Neonatal Intensive Care Services Reconfiguration in Teesside
Improvements to regional neonatal services
The NHS is changing the way neonatal services are delivered in the Teesside area.
The changes follow the findings of an independent report * which looked at how to ensure the best outcomes for parents and their babies from neonatal services.
It recommended that the Neonatal Intensive Care Unit at James Cook University Hospital be developed as a centre of excellence, caring for the very premature and most vulnerable babies, and that University Hospital of North Tees becomes a Special Care Baby Unit for babies born over 30 weeks’ gestation.
A small number of babies that would have been delivered in North Tees, under the current configuration, will now be cared for at James Cook University Hospital. It is anticipated that this may affect around ten babies per year from the Hartlepool and Stockton areas.
North Tees and Hartlepool NHS Foundation Trust, and South Tees Hospitals NHS Foundation Trust have been consulting with staff and reconfiguring services as they prepare to implement the changes from September.
Dr Mithilesh Lal, Consultant Neonatologist and Clinical Director for Neonatal Services at South Tees Hospitals NHS Foundation Trust, said: “The changes mean that Neonatal Intensive Care in the Teesside area will be provided at James Cook University Hospital in Middlesbrough, with special care continuing to be provided at University Hospital of North Tees.
“Any baby, born before 30 weeks’ gestation, in the Teesside area, will be cared for at James Cook University Hospital in Middlesbrough, and pathways will be put in place to ensure, as far as possible, that this is where these babies are delivered.
“Neonatal care is provided across the country in a variety of settings depending upon the interventions required, with dedicated transport services to support babies being transferred to and from neonatal care units.
“Not all hospitals provide specialist neonatal services, so a baby may be transferred to another hospital if neonatal care is required. Four trusts in the region currently provide Neonatal Intensive Care Units (NICU).”
Lynn Kirby, Associate Director, Operations (Elective Care, Women And Childrens, Cancer Care Services) from North Tees and Hartlepool NHS Foundation Trust, said: “University Hospital of North Tees will continue to provide care for babies born over 30 weeks’ gestation. So the majority of activity, cots and staffing will remain unaffected on the North Tees neonatal unit under the plans proposed.
“There will be very little impact on maternity services provided at University Hospital of North Tees. Local mums will still be able to safely deliver their babies at the hospital.”
Neonatal services provide care for all new-born babies that require ongoing medical care. Babies can be admitted for a number of reasons, including when they are born early. One baby in 13 is born early, and babies born before 34 weeks may need extra help with breathing, feeding and keeping warm.
NHS England’s Medical Director for North Cumbria and the North East, Professor Chris Gray, said: “These changes will ensure a safe and sustainable model of care in the Teesside area for premature and the most vulnerable babies, concentrating expertise and resources to provide the best possible outcomes.
“This is particularly important for the most high-risk babies who are born extremely prematurely and are in need of the most intensive care including respiratory support and one-to-one specialist neonatal nursing care.”
Reference: *The Independent Review of Neonatal Intensive Care Services in the North East and North Cumbria, undertaken by the Royal College of Paediatrics and Child Health, 2015.
Notes to editors:
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What is neonatal care?
NHS England commissions neonatal critical care, which encompasses intensive care, high dependency care and special care. Neonatal services provide care for all babies less than 44 weeks post-menstrual age that require ongoing medical care. The services form part of an integrated pathway for high quality maternity, paediatric and family care serving a geographically defined regional population.
Intensive care is care provided for babies who are the most unwell or unstable and have the greatest needs in relation to staff skills and staff-to-patient ratios.
Why do babies need neonatal care?
Babies can be admitted to neonatal care for a number of reasons, including when they are born early and babies born before 34 weeks may need extra help with breathing, feeding and keeping warm.
There are different levels of care available within the NHS:
Level 1 Special Care Baby Unit (SCBU)
SCBU is for babies who need continuous monitoring of their breathing or heart rate, additional oxygen tube feeding, phototherapy recovery (to treat neonatal jaundice) and convalescence from other care.
Level 2 Local Neonatal Unit (LNU)
LNU is for babies needing short-term intensive care with apnoeic attacks who require support, including receiving continuous positive airway pressure (CPAP). Some babies receiving parenteral nutrition (tube feeding) may also need this level of care.
Level 3 Neonatal Intensive Care Unit (NICU)
NICU is for babies needing respiratory support (ventilation) and needing significant CPAP support (continuous positive airway pressure). Babies with severe respiratory disease who also require surgery may need this level of care too.
Transitional Care is provided when a baby still has some needs but is almost ready to go home – the mother becomes the main carer with support from a nursery nurse or other staff. (Source: NHS Choices and Bliss)
Where are neonatal services currently provided from in the North East?
Currently, Newcastle Upon Tyne Hospitals NHS Foundation Trust, City Hospitals Sunderland NHS Foundation Trust, South Tees Hospitals NHS Foundation Trust and North Tees and Hartlepool NHS Foundation Trust provide neonatal intensive care units (NICU) providing the full range of neonatal services across the North East. In addition, there are five hospital trusts in the region that provide special care baby services only across their hospital sites.
Who provides neonatal care?
Neonatal services are provided by specialised clinicians including consultant neonatologists, paediatricians, nurses, hospital social workers and anaesthetists.
About NHS England
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