What is the project?
In February 2016 Better Births set out the Five Year Forward View for NHS maternity services in England. This report highlighted several challenges facing neonatal medical and nurse staffing, nurse training, the provision of support staff and cot capacity. It recommended a dedicated review of neonatal services. In response NHS England commissioned the Neonatal Critical Care Review (NCCR). Phase one of the NCCR comprised an evidence review undertaken by the NHS England Neonatal Critical Care Clinical Reference Group (CRG) across several work streams. Phase two of the NCCR focuses on turning the evidence review into a specific action plan for Regional Commissioning Teams, Neonatal Operational Delivery Networks (ODNs) and Local Maternity Systems (LMSs) to inform commissioner plans and, where required, service change.
The NCCR examined evidence from the units themselves, the parents whose infants were cared for by the NHS and other professional groups and national data. The NCCR Team identified 5 main areas that required attention:
- Outcomes
- Activity, demand and capacity
- Transfers
- Staffing levels
- Pricing
The NCCR has made a series of recommendations to address the above findings. They are grouped under the following themes, which align with commitments made in the NHS Long Term Plan (2019): • Aligning capacity (Actions 1 – 2)
- Action 1: Review and invest in neonatal capacity
- Action 2: Develop transport pathways
- Action 3: Develop the neonatal nursing workforce
- Action 4: Optimise medical staffing
- Action 5: Develop strategies for the allied health professions
- Action 6: Develop and invest in support for parents
- Action 7: Develop local implementation plans
- Action 8: Ensure neonatal services are integrated into maternity planning
- Action 9: Establish a national infrastructure to oversee implementation of the actions in this plan
- Action 10: Establish national reporting of regional neonatal outcomes
For each theme, the report summarises the evidence for the change, who needs to do what by when to inform regional commissioning planning processes and decision making and what support is available.
What are the expected outcomes of the project?
1. Developing neonatal capacity: redesigning and expanding neonatal critical care services to further enhance safety, effectiveness and the experience of families, to improve neonatal capacity and triage within expert maternity and neonatal centres.
2. Further developing the expert neonatal workforce required: extra neonatal nurses and expanded roles for some allied health professionals to support clinical care.
3. Enhancing the experience of families through care coordinators and investment in improved parental accommodation.