Page last updated at 00:23 GMT, Wednesday, 4 November 2009

Call to improve sick-baby units

By Nick Triggle
Health reporter, BBC News

Ann Chitan talks about the roller coaster ride of having a baby in specialist care

New standards for the care of sick babies have been published in an attempt to improve services in England.

Specialist baby care was heavily criticised by the National Audit Office two years ago.

Ministers have now responded by demanding one-on-one nursing care for the most ill babies as well as better transport services between hospitals.

But campaigners and doctors have voiced their concerns, because there is no new money for the service.

Nearly 70,000 babies a year are treated in neonatal units - the equivalent to one in 10 births.

Demand has been increasing - up 9% in the past three years - as there are more older women having children, multiple births due to fertility treatment and premature babies surviving birth, all of which are more likely to lead to complications.

To cope, the 180 neonatal units have organised themselves into 23 regional networks.

Level one - Known as special care baby units, these are the least intensive and most common type of neonatal care. Their work normally involves monitoring breathing and heart rate. Recommended staffing ratio is four babies to one nurse
Level two - Babies are admitted into high dependency units if they weigh less than 1,000g (2lbs 3oz). These children will usually require help breathing and there should be one nurse for every two babies
Level three - Only the most severely ill babies end up in these intensive care units. They are highly specialised with babies requiring ventilation and constant care to keep them alive. Staffing ratio should be one-on-one

This has allowed health chiefs to concentrate the most difficult treatment - intensive care - in about 50 main centres.

But the National Audit Office said babies were still suffering because of staffing shortfalls.

The Department of Health has now recommended one-to-one nursing in intensive care, one-to-two in high dependency units and one-to-four in special care.

Most special care units will already be achieving this standards, but for intensive care only about a quarter currently are.

There also need to be better transport arrangements, the government said.

All hospitals have dedicated transfer teams, but only half of these are operational 24 hours a day.

The government said it wants to see every unit achieve this standard.

Health Minister Anne Keen said she hoped the standards would make a "real difference".

However, she confirmed there was no extra money to help hospitals take on more staff - another 2,700 nurses are estimated to be needed to meet the staffing ratio in the UK - although she pointed out the NHS budget had been increasing in recent years.

Investment fears

A spokeswoman for Bliss, the premature baby charity, said: "We are concerned that, with the lack of upfront investment, this could be another wasted opportunity to deliver the care that vulnerable babies desperately need."

And the Royal College of Paediatrics and Child Health said resources needed to be made available to ensure standards were met.

Professor David Field of the British Association of Perinatal Medicine admitted money was a concern, but he added: "It does at least give us something with which to go to managers and put the case for services.

"It is the first time we have had a written set of standards."

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