community Connectors to help with the project. If you live in Bridgwater and you or someone you know has COPD, or you have a good understanding of respiratory disease and health inequalities, your support will make a huge difference. For more information about the project or to get involved, as a volunteer or to share your personal experience, contact Wendy Coward, Project Coordinator, on 07884 370503, email  wendy.coward@healthwatchsomerset.co.uk  or visit  evolvingcommunities.co.uk/copd-project . The project is being delivered independently on behalf of Somerset’s Integrated Care System which includes Somerset County Council and NHS Somerset. Emma Savage, Deputy Director of Quality and Improvement, NHS Somerset Integrated Care Board , said: “This is an exciting project and innovative way to reach out to people living with COPD in Bridgwater using a community, strengths-based approach to help improve their health and wellbeing. We intend to evaluate this project and apply any learning to working with others in Somerset living with a long-term condition.”

With spiralling costs of living, Healthwatch England is warning people are making changes to how they use health and social care services, which can have an adverse impact on their health and wellbeing. The number of people avoiding an NHS appointment because they can’t afford travel almost doubled between October and December as the cost of living crisis is forcing many to change how they use health and care services. Over a third (39%) of people say the changes they have made to their lives due to the cost of living crisis have affected their mental health. Women are disproportionately affected by spiralling costs, with 35% saying their mental health has got worse over the last two months, compared to 26% of men. With spiralling costs of living, Healthwatch England is warning people are making changes to how they use health and social care services, which can have an adverse impact on their health and wellbeing. The impact the cost of living crisis is having on many people’s ability to heat their homes and eat well has been widely reported. However, new Healthwatch data suggests people are increasingly avoiding prescriptions, out-of-pocket costs for carers and attending NHS appointments due to the costs involved. National body Healthwatch England conducted a tracker poll with 2,000 adults in England between October and December to assess the impact of the cost of living on their health and wellbeing and whether it has affected how they use health and social care services. It found that more people avoided getting prescription medicines, and booking NHS appointments, including dental treatment, due to the fear of extra costs in December than in October. The number of people who avoided an NHS appointment due to the cost of travel doubled to almost one in 10, 11%, in December, from 6% in October. The poll found that in December: Over one in seven, 15 %, of respondents avoided going to a dentist because of the cost of checks ups or treatment, an increase of 3% since October; Nearly 11% of respondents have made tough decisions to change, cut down on or stop support from paid carers, 4% higher than October; Over one in ten (11%) have avoided booking an NHS appointment because they couldn’t afford the associated costs, such as accessing the Internet or the cost of a phone call; up from 4% in October; One in ten, 10%, avoided buying over the counter medication they normally rely on, up 3% from October; And one in ten, 10%, of people have also avoided taking up one or more NHS prescriptions because of the cost, which is 4% higher. More than a third of the respondents, 39%, said that the changes they have made to keep up with the rising cost of living have negatively affected their mental health, while 35% said their physical health had got worse in the last two months. The findings also suggest women are disproportionally affected by spiralling costs compared to men and more have taken action to cut back on: heating, which 42% of women have not turned on when they usually would, compared to 33% of men; food, which 27% of women say they have bought less of, because of the increased cost, compared to 20% of men; and energy costs in general, with 33% of women saying they have turned off or avoided using essential appliances to save energy costs, compared to 25% of men. Louise Ansari, National Director of Healthwatch England said: “It is clear that the impact of the cost of living crisis on people’s health and wellbeing is beginning to hit home. “We are very worried that people are increasingly avoiding getting prescription medicines, booking NHS appointments and travelling to their appointments because of the extra costs. The steps people are taking to cope with the cost of living can have serious implications on their physical and mental health. This is likely to place a further burden on the already stretched NHS.” Healthwatch England has set out immediate actions the government working with health and care services can take to support people in the cost of living crisis and save money:

What is the six-week postnatal check for new mothers and why it’s important that you attend it? In this advice piece, we cover all the basic questions you may have about it. In 2020, NHS England launched a  six-week mental health check for new mothers  to ensure they feel well and have the support they need if they are struggling with their mental health.     In this advice piece, we answer your questions about postnatal checks. 1. What is the six-week postnatal check?   GPs must offer a six-week postnatal check to all new mothers and birthing parents within six to eight weeks after birth. Your GP surgery should reach out to you to arrange your postnatal check. If they don't, you are entitled to request one.   The six-week mental health check for new mothers is separate from your baby's six- to eight-week review, which focuses on the health and development of your baby. The appointments can happen immediately after one another, or you can have them at separate times.   2. What should I expect from my six-week postnatal check with the GP?   