The National Bereavement Care Pathway for pregnancy and baby loss
This Bereavement Pathway website raises awareness of issues around pregnancy and baby loss and has a range of resources to upskill staff and standardise care in the way that families say they need.
The website has informational resources, videos, animations and self-reflective / assessment resources. There are links to resources to help standardise care for families, e.g., Creating Memories, Offering Choices checklist.
The website includes training and support across five Pathways:
- Miscarriage, Ectopic and Molar Loss
- Termination for Fetal Abnormality
- Stillbirth
- Neonatal Death
- SUDI
As well as links to Self-Assessment Tools and Bereavement Care Standards
Is there a cost for this learning resource? :
No
Has this resource been accredited or endorsed by any organisation? :
Scottish Government, NHS Education for Scotland (NES) and Sands, the stillbirth and neonatal death charity
Training model:
This is an online resource open to all staff. Self-reflective / assessment resources are embedded throughout to aid implementation.
Staff capacity and time commitment:
This is a rich and extensive resource that staff can access as required.
Author/developer:
Scottish Government and Sands, the stillbirth and neonatal death charity
Contact for Further Development
Link to resource
Quality dimensions
Usability
The National Bereavement Care Pathway (NBCP) for pregnancy and baby loss in Scotland aims to improve the quality of bereavement care experienced by families at all stages of pregnancy and baby loss. Parents talk about why they feel the pathway is important and how they hope it will help other families in the future. The pathway covers miscarriage, ectopic and molar pregnancy, termination of pregnancy for foetal anomaly, stillbirth, neonatal death, and sudden and unexpected death in infancy up to 24 months. We seek to put the voices of women and men affected at the heart of our work. Their voices are guiding us as we develop the pathway for Scotland and will be heard at every stage of the process.
The content is all available within the website
Supports
Supports - Workforce
Staff will need time to work through the resources relevant to their roles.
Supports - Technology
Internet connections and digital device to view the content.
Supports - Administrative
Not applicable
Supports - Financial
Not applicable
Evidence base
Impact assessments
Reaction
There is a ‘contact us’ page for comments or questions.
Learning
There is self-assessment and reflection on practice all through the resource.
Behaviour
This is not achievable for an online resource.
Results
This resource has been co-produced with bereaved families so reflects their views. It is not clear how the impact of the website will be measured on the families who receive care from professionals who use this resource.
KSF dimension information in relation to the learning resource
Child Development and Attachment
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that child development results from a combination of genetic and environmental influences from conception onwards
- Be aware of physical, emotional, communication and social developmental milestones across childhood and adolescence
Included in Training (Knowledge)
- Be aware that ill health may mean infants experience separation from their parents and this can interfere with bonding
Not Included in Training (Knowledge)
- Be aware that the infant’s early relationship with their primary caregiver is critical to how a child develops
- Be aware that encouraging good parent-infant relationships promotes optimal child development
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware play is vital for all aspects of child development
- Be aware of the value of child-led rather than adult-led play activity
- Be aware of how play provides opportunities to develop language and communication
Included in Training (Knowledge)
- Be aware that there are significant transitions and developmental tasks in childhood such as puberty, school moves, and life events
- Be aware that adolescence has discreet phases that alter relationships with family and peers and ends with an understanding of themselves as an individual
Not Included in Training (Knowledge)
- Be aware that transition points can be especially challenging for some groups of children and young people such as neurodiverse children and young people, those with long term health conditions and care experienced children and young people
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware of the world around the child or young person such as their family, wider society, culture, ethnicity, religion and sexuality
- Be aware of the principles of social inclusion equality and diversity
- Be aware that there are legal frameworks relating to working with children, young people and their families, such as GIRFEC and UN Convention on the Rights of the Child (UNHCR)
- Know about parental rights and responsibilities
- Be aware that cultural beliefs and practices may influence family relationships and parenting style
- Be aware young people may need to balance differing culture and beliefs from family, peers and wider community
Included in Training (Knowledge)
- Be aware trauma and adverse experiences are common experiences that can impact children and young people in many ways, including their mental health and ability to form healthy relationships
- Be aware that the impact of trauma and adversity can be lifelong
- Know about trauma-informed practice and the potential importance of ‘one good adult’
Not Included in Training (Knowledge)
