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Services for England’s sickest babies under pressure

Very premature baby in incubator

Neonatal services in England are overstretched and under incredible pressure, putting the safety of the sickest babies at risk. Findings of new research published today in the Bliss baby report 2015: hanging in the balance, show that there is a severe shortage of neonatal nurses and doctors, meaning units are not meeting national standards on safe staffing levels for premature and sick babies.

Key findings

  • In order to meet these standards* and give babies the best chance of survival and improved long term health, 2,140 more nurses are needed. The nurses that are currently caring for our most vulnerable babies do incredible work, but are being stretched to breaking point.
  • 64 per cent of units do not have enough nurses, and two thirds do not have enough doctors to meet national standards. This is largely due to a severe lack of funding, which accounts for three fifths of those units falling short of nurses and half of those units not having enough doctors. There are also limited training and development opportunities with 72 per cent of units saying they struggle with nurse training and development.
  • The government’s national standards recommend that it is not safe for units to be running at higher than 80 per cent occupancy on average, but over two thirds of neonatal intensive care units are consistently caring for more babies than this. This puts babies at risk and adds to their families’ stress and worry.
  • At 41 per cent of units, parents do not have access to a trained mental health worker, despite parents of premature and sick babies being at a far greater risk of postnatal depression**.
  • One third of units were not able to provide overnight accommodation for parents of critically ill babies or those living many miles from the hospital. It is vital that parents are able to stay close to their baby as research shows that when parents are involved in their baby’s care it improves their development and recovery, and eases the pressure on health professionals.

It is clear that staff are being spread too thin, and neonatal services are under extreme pressure. Without urgent action from the government and NHS England, the gap between the standards expected and the care provided will widen. The report, published by Bliss, the premature and sick baby charity, makes the following recommendations:

  • The government and NHS England must invest in neonatal care so that hospitals are able to recruit the nurses, medical staff, mental health workers and other allied health professionals they so desperately need.
  • Plans must be put in place to address skills shortages so that babies are consistently receiving the best care.
  • Trusts should ensure that parents are offered free accommodation and meal vouchers or free hospital meals to ease the financial strain and enable them to stay with their baby.

Caroline Davey, Chief Executive of Bliss, said: “The government set out a comprehensive vision for neonatal care in 2009, with the publication of the Toolkit for high quality neonatal services. Six years on and we are falling further behind on critical measures of quality and safety, and the shortfall in funding means units are simply unable to meet these standards.

“This must be a wake-up call for policy-makers and healthcare commissioners to take action. This unprecedented shortage is putting babies’ safety, survival and long term development at risk. If serious investment is not made, services will be facing a crisis in years to come. It needs to be addressed as a matter of urgency, so that every baby has the best possible chance of survival and of having a full and healthy life.”


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