At your appointment, your GP should:     ask you about your mental health and general wellbeing    ask you about your physical health following childbirth   provide advice about family planning and contraception   discuss any conditions that require ongoing management, such as gestational diabetes However, GPs do not have set guidelines about what they should discuss with you, and appointments can vary depending on your GP practice. You may find it helpful to prepare for the appointment.   What's your experience?  With  one in four women  experiencing mental health problems during pregnancy and in the first year following the birth of a child, support from maternity services can significantly impact their mental health and wellbeing.    We want to know how your mental health was supported during pregnancy or after birth. Tell us your story to help improve care for other parents.  3. Do I need to prepare for the postnatal check?    It’s a good idea to make a list of questions to take along with you. It will help you reflect on how you feel and whether you need any support. It will also help kick-start the conversation with your doctor and get the most out of the appointment.    Some useful tips:   Write down what you want to say in advance and take your notes with you.   Try to get to the appointment early so that you don’t feel stressed for hours beforehand.   4. What should I tell my GP about?    The postnatal check is an opportunity for you to discuss your mental health and wellbeing and notify your GP of any issues.     It can be difficult to talk to the GP about your mental health, especially if you are feeling overwhelmed. It is very common for new mothers to experience mental health difficulties. So it can be helpful to explain any changes to how you have been feeling over the past few weeks or months. Try to be honest and open with your GP so that you can access the right support as soon as possible.   It is entirely up to you what you want to highlight, but some of the things you may wish to tell your doctor could be:    You’re feeling sad, overwhelmed or anxious when looking after the baby.   Difficulty bonding with the child.   You’re feeling lonely.     You're having trouble holding in your pee or wind, or you're soiling yourself with poo.   Having sex is painful.   Suicidal thoughts.  5. How can the GP support me with my mental health?   Your six-week check is an opportunity to raise any concerns about your mental health with the GP. Your GP can support you in different ways, such as:    Providing information such as information booklets and resources. Signposting to local support services, including third-sector and voluntary services.    Referring to local or specialist services, for instance, specialist perinatal mental health teams, parent and infant mental health teams, home-start, psychological services such as IAPT and other national equivalents, and adult mental health services.  6. I didn’t get the support I needed from the GP, what next?    It's so important that you feel supported as a new parent. This  article  outlines where you can go to get the help you need.   7. How long will the appointment be for?   The length of the appointment will depend on your GP surgery. If you are concerned your appointment length will not be enough time, you can ask for a longer one.    You can also take a partner or a friend with you to the appointment if you feel you need their support.    Looking for more support? Read more  about what happens at your NHS six-week postnatal check.

Healthwatch is launching a national survey to understand if care works for new mothers and birthing parents. Pregnancy is a major life event for any family. It can be joyful and fulfilling but also challenging.  With  one in four women experiencing mental health problems during pregnancy and in the first year following the birth of a child, support from maternity services can significantly impact their mental health and wellbeing. Healthwatch has launched a national survey to understand better what is working and what needs improving for people who develop mental health difficulties relating to their maternity experience. Background Healthwatch has done several national pieces of research into maternity services over the years. Our work has contributed to securing important policy wins, such as the rolling out of mother and baby units in every part of the country. In 2020, following Healthwatch's work, NHS England launched 6-week mental health checks for new mothers to ensure they feel well and have the support they need if they struggle with their mental health. Healthwatch's recent review of the evidence of 2,500 people's experiences of maternity services showed that feedback from patients to Healthwatch about maternity care is worsening. Opportunity to share your views Over the last two years, it is not just physical maternity services that have been under pressure. The lack of support available to help with mothers' and birthing parents' mental health also appears to be worsening. Our national survey aims to give you the opportunity to share your views and experiences to help better understand what is working and what needs improving for new parents. For instance, we want to know whether the support you received for your mental health during pregnancy and birth met your needs. We also want to see if you had your six-week postnatal check-up and what it was like. Who do we want to hear from?  We want to hear from you if you have been pregnant in the last two years and have experienced mental health difficulties before, during or after giving birth. We are very interested in the experiences of women from ethnic minority communities and LGBTQ+ birthing parents. Everything you tell us is confidential and will help us and the NHS understand what they need to put in place to better support people like you. So whether you had a positive or negative experience with mental health support during or after pregnancy, we want to hear it. Share your story by 13 Dec [survey now closed]