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware of the importance of recognising the significant strengths that neurodiverse children and young people have
- Be aware of common neurodevelopmental conditions, such as Autism, ADHD and Learning Disabilities
- Be aware of the potential harm of stereotyped views of neurodiverse children and young people
- Understand that difficulties and needs may be invisible, or uncommunicated, and could go unrecognised
- Be aware that children and young people who have additional support needs can reach their development milestones at a different rate and their quality of play can be different
- Be aware neurodevelopmental diversity can impact the child and young person’s social skills and ability to relate to others
- Be aware that neurodiversity and additional support needs may impact on a child or young person’s ability to engage with usual practices, such as, waiting rooms, dentists, changes in teaching staff, such as supply teachers
- Be aware of relevant educational legislation such as Additional Support for Learning Act
Mental Health in Children, Young People and their Families
Included in Training (Knowledge)
- Be aware that children and young people can experience emotional distress in response to life events, and this is normal and usually short-lived
Not Included in Training (Knowledge)
- Be aware that it is important to consider the mental health needs of all children and young people from infancy to adolescence
- Be aware that mental health and wellbeing is as important as physical health
- Be aware that emotional distress can be associated with risk (Dimension 4: Risk of Harm)
- Be aware that multiple mental health difficulties can occur at the same time
- Be aware that the universal ‘right to health’ also includes mental health
Included in Training (Knowledge)
- Be aware that how a child or young person shows distress will vary depending on their age and stage of development
- Know how the children and young people that you work with might demonstration emotional distress
- Be aware that what a child or young person finds distressing may differ from what adults find distressing
Not Included in Training (Knowledge)
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that physical health can impact mental health and wellbeing and vice versa
- Be aware that physical activity can support mental wellbeing
Included in Training (Knowledge)
Not Included in Training (Knowledge)
Included in Training (Knowledge)
- Be aware of what your service or organisation does to promote emotional wellbeing and resilience
Not Included in Training (Knowledge)
- Be aware that health inequities such as poverty and poor housing can impact mental health and wellbeing
Included in Training (Knowledge)
- Be aware that parental wellbeing and child wellbeing are interlinked
- Be aware that caring for a physically or mentally unwell child can impact on parental wellbeing
Not Included in Training (Knowledge)
- Be aware of that children and young people may have a caring role in relation to their parent’s mental health
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that stigma and discrimination is commonly experienced by those with emotional distress and mental ill health
- Be aware that experience of stigma and discrimination can lead to emotional distress
Engagement, Containment and Communication
Included in Training (Knowledge)
- Understand that all behaviour is communication
- Be aware of the importance of safe, confiding, reliable relationships for good mental health and wellbeing
- Be aware of the concept of ‘one good adult’ and the basis of nurture approaches
Not Included in Training (Knowledge)
Included in Training (Knowledge)
- Be present and listen actively and reflectively
- Demonstrate empathy, ‘feeling with’
- Be able to work with children and young people to meet their developmental needs which may be at a different level to their chronological age
Not Included in Training (Knowledge)
- Be reliable, doing what you say you’ll do
- Use active listening demonstrating undivided attention, eye contact, facial expression, and non-verbal encouragement
- Work in a way that empowers and takes account of the necessary changes in language for example relating to care experienced young people and how young people self-identify
- Work in a culturally sensitive manner, being respectful and valuing diversity and difference of experiences, approaches and opinions
- Listen to, and acknowledge, children and young people’s experiences of stigma and discrimination
- Be able to work in a trauma informed way, that recognises the potential impact of trauma and adversity on a child or young person’s ability to form trusting healthy relationships
Included in Training (Knowledge)
- Know the importance of identifying and understanding the emotional communication of children and young people and not being overwhelmed
Not Included in Training (Knowledge)
Included in Training (Knowledge)
- Support the development of emotional literacy through everyday interactions with children and young people, for example labelling emotions
- Be able to encourage a discussion about a range of emotional experiences and normalise these experiences, knowing all emotions are valid
- Be empathetic and recognise that the feelings of distress are very real
- Be able to listen to and empathise with the emotional expressions of children and young people without becoming overwhelmed
Not Included in Training (Knowledge)
Included in Training (Knowledge)
- Be aware that child and young people communicate differently at different developmental ages and stages
- Be aware that children and young people communicate in a range of ways, such as verbally and through gesture, play and behaviour
