Table 4 Implementing validated objective outcomes into routine practice

In Bradford Health Visitors complete a 3–4 month visit to assess the mother-child relationship. The National Institute for Clinical Excellence guidance in the UK [1] recommends that the mother-child relationship is assessed but doesn’t recommend any particular measure for use with babies and consequently the assessment in Bradford (and other places across the UK) is based on subjective observations. To allow us to evaluate the impact of interventions on attachment we needed to implement an objective validated measure.

We have worked with Health Visitors, their managers and commissioners to pilot the use of the Maternal Postnatal Attachment Scale (MPAS) [2]. The pilot is exploring the utility and acceptability of this measure as a swift, inexpensive screening tool for Health Visitors. It will also look to see if the measure helps identify attachment issues for appropriate referrals. Based on the results of this pilot, the tool will either be implemented or adapted (and validated) using a co-design method to provide a feasible tool for practitioners and mothers.

1. National Institute for Health and Clinical Excellence. NICE guidelines [PH40]: social and emotional wellbeing: early years. NICE, 2012.

2. Condon JT & Corkindale CJ. The assessment of parent-to-infant attachment: Development of a self-report questionnaire instrument. Journal of Reproductive and Infant Psychology. 1998: 16:1, 57–76.