Impact of the NHS reform on care for premature and sick babies

An intubated female premature infant born prem...

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This is my letter I sent to David Wright MP today:

I am writing to you as a constituent of Telford, to ask for your support for services for premature and sick babies. It may be a little hard to believe but I too was a sick and premature baby born in 1979 in Swindon and was only saved by the determination and hard work of my parents and doctors and nurses. My story, sadly, is an exception rather than the rule for premature babies.

I’m desperately concerned that the current changes to the NHS could result in babies born too soon, too small or too sick being inappropriately and unnecessarily transferred long distances in the search for a hospital cot and denied the care they need when they get there. There’s a story in today’s Shropshire Star of a family in a similar position to mine having a premature baby which is being used to argue to keep neonatal care at the Royal Shrewsbury Hospital. The lives of small, vulnerable children must not be politicised in this way. The best location for the most people should be a driver for decisions, not an emotive personal story that plays with “What if…?” scenarios.

Currently neonatal care in England is organised in over 20 neonatal managed clinical networks. The networks were first established in 2003 to improve the safety and effectiveness of services for mothers and babies. By 2007, the National Audit Office found that the establishment of networks had already resulted in improved communication and coordination between neonatal units and significantly reduced the number of mothers and babies being transferred long distances for care.

The Health and Social Care Bill currently going through Parliament does not set out how managed clinical networks, including neonatal networks, will be supported in the new NHS structures. If these networks are abolished, or stripped of their resources to perform their role, it will lead to many more babies being unnecessarily transferred long distances across the country. This would place a huge financial, practical and emotional strain on families forced to travel many miles every day to see their baby. I believe that it would be disastrous to turn the clocks back to the time before 2003 when long distance transfers of premature and sick babies across the country were a common occurrence.

Neonatal services are already overstretched and understaffed. Research by Bliss, the special care baby charity shows that an extra 1,150 neonatal nurses are needed for all hospitals caring for babies born premature and sick to meet minimum standards set out in the NHS and Department of Health’s Toolkit for High Quality Neonatal Services (Toolkit), published in 2009. In the light of these pressures already facing services for premature and sick babies, any cuts to neonatal nursing jobs could put babies lives at risk: evidence published in the BMJ in 2006 shows that “increasing the ratio of nurses with neonatal qualifications to intensive care and high dependency infants to 1:1 was associated with a decrease in risk-adjusted mortality of 48%.” In other words if the standard of one neonatal nurse per baby in intensive care as set out in the Toolkit is met, more babies are likely to survive.

I am asking you to write to Andrew Lansley, Secretary of State of Health, on my behalf urging him to ensure that the important role performed by neonatal managed clinical networks is not lost in the new NHS structures. In particular, to ensure that the Government:

• Sets out clear plans about how funding for neonatal networks will be continued in the short term while the current structures are being wound down and the new bodies created

• Clarifies how the important work of networks will be continued under the new bodies they are introducing

• Ensures that their plans for maternity networks compliment the work of neonatal networks

• Provides guidance to NHS bodies responsible for commissioning and providing neonatal care that the minimum nursing standards as set out in the Toolkit should be implemented and that efficiency savings should not impact on frontline neonatal services

In addition, I would be grateful if you could write to the Chief Executives of the local Primary Care Trust and regional Strategic Health Authorities and ask them to:

• Ensure that no neonatal nursing jobs are cut

• Put initiatives in place to recruit more neonatal nurses to ensure that more babies are likely to survive in neonatal care

I would be grateful if you could send me a copy of your letters, and look forward to hearing from you soon.

Kind regards,

Ben Whitehouse.

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