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Quarter of extremely premature babies born in ‘wrong hospital’

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More needs to be done to ensure that extremely premature babies are born at a hospital which is best equipped to properly care for them, according to a charity.

The warning from Bliss, the charity for premature and sick babies, come in response to the latest National Neonatal Audit Programme (NNAP) report.

“Extremely premature babies born at hospitals with a NICU have the best possible chance”

Caroline Lee-Davey

It found that one in four babies born at less than 27 weeks gestation was born at a hospital without an on-site neonatal intensive care unit (NICU).

Further to this, the report showed that only two of 15 neonatal networks were meeting their target of ensuring that 85% of babies born before 27 weeks were delivered in centres with a NICU.

The NNAP report also found that some babies admitted into neonatal care might be separated from their parents for longer than necessary.

Term babies receiving a low level of specialist care spent an average of 3.2 days in the neonatal unit when separation from their mother was not necessary.

The report recommends that neonatal units with above average numbers of separation days for term, or late preterm babies should consider a revision of their admission or discharge criteria.

“Babies have the best start in life when they are able to have their parents with them”

Caroline Lee-Davey

The National Neonatal Audit Programme (NNAP) uses routinely collected data to support quality improvement in neonatal units of all types.

It is commissioned by the Healthcare Quality Improvement Partnership, funded by NHS England, the Scottish and Welsh governments, and is delivered by the Royal College of Paediatrics and Child Health.

For most audit measures, the report looked at care provided to babies with a final discharge from neonatal care between 1 January and 31 December 2017.

In response, Bliss chief executive Caroline Lee-Davey said: “It is extremely disappointing that opportunities for transfer before birth in complicated pregnancies are being missed.

“Evidence shows that extremely premature babies born at hospitals with a NICU have the best possible chance of survival thanks to the specialist staff and equipment in place at these units,” she said.

She noted that, while it was not always possible for mothers in spontaneous labour to be transferred to a hospital with a NICU, there was “wide and unacceptable variation” in how often it happened.

She said the charity echoed the recommendations of the report and called upon neonatal and maternity services to work together “as a matter of urgency to address this variation in practice”.

Bliss

‘Unprecedented’ nurse shortages hitting neonatal units

Caroline Davey

Ms Lee-Davey added: “Babies have the best start in life when they are able to have their parents with them – for term or late preterm babies who need a little bit of extra help after birth.

“This means being cared for alongside their mother in a post-natal or transitional care ward, rather than being admitted into neonatal care and separated from their parents,” she said.

“Research has shown that parental involvement in a baby’s care supports brain development and cognition,” she said. “Other benefits for parents staying with their babies in hospital playing a hands-on role in their care include improved breastfeeding rates, earlier discharge from hospital, and reduced re-admission rates.

“It is, therefore, essential that avoidable separation of babies from their parents is closely scrutinised and that processes of admission into and discharge from neonatal care are reviewed,” she stated.

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