Children and Young People Committee
CYP(4)-05-12 Paper 5

Neonatal Services in Wales

Evidence from Dr Sybil Barr (Consultant Neonatologist and Welsh representative of the British Association of Perinatal Medicine-BAPM).

Areas of progress:

1. Establishment of Neonatal Network

-Network lead

-Network manager and support staff

2. Neonatal Transport Service

-Consultants appointed

-Dedicated ambulance/equipment/staff training

-12 hour service

3. Neonatal clinical information system

-Badgernet system (neonatal clinical software) installed in all 13 units (clinical use and audit)

-Cot locator system

Areas of concern:

1. Capacity (Utilisation of ITU/HDU cots; SC care provision)

-ITU: some underutilisation (in level 2 units’ i.e. inappropriate location);   also some occurring outside level 3 units due to capacity.

-HDU: overall not enough capacity, cots underutilisation in some areas (clinical competency/SC care babies taking up HDU cots).

-wide variation in SC utilisation and admission criteria

2. Staffing       -Nursing     low compliance with All Wales Standards

              -Medical     reduction in trainee numbers

                                  Immigration rule changes

                                  European Working time directive

3. Compliance with standards Poor

- All Wales Neonatal service (shortfall in nursing numbers)

- BAPM 2010 standards        (high occupancy)

4. Rising birth rate (increased by 17% since 2002)

5.  Risk of precipitous change rather than planned

Challenges:

1. Care closest to home Vs quality and safety.

2. Any change will need investment and reconfiguration.