Care Services Of Scotland's Most Vulnerable Babies Overstretched And Understaffed, Says Charity Bliss

Main Category: Pediatrics / Children's Health
Article Date: 04 Nov 2008 - 8:00 PST

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One in seven babies born each year is admitted to specialist care in Scotland, yet the neonatal services to care for these most vulnerable babies are overstretched and understaffed, says a report published today by special care baby charity Bliss.

Bliss' Baby Report, Baby steps to better care, includes a comprehensive survey of all of the specialist baby units in Scotland. The results show that minimum staffing standards are still not being met and units regularly have to close to new admissions due to lack of staff. This means that mothers and babies are being transferred, in some cases very long distances, putting intense strain on families at a critical time.

The findings of the report were based on a Freedom of Information request that every neonatal unit in Scotland completed and a survey of parents. From this Bliss found that staff shortages remain a significant problem. A total of twelve more specialist neonatal nurses were recruited in Scotland between 2006 and 2007. While this shows there has been some progress, there was a shortage of around 140 specialist neonatal nurses in 2007.

One to one nursing care is the minimum standard for anyone admitted to intensive care in the UK. Currently this standard is met for children and adults but not for babies. It remains all too common for a nurse to have to care for two babies at a time. This means that they are not able to spend enough time with parents giving them reassurance and vital information.

For units to effectively deal with peaks and troughs in admissions, experts recommend that they do not exceed an average occupancy of 70 per cent. However, the report shows that one in three units went to 100 per cent capacity or more at some time. Worryingly, these units were the larger, most specialised, intensive care units.

With the service being so overstretched and understaffed, almost half of units in Scotland had to close their doors to new admissions at some point during 2007, leading to unnecessary transfers. The transport service, although among the best in the UK, is under increasing pressure as NHS Quality Improvement Scotland's Perinatal Collaborative Transport Study (CoTS) reported in July 2008. It found that intensive care units were frequently unable to accept referrals from other hospitals.

Bliss' report includes research into the impact on families of being transferred before their baby was born. Almost a third of parents reported financial difficulties related to the transfer. What is more, over half of partners were unable to travel to the hospital where the mother was transferred and over half of mothers felt "isolated" at their destination hospital.

Andy Cole, Chief Executive of Bliss said, "Amazing care is being provided to premature and sick babies and their families in Scotland every day, but doctors and nurses are being increasingly stretched to the limit. It is extremely concerning that the most specialised baby units in Scotland are often closed to new admissions, mainly due to lack of staff. The care of our most vulnerable babies and the support for their families is crucial to get right at what is already a very difficult time. We hope that the forthcoming Scottish Executive report on neonatal care will be swiftly acted on by both the Government and Health Boards to bring about much-needed investment in special care baby services."

- Bliss, the special care baby charity, was founded in 1979 and is dedicated to ensuring that babies survive and go on to have the best quality of life. It does this by:

- providing practical and emotional support for families during an extremely difficult time, so they can give the best care to their babies.

- providing training and support for doctors and nurses and funding research to improve the care of all sick and premature babies

- raising awareness of the issues affecting special care babies and fighting for essential change within government and the NHS.

- NHS Quality Improvement Scotland Perinatal Collaborative Transport Study (CoTS) Dr Charles Skeoch et al (2008) CoTS looked at the 599 in-utero transfers that took place over a six month period.

- The Maternity Services Action Group (MSAG) was formed in 2006 by the Scottish Executive and has been an important development in Scottish neonatal care. A neonatal subgroup has developed a report to map out the future of neonatal services in Scotland. This report was due to be published in autumn 2008.

http://www.bliss.org.uk