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NHS baby care "struggling to meet demand"

17/06/2008

NHS services for vulnerable babies needing specialist care are "struggling to meet demand", MPs warned today.

The Public Accounts Committee (PAC) said neonatal care - help for babies born prematurely or with an illness or condition needing specialist support - is failing due to constraints in capacity and a serious shortage of neonatal nurses.

The MPs uncovered neonatal units being forced to close and a lack in transport services to help move babies to the appropriate care.

They studied the standard of care following a reorganisation of the 180 neonatal units in England in 2003 into 23 geographical networks.

Problems over recruiting, retaining and training the staff required to deliver neonatal service were found to still be "a major challenge".

The committee's report revealed that only half of the 23 networks provide specialist neonatal transport services 24 hours a day, seven days a week.

And on average in 2006–07 each neonatal unit had to close to new admissions once a week due to a lack of baby cots.

A third of neonatal units operated above the recommended occupancy rate of 70 per cent and three of the 178 units operated above 100 per cent.

High occupancy rates are a concern as they could have major implications for patient safety due to increased risk of infection or inadequate staffing levels.

"There was widespread support for the reorganisation of neonatal services five years ago," commented PAC chairman Edward Leigh.

"However, this change has had limited effect in reducing regional variations in mortality rates of babies born prematurely or suffering an illness needing specialist care.

"There are complex combinations of factors at work here, and primary care trusts [PCTs] need to improve their understanding of the high risk groups in their local populations."

The PAC recommended that the Department of Health (DoH) sets the Neonatal Taskforce clear objectives and associated milestones for improving services, and monitor achievements against these milestones to ensure delivery of the objectives by the end of 2008–09.

Dr Sheila Shribman, national clinical director for children, young people and maternity services, said that the DoH is "committed to delivering real improvements for mothers and babies and have made neonatal services a top priority for the NHS".

She highlighted the 22 per cent increase in spending on neonatal services and the progress made by the newly-created networks in improving cot numbers and reducing the distance sick babies have to travel.

"However, we recognise there is still more to do and we have established a Neonatal Taskforce to support the NHS to identify and deliver real improvements to neonatal services," Dr Shribman said.

"PCTs should also aim to ensure that sufficient numbers of maternity staff and neonatal teams are in place to meet local needs, planning maternity and neonatal networks together. As part of its work programme, the Neonatal Taskforce will develop minimum quality standards for neonatal care."