Our new report looks at people’s experiences of using GP websites to access healthcare services and information, highlighting that improvements are needed to make it easier for more people to get good care and support online. The NHS is committed to developing the use of digital technology to deliver care, to help more people get the care they need and to help manage patient demand for services. To achieve this goal, digital services need to be good quality and easy to use, and they need to be accessible to as many people as possible, including those who are currently unable or reluctant to use digital technology. Since the emergence of COVID in 2020, GP practices have increasingly used websites to communicate with people and to deliver services and support. Most GP practices in Somerset are managed as small independent businesses – they receive  guidance from the NHS  on what should be included on their websites, but the design and structure is managed through the practice. In Somerset, 58% of people who completed the NHS England National GP Patient Survey in 2021 said they do not use GP online services to book appointments, order repeat prescriptions, access medical records, or for consultations or appointments. And 50% had not used their GP website to look for information or services. In response to those results, and ongoing public concerns about difficulties accessing GP care, we decided to investigate the impact of digitalisation on patients using GP services. We gathered feedback from 242 people about GP websites and our volunteers also carried out a review and evaluation of all Somerset GP websites. Based on this research, we have shared the following recommendations with NHS Somerset and Somerset GPs to help improve the quality and accessibility of information and services delivered through GP websites. Website design and content should be simple and uncluttered, and frequent changes to design and layout should be avoided so that people can become familiar with using the site. Patient input should be sought when developing GP websites, for example through Patient Participation Groups or NHS Somerset Digital Champions. Simple instructions should be provided, so that people know how to use the website and how it can help people them get the care they need. This guidance needs to be offered in a variety of formats so that people who do not have to go online to find out how to use the website. More help should be provided for people who lack digital knowledge and skills. This could be through Somerset’s GP practice Digital Outreach Team, or by making sure people are directed to support schemes such as ‘Spark iT’ which is provided by Spark Somerset. If people are unable or reluctant to use digital services, they must not be criticised or excluded from getting the care they need from their GP practice. Healthwatch Somerset Manager, Gill Keniston-Goble, said: “NHS leaders believe that digital healthcare services can benefit patients, carers and those providing care, by helping more people to stay healthy and well and helping services manage patient demand. Digital technology is rapidly becoming the main way to get information from GPs and to access their services. It’s vital therefore, that digitalisation is used to make it easier and not harder for everyone to get care and support. Listening to public feedback will help GP practices understand how to achieve this.” Commenting on the report, NHS Somerset said: “We know that many people access NHS services online… Part of the work of NHS Somerset is to help to improve these digital services. Our Digital Outreach Team (DOT) works with all 64 General Practices in Somerset to help them to provide a range of excellent services… We also know that some people cannot use digital services. That is why we are currently working with partners including Spark Somerset, our local libraries and our GPs, to offer loans of devices and internet connection to those who don’t have them, as well as training sessions via digital champions in the community, and care coordinators at General Practices. This includes how to use websites, how to use the Somerset apps library, how to use the NHS App, and much more. If you’re interested in finding out more, please ask your GP care coordinator who can link with the NHS Somerset DOT team or contact Spark Somerset. We will use the feedback in this report to help inform this digital improvement work – thank you for sharing it with us.”

Becoming a parent can be a wonderful and exciting experience, but it can also be overwhelming. To help, we’ve broken down the pregnancy care you should expect from the NHS. Finding out you’re pregnant You should see your GP or a  midwife  as soon as you find out you’re pregnant. They will be able to tell you about pregnancy care (also known as antenatal care) and the next steps you need to take.   Your pregnancy will be treated confidentially, even if you’re under 16. Mental health and pregnancy Being pregnant can have a significant impact on your mental health. While it’s an exciting time for many, you might also feel anxious, worried, confused or shocked. You should speak to your GP: If you have a mental health condition and are worried about how it could affect your pregnancy. If you’re taking medication for a mental health condition and find out you’re pregnant. You might also develop a mental health condition during pregnancy or after birth. Your GP or midwife might offer you two types of treatment: Talking therapies Medication Partners might also have mixed feelings about becoming a parent. It’s important that partners also seek support for their mental health if they need it. What is antenatal care? Antenatal care is the care you get during your pregnancy. It is also called pregnancy care or maternity care. Once you have told your GP you’re pregnant, you should be offered appointments with a midwife or sometimes a doctor who specialises in pregnancy and birth. The midwife or doctor providing your care will: Check the health of your baby. Give you information about having a healthy pregnancy. Discuss your options and choices for care during your pregnancy, labour and birth. Ask you how you’re feeling. Answer any questions you have. What antenatal appointments will I have? In England, the NHS should offer you the following: Two pregnancy ultrasound scans at 8 to 14 weeks and 18 to 21 weeks. Antenatal screening tests to determine the chance of your baby having certain conditions. Blood tests to check for syphilis, HIV and hepatitis B. Screening for sickle cell and thalassaemia. Your GP or midwife should do some of these tests before you’re ten weeks pregnant, so it’s essential to see a midwife or GP as early as possible. Your midwife will also carry out some checks and tests, such as urine and blood pressure checks, throughout your pregnancy. How many antenatal appointments will I have? If you’re expecting your first child, you can have up to 10 appointments. If you have had a baby, you’ll have around seven appointments. This could change if you develop a medical condition.   