National standards for neonatal care

Dad looking over his sleeping baby while holding a syringe of milk above the baby to allow tube feeding

For babies to have the best possible outcomes, it is important that they are cared for in neonatal units which meet the highest standards of quality care.

In this section, you can find out what the national standards are, how Bliss helped to shape them and the different sets of standards that exist across the UK.

What are the standards?

The national standards for neonatal services set out clear frameworks for the care that neonatal units need to provide, and the resources should have in place to be providing the highest quality and safest care possible. They set out:

  • How many nurses, doctors and other health professionals need to be on the unit.
  • What levels of experience professionals working on the unit should have.
  • The equipment and resources they should have access to.
  • That units should foster a family-centred environment, where staff support parents to care for their baby, and there are facilities and support available so families are able to be with their baby for long, uninterrupted periods of time.

There are a number of different sets of standards

England, Scotland and Wales all have their own national standards which reflect the different political settings in each of these countries, and the different health services which operate there.

Northern Ireland is the only UK nation without its own set of neonatal standards, and we have recommended that they are created urgently.

In adition, other organisations like the British Association of Perinatal Medicine (BAPM) and the National Institute of Clinical Excellence (NICE) have produced standards which can be applied across the UK.

Bliss also has our own set of standards for the provision of high quality family centred care in our Bliss Baby Charter.

Some key measures are the same across all the standards

Despite there being a number of different sets of national standards in England, Wales and Scotland, many of the key requirements for services remain the same.

One key measure which units strive to meet are nurse-to-baby ratios which set out how many babies a nurse can care for:

  • Intensive care: one nurse should look after no more than one baby
  • High dependency: one nurse should look after no more than two babies
  • Special care: one nurse should look after no more than four babies.

However, Bliss research has shown that units across the UK are struggling to meet and maintain these minimum nursing ratios, despite there being strong evidence that when they are met babies have better outcomes, including for survival.

What role did Bliss play in shaping these standards?

Bliss has played a central role in shaping standards from BAPM as well as the national standards in England, Scotland and Wales. We have made sure a culture of family centred care is a key marker of high quality services, and ensured that critical measures on staffing levels are retained and strengthened.

In England, Bliss representatives were key members of the Neonatal Taskforce that produced the Toolkit for High Quality Neonatal Standards, and Bliss Scotland was represented on the Neonatal Expert Advisory Group which developed the Quality Framework for Neonatal Care in Scotland.

Bliss has played a vital role in shaping standards from BAPM as well as the national standards in England, Scotland and Wales. We have made sure a culture of family centred care is a key marker of a high quality service.