- NHS hospital
Leeds General Infirmary
Report from 10 September 2024 assessment
Contents
Ratings - Neonatal services
Our view of the service
We carried out an assessment including onsite inspection of neonatal services at Leeds General Infirmary, Leeds on 14, 15, and 16 January 2025. The service provided neonatal services along with transitional care. It was a tertiary unit and therefore provided care for babies born pre-term and with complex needs from across the region. The service worked closely with the neonatal service provision at Leeds General Infirmary and was overseen through the same management structure. The outreach team, family integrated care team and allied health professionals worked across sites.
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The assessment and inspection took place in response to a range of concerns identified through review of a serious incident.
The service was in breach of regulations relating to managing risk, staffing, safe environments, infection prevention and control and medicines management.
The neonatal unit (NNU) provides intensive care (ICU), high dependency care (HDU) and specialist surgical care to babies born at all gestational ages. There were 14 ICU cots, 6 HDU and 4 Surgical cots. All were occupied at the time of the inspection. There were an additional 6 transitional care beds situated on the postnatal ward. Neonatal nurses and midwifery staff provided care for these babies and midwives provided any care required for the mothers.
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Whilst we found that staffing numbers were managed accordingly, there was not always the correct skill mix or numbers of qualified staff to care for babies with very complex needs. We observed staff taking calls from the regional neonatal network to accept more babies than the unit could safely manage. Staff told us this was a regular occurrence and that they felt very pressured to take babies even when they explained to callers there was no capacity. Staff said it was very common for repeated calls until staff agreed to accept these babies. We also observed discussions about babies that were later transferred to the special care baby unit at St James University Hospital when they did not meet the correct criteria for safe care on that unit. Therefore, there was a risk of harm to babies with complex needs. There was often pressure from the regional neonatal network to accept more babies than the unit could safely manage. Therefore, some babies were transferred to the special care baby unit at St James University Hospital when they did not meet the correct criteria for safe care on that unit. Therefore, there was a risk of harm to babies with complex needs.
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We raised these concerns with the trust through a letter of intent to take further action regarding the St James University Hospital Neonatal service provision. The trust provided details of immediate changes to mitigate these risks along with action plans to ensure future safe care provision, which was accepted.
People's experience of this service
We spoke with 3 parents and family members of babies on the neonatal unit. Those we spoke to during the inspection felt they had been involved in the care of their baby or babies, had information provided to them and were aware of care plans going forwards. We heard examples from the outreach and family integrated care teams of ways that care was tailored to meet individual needs in the community.
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However, we heard from allied health professional staff there were challenges in providing enough care to all babies because of significant staffing shortfalls against the recommended requirements for the neonatal service.
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