Chamber and committees

This is a matter for NHS boards. The information requested is not held centrally.

Services should be offered locally where possible, however both the highly specialist and unpredictable nature of neonatal services means they cannot always be provided locally. It is regrettable when babies and/or pregnant women have to be transferred to another unit but we recognise that on occasion this may be appropriate or necessary.

We have a dedicated 24 hour neonatal transport system which surpasses arrangements in the rest of the UK, with dedicated and professional staff who provide high quality care to these babies and their families.

The Scottish Neonatal Transport Service will only transport sick infants when there is a clear clinical need, such as the need for intensive care, a cardiac condition requiring surgery or ECMO. The team will also transfer infants back to the referring unit and this accounts for 40% of the team''s annual activity.

Neonatal transfers only take place when it is in the best interests of mother and baby. We would expect NHS boards to ensure that both the accommodation and transitional care facilities for parents of ill babies who are a distance from home is of an appropriate standard.

The day-to-day management of NHS property, including accommodation issues related to service needs, is devolved to NHS boards to undertake and prioritise in line with their property and asset management strategies. This would include any necessary improvements associated with the outcomes of service reviews.

Best practice guidance available to NHS boards is published by Health Facilities Scotland (HFS). The current guidance for the provision of maternity services is the English Health Building Note HBN 09-02: Maternity care facilities, which HFS are presently looking to adapt for use in Scotland.

The information requested is not held centrally. However, information on staff in post showing nursing staff specialising with children and clinical nurse specialists in neonatology is published annually as part of the workforce census as at 30 September each year. Data for nursing and midwifery staff in post and clinical nurse specialists is available at:

http://www.isdscotland.org/isd/5352.html.

We expect all NHS boards to ensure they have the right number of appropriately skilled and experienced nurses to meet the needs of the babies they care for.

We have also recently written to NHS board chief executives to seek assurances that the levels of neonatal staffing and skill mix are sufficient to ensure a high-quality neonatal service to meet their local need along with clarification of the designated level of service that the unit provides.

Since 30 September 2008, the number of paediatric consultants has increased from 218 to 288 an increase of 70 (whole-time equivalent) 32.5%. Neonatology is a sub specialty of paediatrics and doctors working in neonatal services are trained to the standard required by the General Medical Council.

Neonatal services are provided by a multi professional Clinical Team which includes Consultants and Clinical Nurse Specialists who provide a treatment pathway to meet the needs of the patient.

However, the current policy of Reshaping the Medical Workforce will address the issues of staffing affecting neonatal services. The Reshaping Medical Workforce Project is our strategic policy objective of moving to a service predominantly delivered by trained doctors and reducing the reliance on doctors in training for front-line service delivery. This will ensure better health and higher quality healthcare services for patients resulting in improved patient outcomes and clinical safety.

We have also written to NHS board chief executives to seek assurances that the levels of neonatal staffing and skill mix are sufficient to ensure a high-quality neonatal service to meet their local need.

The number of neonatal transfers were fewer in previous years due to service limitations. As both specialist services and the Scottish Ambulance Service have continued to evolve, sick and premature babies can receive the most appropriate treatment and best possible care from this excellent system.

A review of the Scottish Neonatal Transport System has recently been completed which concluded that the service is staffed appropriately to respond to current demands, however the demands on the service will continue to be monitored.

A wider review of specialist transport services will be undertaken to consider the future needs and demands of all specialist transport services.

The information requested is not held centrally. However, information on staff in post showing nursing staff specialising with children and clinical nurse specialists in neonatology annually as part of the workforce census as at 30 September each year. Data for nursing and midwifery staff in post and clinical nurse specialists is available at:

http://www.isdscotland.org/isd/5352.html.

NHS Scotland has developed, tested and begun implementation of a neonatal nursing workload and workforce planning tool that will identify the nursing needs of this vulnerable group of babies. This tool takes in account the British Association of Perinatal Medicine (BAPM) staffing recommendations and will capture actual nursing workload on a real-time basis. The implementation of this tool will help to develop quality measures for neonatal care, and equip boards with valuable information that will inform their planning and provision of services. Neonatal units have been collecting the data for six months and the Nursing & Midwifery Workload and Workforce Planning Programme are now analysing the data.

We have also recently written to NHS board chief executives to seek assurances that the levels of neonatal staffing and skill mix are sufficient to ensure a high quality neonatal service to meet their local need along with clarification of the designated level of service that the unit provides.

We have a dedicated 24 hour neonatal transport system which surpasses arrangements in the rest of the UK, with dedicated and professional staff who provide high quality care to these vulnerable babies and their families.

The Perinatal Collaborative Transport Study commissioned by Quality Improvement Scotland in 2008, captured information about in-utero transfers in Scotland not previously known. It provides reassurance that transfers are being managed in line with agreed pathways of care. The study can be viewed at http://www.nhshealthquality.org/nhsqis/files/CoTS%20Final%20Report.pdf.

We expect all NHS boards to ensure they have the right number of appropriately skilled and experienced nurses to meet the needs of the babies they care for.

A comprehensive review of neonatal services across Scotland was undertaken to identify needs and help services where necessary. A report of the review''s findings was published and can be accessed at http://www.scotland.gov.uk/Publications/2009/04/30153006/17.

To further increase the nursing capacity within neonatal units, the Scottish Government has funded the training of 20 advance neonatal nurse practitioners to date and has recently invested £100,000 in neonatal education. A further £160,000 has been invested for training this year.

The Scottish Government is committed to ensuring that this vulnerable group of babies receives the highest quality of care, by the most appropriate professional, at all times. We know that admissions to neonatal units are not always predictable, that the level of care a baby requires may change at any given time, and that units have the responsibility to look after safely all of the babies in their care. Staffing and levels of care provided must be flexible to cope with this change in demand.

In addressing this, NHS Scotland has developed, tested and begun implementation of a neonatal nursing workload and workforce planning tool that will identify the nursing needs of this vulnerable group of babies. This tool takes into account the British Association of Perinatal Medicine (BAPM) staffing recommendations and will capture actual nursing workload on a real-time basis.