- Be aware that communication needs to be adapted to age, developmental stage and take account of neurodevelopmental diversity and trauma history
Not Included in Training (Knowledge)
Included in Training (Knowledge)
- Be able to identify when a child and young person may have difficulty understanding language and communication
- Be able to use simplified language, visuals and other language and communication friendly approaches
- Be able to use clear and unambiguous language
Not Included in Training (Knowledge)
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware of children, young people and their parent’s right to privacy and confidentiality
- Be aware that children and young people may have difficulty giving informed consent due to underlying language or communication difficulties that are not readily evident
- Understand GIRFEC policies on confidentiality and information sharing both within teams and between different agencies
- Be aware of parental rights and responsibilities and how these relate to rights and responsibilities and how this relates to information sharing, for example when parental rights and responsibilities have been moved to the local authority
- Know about GDPR and follow rules put in place by your organisation to comply with this
Not Included in Training (Knowledge)
- Be able to respect a child or young person’s privacy and maintain confidentiality appropriately and seek guidance if unsure
- Ensure that a child or young person’s views are incorporated into any support and intervention plan
- Follow local procedures and protocols to share information appropriately and securely
- Ensure that not all information about a child or young person is shared automatically with a family/team/ colleagues and be able to negotiate with the young person what is useful to share
- Ensure all information regarding confidentiality, consent and capacity is given in an accessible way to the young person
- Seek advice if unsure about any aspects of consent, confidentiality and capacity
Identification and Understanding of Need
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Understand the role of the named person and lead professional as specified within the core components of the GIRFEC National Practice Model
- Know that the child or young person’s view needs to be given appropriate weight when making decisions that concern them
- Be aware of the benefits of early identification of difficulties
- Be aware that the views and aims for intervention can vary significantly between children, parents, school and other professionals involved
- Be aware of the role and duties of the lead professional in relation to the development of the child’s plan
Included in Training (Knowledge)
- Work within boundaries of your professional role as outlined by your professional body and seek support/ supervision where necessary
Not Included in Training (Knowledge)
- Be able to identify any change in a child or young person’s usual presentation and understand why it is important to record and take further action when required
- Share information for GIRFEC single or multi-agency wellbeing assessment
- Maintain records at appropriate level, in line with GDPR guidance
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that identification and understanding of mental health and wellbeing involves gathering information from a wide range of people, across a wide range of settings
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to observe, describe and record the behaviour of the child in the context of where you work
- Recognise whether a child’s level and type of play is broadly typical for their age
- Be able to recognise when a child or young person is experiencing signs linked to poor self-esteem, self-worth and confidence, and explore with them ways they can be supported
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that all adults have a statutory responsibility to keep children and young people safe from harm, even if not working with them directly
- Be aware of the wide range of risks that could affect a child or young person: risk of harm to self (self-harm, suicide), self-neglect, harm from or neglect from others, harm to others, non-engagement in treatments (physical and mental health)
- Be aware that self-harm can take many forms, including suicidal and non-suicidal self-injury
- Be aware that self-harm may be used by a child or young person as a coping strategy
- Be aware that thoughts of self-harm and suicide are common in young people but much less common in children
- Be aware of the legal position regarding the physical punishment of children and young people
- Know local child protection standards, policies and procedures
- Know who to report concerns to within GIRFEC framework
- Know that some children and young people are more at risk than others, such as care-experienced children
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to give a child or young person a safe space and the time to talk about their feelings by asking and listening
- Be able to ask child about risky behaviours that they may be showing or referring to
- Act urgently, in conjunction with other professional colleagues, to protect a child where there is evidence of immediate risk
- Use the GIRFEC National Practice Model including the wellbeing indicators and My World Triangle as a frame of reference to inform judgments about any areas of risk and unmet need
- Be able to jointly decide with the child or young person who and what else could help
- Adopt a trauma informed approach underpinned by the five principles of trauma Informed practice (safety, choice, collaboration, trust and empowerment)
