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Neonatal staff shortage warning

Two thirds of NHS neonatal ICUs do not have enough nurses or doctors

Mark Gould

Monday, 19 October 2015

Neonatal services in England are overstretched and under incredible pressure, putting the safety of the sickest babies at risk, according to a new report.

The Bliss baby report 2015: hanging in the balance, produced by the sick and premature baby charity Bliss, reveals a severe shortage of neonatal nurses and doctors, meaning units are not meeting national standards on safe staffing levels for premature and sick babies.

Key findings include:

  • 2,140 more nurses are needed to meet national staffing standards.
  • 64 per cent of units do not have enough nurses, and two thirds do not have enough doctors to meet national standards. This is largely due to a severe lack of funding, which accounts for three fifths of those units falling short of nurses and half of those units not having enough doctors. There are also limited training and development opportunities with 72 per cent of units saying they struggle with nurse training and development.
  • The government’s national standards recommend that it is not safe for units to be running at higher than 80 per cent occupancy on average, but over two thirds of neonatal intensive care units are consistently caring for more babies than this. This puts babies at risk and adds to their families’ stress and worry.
  • At 41 per cent of units, parents do not have access to a trained mental health worker, despite parents of premature and sick babies being at a far greater risk of postnatal depression.
  • One third of units were not able to provide overnight accommodation for parents of critically ill babies or those living many miles from the hospital. It is vital that parents are able to stay close to their baby as research shows that when parents are involved in their baby’s care it improves their development and recovery, and eases the pressure on health professionals.

Bliss wants the government and NHS England to invest in neonatal care so that hospitals are able to recruit the nurses, medical staff, mental health workers and other allied health professionals they so desperately need. It says concrete plans must be put in place to address skills shortages so that babies are consistently receiving the best care, and trusts should ensure that parents are offered free accommodation and meal vouchers or free hospital meals to ease the financial strain and enable them to stay with their baby.

Bliss chief executive Caroline Davey said: “The government set out a comprehensive vision for neonatal care in 2009, with the publication of the Toolkit for high quality neonatal services. Six years on and we are falling further behind on critical measures of quality and safety, and the shortfall in funding means units are simply unable to meet these standards."

A spokesperson for the Royal College of Obstetricians and Gynaecologists said that around 77,000 babies each year need specialist support to help them survive and this number is steadily increasing each year due to the number of complex pregnancies it is seeing.

“The findings of Bliss’ report are extremely concerning and provide further evidence that, similar to maternity services, pressure on neonatal services is also growing. Stretched and understaffed services affect the quality and safety of care provided to both mothers and babies. Patient care and safety underpin everything we do and long-term investment is needed to ensure healthcare professionals can deliver a high-quality service to all of their patients.

“The RCOG is committed to improving care and preventing avoidable harm in labour and through our Each Baby Counts initiative we aim to halve the number of stillbirths, early neonatal deaths and brain injuries occurring in the UK as a result of incidents during term labour by 2020,” said the spokesperson.

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