The best start

As part of our approach to ensuring babies born in Derbyshire have the best start in life, we have been looking at the support we give pregnant women to quit smoking.

That’s why I was delighted to sponsor Derbyshire’s submission to the Design in the Public Sector programme (see below, right), which explored how to reduce rates of smoking in pregnancy to 6 per cent by 2022.

Currently, around 15 per cent of women in Derbyshire smoke while pregnant, compared with 10.8 per cent nationally. To deal with this effectively, we needed an integrated and innovative plan in line with the county council’s new ‘Enterprising Council’ approach, which is designed to meet the challenges in local government while getting the best results from local services for Derbyshire’s residents.

As part of this, we’re challenging staff to think and do things differently – so being part of the Design in the Public Sector programme allowed the team to think ‘outside the box’.

Derbyshire’s team was made up of a midwife from University Hospitals of Derby and Burton NHS Trust and staff from our public health team, including Live Life Better Derbyshire (LLBD), our free lifestyle service that helps local people stop smoking, manage their weight and get active.

The tools and frameworks provided by the Design Council’s experts challenged the team to better understand the lives of pregnant women who smoke. Using this information, we explored more supportive approaches and services. The person-centred principle shifted the focus from thinking about solutions from a professional perspective to one that focused on what matters to local pregnant women who smoke.

A design for life

The LGA and Design Council have worked in partnership for five years, with a shared vision to grow the public sector’s capacity to deliver efficient and effective public services that improve people’s lives.

Our Design in the Public Sector programme supports councils to think about and address key service challenges in new ways, and is fully funded by the LGA. It has previously supported councils’ challenges around public health, housing, adult social care and children’s services.

Councils that are successfully selected for the scheme embark on a 16-week programme led by design experts, which includes full-day workshops and coaching sessions. Teams are introduced to various design tools and techniques that will enable them to discover and redefine their service challenge collaboratively, ensuring their residents are at the heart of the process.

Applications for the programme are now open. For more information and to apply please visit

The most important stories we gathered came from women who had smoked through their pregnancy, who shared the concerns they had and the barriers they’d faced that prevented them from quitting. These included family and friends continuing to smoke while they tried to stop and women having very little confidence in their own ability to quit. This information allowed the project team to understand the challenges experienced by the women.

We’ve already improved the support we provide to help pregnant women quit, including co-delivery of antenatal clinics by midwifery staff and LLBD stop smoking advisers.

Other ideas include: improving communication between midwives and stop smoking advisers; expanding support to pregnant women to include other elements, such as weight management and getting active; considering the role that family and friends can play in quit attempts; and making sure successful quit attempts are celebrated.

As with many public health challenges, reducing smoking rates during pregnancy requires the involvement of organisations across the local health and care system, and we’re beginning to work with even more partners to help make a difference.

For further information about Derbyshire’s Design in the Public Sector project please contact Iain Little, Assistant Director of Public Health, at

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