- Recognise limits of own skills and service setting and escalate concerns as appropriate
- Seek advice and support where parental practice may seem in conflict with the need to safeguard the child or young person
- Identify concerns of fitness to practice responding promptly when there is evidence that the actions of a colleague put a child or young person or another colleague, at risk of harm
Included in Training (Knowledge)
- Be aware of the emotional impact on you of working with children and young people at risk of harm
Not Included in Training (Knowledge)
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to seek support from a work colleague to talk through your feelings and reactions about doing this work
- Be able to seek further support to manage the impact of this work on yourself, such as, from your line manager
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that the aim of the assessment process is to help build an understanding of the child’s strengths and needs to help guide intervention and improve the quality of life for child and family
Included in Training (Knowledge)
- Understand your role in supporting a child or young person during assessment of need
- Encourage and support people to get help and support
Not Included in Training (Knowledge)
Supports and Interventions
Included in Training (Knowledge)
- Be aware that all people that work with children and young people have a valuable role in supporting mental health and wellbeing
Not Included in Training (Knowledge)
- Be aware that support for children and young people’s mental health can take many different forms, including work directly with children, working with parents and working to change aspects of the environment
- Be aware of how and where to signpost people to appropriate self-help activities, peer support or other agencies and resources
- Be aware of community resources and projects relevant to the promotion of mental wellbeing (such as youth clubs, drop-in centres, sports facilities and so on)
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Direct families to sources of information that promote good health, positive parenting practices and caring for their child
- Provide information and support families to link in with services that can help
- Be able to talk to children and parents about typical development
- Be able to support children and young people consistent with role and child’s plan
- Understand the importance of working within the limits of own competence and role
- Be able to use evidence and information relating to children and young people to agree interventions to support them at the earliest opportunity
- Be able to draw on knowledge of the relevant legislation and polices that apply to the settings in which interventions take place
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to talk to children, young people and families about mental health and wellbeing
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that transitions and change can be particularly difficult for some children and young people, such as those who are neurodiverse and/ or have experienced trauma or adverse experiences
- Be aware of the impact of endings, such as the end of contact with a child or young person
- Be aware of that ending can happen for many reasons, including job changes, and can be planned or unplanned
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to identify transition points
- Prepare child and young people and families for transitions and change appropriately to meet their needs
- Communicate upcoming endings to others working the child or young person
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware of GIRFEC and the importance of multiagency working and information sharing
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to effectively communicate with all partners and agencies involved in supporting a child or young person using local Information Sharing Policy and Guidance
- Be able to seek advice on information sharing if unsure
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that noticing and recording change in a child or young person’s presentation is important to support their mental health and wellbeing
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to provide information about any changes using the GIRFEC national practice model
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be aware that for some children and young people medication is part of a holistic intervention
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to support a child or young person to take medication as part of holistic treatment intervention.
- Be able to report concerns as required
Included in Training (Knowledge)
- Be aware of the concepts of self-care and emotional toil
- Be aware of that self-care is particularly important when working with distressed young people and/or those who have experienced trauma
- Understand what impacts one’s own wellbeing and mental health, its impact on others, and how to improve it
Not Included in Training (Knowledge)
Included in Training (Knowledge)
- Be able to identify your own need for self-care/restorative supervision and seek this appropriately within your place of work
- Be a positive role model in managing emotional wellbeing
- Maintain and update skills and knowledge through participation in continuing professional development
Not Included in Training (Knowledge)
Included in Training (Knowledge)
Not Included in Training (Knowledge)
- Be able to be flexible and adjust usual practices to meet the needs of children and young people with neurodiversity and additional support needs.
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