Chamber and committees

The recommendations for the new neonatal model of care are underpinned by strong clinical evidence that population outcomes for the most premature and sickest babies are improved by delivery and care in units looking after a critical mass of these babies.

The change in service delivery will bring Scotland in line with established practice across the rest of the UK and indeed the way neonatal care is delivered across the Western world.

This evidence has since strengthened with the publication in 2021 of the British Association for Perinatal Medicine (BAPM) ) Optimal Arrangements for Neonatal Intensive Care Units in the UK (2021) | British Association of Perinatal Medicine which sets out optimal arrangements for neonatal intensive care and is the recognised optimal model for neonatal intensive care in the UK.

A review of evidence was also carried out by Dr Anna Gavine, Dr Steve MacGillivray and Prof Mary Renfrew of the University of Dundee - Maternity and neonatal services: efficient evidence review. The evidence showed that outcomes for very low birth weight babies (VLBW) are better when they are delivered and treated in NICUs with full support services, experienced staff, and a critical mass of activity.

In November 2023, I asked the Deputy Chief Medical Officer, Marion Bain, to review the evidence, the options appraisal report and the post COVID review.

Marion Bain confirmed the process was robust and took account of the available evidence, relevant clinical advice and confirmed that her investigations produced no concerns about the process, or the validity of the conclusions reached.

She also noted that it involved clinical experts from both within Scotland and beyond, and that the process was informed by and considered existing guidance from well-respected clinical organisations.