What’s your experience of maternity care?  If you are pregnant or have recently had a baby, we want to hear your experience of maternity care, including what support you have had for your mental health. By sharing your feedback, you can help improve care for other parents like you. Where will I have my antenatal appointments? Your appointments can happen at your home, a children’s centre, a GP surgery or a hospital. You’ll usually go to the hospital for any scans. Your appointments will become more frequent from around 24 weeks. If your pregnancy is uncomplicated, and you and your baby are in good health, this might not be the case. In your later appointments, your midwife or GP will: Check your urine and blood pressure. Feel your tummy to check the baby’s position. Measure your womb to check your baby’s growth. The measurement will be recorded in your notes. Listen to your baby’s heartbeat if you want them to. What information should I be given during pregnancy? At later antenatal appointments, you should be given information about the following: Preparing for labour and birth, including how to make  a birth plan . How to tell if you’re in  active labour . Induction of labour if your baby is overdue ‘Baby blues’ and mental health conditions like  postnatal depression . Feeding your baby. Vitamin K (given to prevent vitamin K deficiency in your baby). Screening tests for newborn babies. Looking after yourself and your new baby. What questions might I be asked at antenatal appointments? Your GP or midwife might ask you about the following: The date of the first day of your last period. Your health. Any previous illnesses or operations. Any previous pregnancies or miscarriages. The ethnic backgrounds of you and your partner to find out whether your baby might be at risk of certain conditions. Whether your family has a history of twins. Your job, your partner’s job and what kind of housing you live in. How you’re feeling and whether you have had a mental health condition in the past. What should I tell my midwife or GP? Your antenatal appointments allow you to tell your GP or midwife about any additional support you might need or if you’re in a vulnerable situation. You can speak to your midwife or GP about the following: Your mental health. Any special health needs. A disability or long-term condition. Domestic or sexual abuse. Drugs or alcohol misuse. You should also tell your midwife or GP if you speak English as a second language or if you do not speak English. Your midwife will also ask you about any social care support you may have or need. More detailed information Pregnancy week-by-week The NHS has produced a week-by-week breakdown of what to expect from your pregnancy. It includes information about your baby's development and what you should be aware of as your pregnancy proceeds. For example, at 13 weeks, you’ll probably start to feel less sick and tired. It also includes things to think about each week, like when to have your flu vaccine. Your antenatal appointments week-by-week This NHS guidance explains the support you should receive from your midwife or doctor throughout your pregnancy. For example, if this is your first baby, you should have an appointment at 31 weeks. Pregnancy-related health conditions During pregnancy, your body goes through enormous changes. As a result, you may experience some common health problems. However, some people have more severe complications, such as excessive nausea. You might need specialist advice or care if you have a long-term health condition, such as diabetes or asthma. You should speak to your GP or midwife if you have any worries. You can also phone NHS 111. In some cases, you might need to seek urgent medical attention. For more information about specific conditions, look at the NHS guidance. Tommy’s pregnancy hub Tommy’s is the largest UK charity researching the causes and prevention of pregnancy complications, stillbirth, premature birth, and neonatal death. They run a midwife-led information hub, which covers everything you need to know about having a safe and healthy pregnancy. They also offer extra support for Black and Black Mixed Heritage people in the UK. Tommy's set this service up because Black women experience higher risks during pregnancy. Tommy’s hub I’m unhappy with my maternity care. What should I do? NHS services and staff should treat you with dignity and respect. If you are worried about your maternity care, talk to our midwife or doctor as soon as possible. You can also contact the Head or Director of Midwifery. Their details will be on the NHS Trust or Board website. If you want to make a complaint, you should: Make your complaint within 12 months from the time of the treatment you are complaining about. Make your complaint to the NHS body responsible for your care. Ask to see your healthcare records before you complain. Make notes of what happened as soon as possible. For more detailed advice on how to make a complaint about NHS maternity care and other ways you can provide feedback about your experience, take a look at the  Birthrights complaints factsheet . Where can I get support to make a complaint? Birthrights is a free and confidential service that helps anyone who needs advice about their rights during pregnancy and childbirth. They can also give you advice on making a complaint. Get in touch via their  contact form  or email  advice@birthrights.org.uk .