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We plan to look at services provided for newborn babies that need extra care, exploring variation in the management of care and how it's handed over between services.
Neonatal services are services for newborn babies who need extra care – for example, because they are born prematurely or need treatment in hospital after birth. Where services are provided depends on what treatment is needed. This can include neonatal intensive care units (NICU) and special care baby units (SCBU).
What the review will look at
As part of the review, we’ll look at about 20 services across England.
We'll explore variation and consistency in the management and handover of care between services.
We'll look at how well fetal medicine, obstetrics, neonatal and community services work together to care for newborn babies with declining health problems, particularly those with hypertension (high blood pressure) and tracheostomies.
The project will:
- Review how suspected fetal abnormalities are handed over between obstetric and neonatal services.
- Review current practice in the management of care of newborn infants whose health is deteriorating, with particular focus on the diagnosis and management of hypertension.
- Review current practice in the management of care of high-risk infants in the community, with particular focus on the management of respiratory support technologies (including tracheostomies).
- Identify and describe good practice in the above areas and understand how barriers to implementing good practice guidance have been overcome.
- Feed into the continuous improvement of our regulatory model and specifically our assessment of safety in services that provide the above areas of care.
- Make key recommendations for action by providers and commissioners to monitor and improve the quality of care in the above areas and to ensure effective learning is shared and sustained.
What we aim to achieve
We aim to identify what care is delivered, what variations exist and what good looks like in the areas of clinical practice and the care we are looking at.
As we will not be rating these services, we don't expect the review to give us a national picture of the quality of care. However, we hope that it will lead to the development of clinical guidelines where they're needed, so that there is consistency in care across England.
How we plan to carry out this work
We'll look at these services in the course of carrying out our comprehensive inspections.
Our inspectors will collect policies and trust guidance documents and verify these using case note reviews and interviews with staff and families.
Expert advisory group
An expert advisory group will provide support throughout the review. It is made up of clinicians put forward by various professional bodies. These include:
- National Institute of Health and Care Excellence
- British Association of Perinatal Medicine
- Royal College of Obstetrics and Gynaecology
- Royal College of Paediatrics and Child Health
- Royal College of Nursing
How we will report our findings
When the work is complete, we will publish a report describing our key findings.
The report will set out:
- Barriers to good-quality care.
- If required, recommendations about clinical areas that may benefit from additional clinical guidance or best practice guidelines.
- Good practice examples that others can learn from.
- How we will improve the way we inspect services that provide obstetric, neonatal and paediatric care.
We expect to publish our findings later this summer (2016).
This review draws on the experiences of the Dixon family. Elizabeth Dixon died in 2001 as a result of failures in the tracheostomy care she received at home, while under the care of a newly qualified agency nurse.
- Last updated:
- 21 April 2016