Bliss Reports Neonatal Units are Overstretched

The UK's most vunerable newborn babies still at risk.

Every six minutes a baby is born in the UK who needs specialist hospital care yet our neonatal services are overstretched and understaffed, says a report published today by special care baby charity Bliss.

In Bliss' fourth annual Baby Report, Baby steps to better care, we have found that minimum staffing standards are still not being met and units are regularly having 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 sent to every neonatal unit in the UK where we asked about their activity between 1 April 2007 and 1 September 2007 and a survey of 500 parents. From this we found that staff shortages remain a huge problem. Between 2006 and 2007, 160 more nurses were recruited to special care baby units. While this shows some progress, there was still a shortage of 1,700 neonatal nurses to provide the minimum care needed to the babies admitted 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. Only one in five neonatal units reported that they met the nurse staffing standard set out by the British Association of Perinatal Medicine in 2001. It remains common for a nurse to have to care for two babies in intensive care at one time. Not only is care for babies not being provided at appropriate levels, but nurses are not able to spend enough time with parents giving them reassurance and vital information. In addition one level three unit (Intensive Care) and 25 level two units (High Dependency) reported having no dedicated neonatal consultant last year.

For units to effectively deal with peaks and troughs in admissions, it is recommended that they do not exceed an average occupancy of 70 per cent. The report shows that in 2007 only one in five of the most specialised units met this standard and a third of all units reached 100 per cent capacity or more, at some point. In addition, one in five units closed for seven weeks out of a year, while worryingly seven units closed to new admissions for over seven months over the same period.

The report also highlights that long distance transfers of babies between hospitals due to lack of capacity are all too common. Over half of units told us that they had to close to new admissions at some point. Over the five month period, almost 500 babies were transferred due to a lack of staffed cots. This is on average three babies a day. While parents' responses were very positive about the care their baby had received on the unit, the financial and emotional impact caused by these transfers was great. Transfers are sometimes necessary for medical reasons, however transfers due to a lack of cots or trained staff should not be occurring.

Andy Cole, Chief Executive of Bliss said,

"Doctors and nurses provide amazing care to hundreds of premature and sick babies and their families every day. However, professionals are increasingly being stretched to the limit. Staffing shortages are all too apparent on units and the care of our most vulnerable babies is being compromised. No other critical care service would permit the capacity and staffing levels seen on special care baby units. While some extremely welcome progress has been made in the past year, there is still much more to do. Action is urgently needed to invest in our special care baby services, both now and for the future."

www.bliss.org.uk