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'Unprecedented' nurse shortages hitting neonatal units


Neonatal services are struggling because of “severe staffing shortages” with the majority of units for premature and sick babies reporting they do not have enough nurses, according to a new report.

Nurses working in neonatal units also find it difficult to access training and develop their skills, found the report by Bliss, the newborn baby charity.

Based on a survey of more than 100 neonatal units, the research paints a worrying picture of services for England’s most unwell infants.

Of the units that provided information about staffing, 64% reported they did not have enough nurses in post.

This was especially true of neonatal intensive care units with 26 out of 30 saying they did not have enough nurses.

“This unprecedented shortage is putting babies’ safety, survival and long-term development at risk”

Caroline Davey

According to Bliss, around 2,140 more nurses are needed to fill staffing gaps.

Units also reported shortfalls in the number of nurses with specialist qualifications. National standards for neonatal services, which set staffing ratios, also state 70% of registered nurses and midwives in each unit should have a specialist qualification in neonatal care.

However, nearly two thirds of units – 65% – reported they did not have enough specialist nurses to meet this standard.

The survey also highlighted widespread problems accessing training and professional development, with 72% of units reporting issues with at least one aspect.

Forty-six per cent said they had difficulty releasing frontline nurses for training, according to the Bliss baby report 2015: hanging in the balance, which was published today.

“This suggests a ‘Catch-22’ situation in some units where there are insufficient staff to cover posts so that nurses can spend time training, but a lack of training is contributing to the shortage of qualified nurses,” said the report.

Meanwhile, 39% said there was a lack of funding for training with several reporting study days had been entirely abandoned.

“The Bliss report makes for grim reading”

Neena Modi

As well as struggling to develop new skills, nurses can find it hard to maintain competency levels, the report found.

This was particularly the case for units delivering high dependency and special care. Twenty-seven per cent of local neonatal units and 13% of special care baby units said nurses lacked opportunities to maintain skills and competencies, because they did not have enough clinical exposure.

Lack of funding was identified as a key reason for services failing to meet national standards, as set out in the Toolkit for High Quality Neonatal Services, published in 2009.

As well as not being able to afford enough nurses, the survey found two thirds of services did not have enough doctors and could not access much-needed support from allied health professionals, concluding health professionals “are spread far too thin”.

Bliss chief executive Caroline Davey said there was an urgent need to address funding shortfalls and lack of staff and hoped the report would be a “wake-up call” for policy makers and commissioners.


Caroline Davey

“This unprecedented shortage is putting babies’ safety, survival and long-term development at risk,” she said.

“Doctors and nurses do incredible work and go above and beyond to provide the best care but if serious investment is not made, services will be facing a crisis in years to come,” she added.

Professor Neena Modi, president of the Royal College of Paediatrics and Child Health, said: “Today’s report describes a service that is overstretched and inadequately funded. [It] makes for grim reading.”

Professor Edward Baker, deputy chief inspector of hospitals at the Care Quality Commission, said: “We welcome this report from Bliss. It is right to highlight the problems that staffing can have on the quality of neonatal care, and this echoes what we found on some of our inspections.

“We are currently looking at quality of neonatal care as part of a national review to see how trusts care for new born infants with deteriorating health; particularly how successful services are at working together,” he said. “We expect to publish our findings next spring.”


Readers' comments (4)

  • Whilst I appreciate the concept of clustering care and having multiple specialities under one roof. I can cite approx' (underestimate I am sure) 30 nurses who did not move with the new centralisation of the Manchester neonatal service.
    I am one! I voted with my feet, it is sad when one loves the work one does, but simply can't absorb the travel costs. Or excellent NICU nurses lose their skills because it is all being centralised. So your unit rarely sees a ventilated infant.
    We just can't have our cake an eat it, I personally feel that people working in ANY ICU whether neonatal, children's or adult should be paid an ICU lead. That would keep the good staff - BUT sadly it would attract people who maybe think it's easy money. ICU is not for all, it is a special type of person who can concentrate for long periods of time on one tiny individual and also care for mum, dad and everyone else.

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  • Every nurse should get the same rates of pay-I have worked in various areas of Nursing including ICU and every area presents it's own stresses -so let's not go down that road

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  • Sadly there is nothing new to report here; staffing neonatal units has always been a huge challenge in the 90's, 00's & beyond. The cost of the services by pushing preterm viability boundaries so far makes it almost impossible to keep up, the pioneering, lengthy treatments mean dependency costs money in terms of nurse:patient ratio & we are all fishing from the same pond for staff. NNU is not for everyone as previously said, it's hard work mentally, physically & ethically.

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  • There are shortages across whole spectrum of nursing. More births, people living longer, more long term conditions, less community prevention, promotion, education + support. Stretched, stressed, demoralising overworked staff will not help.

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