Scotland introduces new intensive care model for neonatal services | Nursing Times

Under plans announced this week by the Scottish Government, three neonatal units have been remodelled as specialist neonatal intensive care units (NICUs) and will be based in Aberdeen, Edinburgh and Glasgow.

In Scotland there are approximately 50,000 births per year, of which 5,000 babies are admitted to neonatal care.

While most of these babies require care which can be delivered in local neonatal and postnatal wards, some need access to specialist treatment which, under the latest plans, will be delivered under the new NICUs.

“This new model is designed to help staff deliver the safest and most effective care for babies across Scotland who need intensive and specialist support”

Katy Ruggeri

A new model of neonatal intensive care in Scotland was first proposed in The Best First Start Report, which set out a vision for the planning and delivery of maternity and neonatal services in the country.

The report argued that the most pre-term and sickest babies should receive specialist complex care in a smaller number of designated NICUs, which would improve health outcomes.

As such, it proposed that Scotland should retain its current neonatal units, but remodel some of them to provide more specialist care.

The report said: “It is proposed that the current total number of 15 neonatal units is retained, with three to five units being re-profiled as neonatal intensive care units and the remaining 10-12 units being designated as local neonatal units or special care units.”

Under the plans announced this week, babies born at less than 27 weeks, lighter than 800 grams or who need complex life support will now receive care at the specialist NICUs at Aberdeen Maternity Unit, Edinburgh Royal Infirmary and Queen Elizabeth University Hospital.

The Scottish Government’s women’s health minister, Jenni Minto, said: “These three neonatal intensive care units will offer the most specialist and complex care in fewer centres for the most pre-term and sickest babies.

“Local neonatal units will continue to offer care to babies who need it, including a level of neonatal intensive care, and no neonatal units are closing as part of these plans.

“This decision has been made in line with advice from expert clinicians.”

Responding to the announcement, Katy Ruggeri, associate midwifery director at NHS Lothian, which runs the Royal Infirmary in Edinburgh, told Nursing Times that the health board was “committed to providing the highest standard of care for pre-term and unwell babies and their families”.

She said: “This new model is designed to help staff deliver the safest and most effective care for babies across Scotland who need intensive and specialist support.

“We continue to work closely with colleagues and partners to provide the best quality care for these families.”

In addition, Mandy Meechan, chief nurse at NHS Greater Glasgow and Clyde, which manages the Queen Elizabeth University Hospital, told Nursing Times: “This new model of neonatal care has been an inclusion in the Best Start plan since it was established, and it’s recognised that by focusing care for these babies in a smaller number of neonatal units, outcomes overall can be improved.

“The model’s success also leans on the networked approach that we’ll be taking with hospitals across the region.”

“Our collaboration with them is paramount to delivering the best outcome for babies and their families across Scotland.”

Meanwhile, Colin Poolman, director of the Royal College of Nursing in Scotland, told Nursing Times that nurse staffing remained “an ongoing challenge” in neonatal units in the country.

He said: “This new model must therefore ensure that staffing in the three specialist units meets the nationally agreed standards for levels of nursing staffing in neonatal intensive care.

“It is vital that appropriate numbers of qualified specialist nursing staff are trained and retained in these new high-volume units, to meet the national standards and the requirements of Scotland’s safe staffing act.”

Mr Poolman said that, under the new plans, local neonatal units would “continue to offer care to babies who need it”.

He therefore argued that there “must be a commitment to maintaining and developing the knowledge and skills of nursing staff working in neonatal units” and providing appropriate career progression for staff within their local area.