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Toolkit for high quality neonatal services

The Toolkit for high quality neonatal services (Toolkit) sets out standards that neonatal services in England should be meeting to make sure babies born premature or sick get the care they need and deserve. It was published by the NHS and Department of Health in November 2009. Bliss was closely involved in drawing up this document.

What does it say?

The Toolkit outlines eight key principles for the delivery of high quality neonatal services, including the following:

Staffing of neonatal services

  • A minimum standard of one-to-one nursing care is provided to babies in intensive care, one-to-two nursing care in high dependency care and one-to-four nursing in special care.
  • Specialist doctors are available at all times.
  • Professionals, such as dieticians, physiotherapists and speech and language therapists, are available to provide support to babies, both in hospital and after they return home with their families.

Care of the baby and family experience

  • Parents are introduced to staff and shown around the neonatal unit where their baby is being cared for. 
  • Parents receive information they can understand about their baby's condition and treatment, and are encouraged and supported to participate in decisions about their baby’s care.
  • Overnight accommodation is made available close by for parents whose babies are in intensive care, facilities are available so siblings can visit, and comfortable and discreet areas are provided for mothers to breastfeed their baby's.
  • Families have access to psychological support.
  • Mums have access to breastfeeding support.


  • A safe and effective transfer service is available at all times for babies who need to be moved to another unit.
  • The service recognises the importance of family circumstances and gives parents the opportunity to travel with their baby.

Since the publication of this Toolkit, quality standards on specialist neonatal care were published by NICE in 2010.


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