MPs Criticise NHS Over Baby Care

There is a “serious” shortage of nurses providing care to babies born prematurely or with specialist needs and hospitals are struggling to meet demand, a committee of MPs said today.

Each of England’s 178 neonatal units had to close once a week on average during 2006-07, with the MPs warning of “major implications for patient safety”.

And five years after a reorganisation was ordered, two areas have failed to fully implement the changes, the Commons Public Accounts Committee said.

The cross-party group of MPs announced the findings in their report Caring for Vulnerable Babies: The reorganisation of neonatal services in England.

It found that the 2003 decision to reorganise the 178 neonatal units into 23 geographical networks had delivered some benefits but more needed to be done.

The committee found there were three vacancies per unit for nurses qualified in neonatal care, and said there was a need for a national action plan to address the shortage.

The MPs also found that a third of units operated above the recommended occupancy rate of 70 per cent.

And they warned: “High occupancy rates could have major implications for patient safety due to increased risk of infection or inadequate staffing levels”.

Only half of networks provide specialist neonatal transport services at all times, and the committee found that almost three- quarters of units had experienced delays in transporting babies. Some 44 per cent believed care had been compromised in such circumstances.

The reorganisation had had “limited impact” in reducing variations in mortality rates across the country, though this was down to a “complex range” of factors and better understanding was needed.

The Northern and Essex networks had yet to be formally established, and there were no arrangements for adequately measuring performance.

The MPs also criticised “variations and mismatches” in the costs of care between units.

Tory Edward Leigh, who chairs the committee, said: “There was widespread support for the reorganisation of neonatal services five years ago, resulting in the creation of 23 clinical networks.

“However, this change has had limited effect in reducing regional variations in mortality rates of babies born prematurely or suffering an illness needing specialist care.

“There are complex combinations of factors at work here, and Primary Care Trusts need to improve their understanding of the high risk groups in their local populations.

“Constraints in capacity mean that the Department of Health is still struggling to meet the demand for neonatal services which has risen year on year.

“The serious shortages of neonatal nurses must be addressed. Only half of the networks provide round-the-clock transport services to transfer babies to other units for the right levels of specialist care.

“And high occupancy rates in a third of units could have major implications for patient safety, owing to increased risk of infection or inadequate staffing levels.

Dr Sheila Shribman, the Government’s national clinical director for children, young people and maternity services, welcomed the report.

She added: “We are committed to delivering real improvements for mothers and babies and have made neonatal services a top priority for the NHS.

“Spending on neonatal services increased from Pounds 655m in 2003/ 04 to Pounds 802m in 2006/07 – an increase of 22 per cent.”

“However, we recognise there is still more to do and we have established a Neonatal Taskforce to support the NHS to identify and deliver real improvements to neonatal services.

However Shadow Health Minister, Anne Milton, accused the Government of letting down mothers and said: “It is clear that the Government is still dragging its feet when it comes to care for the most vulnerable.”

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