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27/09/2016

Report Urges Neonatal Units 'To Form Partnerships'

A new report published by the Royal College of Paediatrics and Child Health (RCPCH) has suggested that neonatal units should form partnerships with neighbouring hospitals in an effort to reduce variation and increase standards of care for very sick babies.

The National Neonatal Audit Programme (NNAP) report also found that very little, or no improvement, had been made over the past 12 months in meeting several important care standards.

The NNAP report assesses whether babies requiring specialist neonatal care receive consistent high quality treatment, but it discovered that progress had stalled on some measures including ensuring that babies' eyes were screened to minimise risk of premature visual loss, their temperature management and that parents received timely consultation with a senior member of staff.

Commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England, the Welsh Government and the Scottish Government, the report assessed 95,325 admissions of babies across 179 neonatal units in England, Wales and for the first time this year, Scotland. It revealed that hypothermia remained a problem, with 28% of babies (born at less than 32 weeks gestation) having a temperature below the recommended range of 36.5-37.5 degrees. The proportion of babies born at less than 29 weeks within the recommended temperature range was only marginally better than in 2014 (52% in 2015 compared to 51% in 2014) and levels of admission within this temperature range vary from 11-91%, highlighting a large variation across the country. Elsewhere, 85% of mothers who gave birth to babies at 24 – 34 weeks gestation received antenatal steroids prior to birth which reduce the chance of breathing problems; more than one in 20 babies (7%) did not receive retinopathy of prematurity screening (eye screening) at the recommended time; while 12% of parents did not have a recorded consultation with a senior member of staff within 24 hours of their baby's admission to the neonatal unit. Adherence to this standard varies widely at unit level ranging from 54-100%.

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In response, the NNAP recommends that by using the new NNAP online reporting tool, which launched today alongside the report, neonatal units will be able to identify good practice and form links with other units. As a result, they would be better equipped to learn from one another and adapt ways of working to improve the levels of care delivered to babies in their own unit.

Commenting on the findings, Dr Sam Oddie, Clinical Lead for the National Neonatal Audit Programme (NNAP) and member of the Royal College of Paediatrics and Child Health (RCPCH) said: "Some units are doing remarkably well when it comes to meeting the care standards measured by the NNAP; however there are others that are simply not delivering on these yet. These units need to be looking at improving this.

"100% of babies should have their temperature taken within an hour of birth and the fact this isn't happening is very concerning. If not monitored closely, low admission temperature can lead to hypothermia and severe illness, so getting this right is essential."

The full report can be read here.

(JP)

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"A new report published by the Royal College of Paediatrics and Child Health (RCPCH) has suggested that neonatal units should form partnerships with neighbouring hospitals in an effort to reduce varia