Chamber and committees

The vast majority of mothers in extreme preterm labour will be transferred before giving birth, and the normal destination for Lanarkshire mothers will be Queen Elizabeth University Hospital in Glasgow.

In the small number of cases where it is not possible to transfer mothers before they give birth, as has been established practice for many years, our specialist neonatal transfer service (ScotSTAR) will transfer those babies in specialist ambulances equipped to care for neonates.

We recognise that all parents want to ensure their baby gets the safest care possible, and would expect that we organise care to ensure that this happens. The Best Start aims to keep mums and babies together as much as possible. If there is a high risk of the baby needing intensive care after birth then antenatal care will be planned with the input of a specialist maternity team, and with the expectation that the woman will be admitted to a maternity unit in a hospital with a NICU on site when it is time to give birth.

If a woman is in suspected extreme pre-term labour, she will be transferred by ambulance to a maternity unit in a hospital with a NICU on site, to deliver the baby there. If there is not sufficient time to transfer the woman before birth, the baby will be born in her nearest hospital and given immediate short-term intensive care on site to stabilise the baby, before being transferred to a NICU by the specialist neonatal transport service ScotSTAR when it is safe to do so.

The same level of care will also be provided to the mother who, once stable enough, will also be transferred to the maternity unit within the same hospital as her baby.

Where cot capacity has been reached then clinical judgement with parental involvement will determine the best receiving unit.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The data provided is then collated and is used to identify any sustained or acute pressure on intensive care cots.

The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made. The perinatal teams across Scotland, including ScotSTAR who coordinate such transfers work hard to negotiate and create space when required.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made.

The Options Appraisal Report , published on 25 July 2023 describes the process undertaken to determine the three final Neonatal Intensive Care Units. Annex D of the report outlines the cot availability for each Neonatal Unit.

Additional information can found on the hospital’s websites or requested directly.

As has been established practice for many years, the staff and vehicle required to move critically ill patients is determined based on circumstances and clinical need. Our specialist neonatal transfer service (ScotSTAR) will transfer those babies by air or road in specialist ambulances equipped to care for neonates.

ScotSTAR will be introducing a Standard Operating Procedure (SOP) which will have variations between emergency and scheduled/planned transfers. NHS Grampian will be on the outer limits for drivers but expectation would be that the journey will be done without a break.

The recommendations for the new neonatal model of care are underpinned by strong 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, with experienced staff, and with full support services.

The Best Start recommended that Scotland should move from the current model of eight Neonatal Intensive Care Units (NICU) to a model of three units supported by the continuation of current NICUs redesignated as Local Neonatal Units (LNU’s).

As part of the next phase of the work Scottish Government have commissioned Consulting firm RSM-UK to undertake detailed modelling work to fully map the capacity requirements across the system to inform capacity building and implementation of the new model.

The Scottish Ambulance Service will be included as part of the modelling work. We expect that mothers in threatened extreme early labour, or those whose babies will need surgery, will be identified pre-birth and will birth in the maternity unit alongside the NICU. The Perinatal Network has been leading some work, and recently published guidance on transfer in these cases.

The Scottish Government does not hold this information.

The Scottish Government aims to publish our new palliative and end of life care strategy for consultation in Spring 2024.

I refer the member to the answer to question S6W-21151 on 19 September 2023. All answers to written Parliamentary Questions are available on the Parliament’s website, the search facility for which can be found at: https://www.parliament.scot/chamber-and-committees/questions-and-answers .

I refer the member to the answer to question S6W-21151 on 19 September 2023. All answers to written Parliamentary Questions are available on the Parliament’s website, the search facility for which can be found at: https://www.parliament.scot/chamber-and-committees/questions-and-answers .