- NHS hospital
St James's University Hospital
Report from 18 October 2024 assessment
Contents
Ratings - Neonatal services
Our view of the service
We carried out an assessment including onsite inspection of neonatal services at St. James Hospital, Leeds on 14, 15 and 16 January 2025. The neonatal service provision at St James Hospital included a special care baby unit, transitional care unit, neonatal outreach team and family integrated care team. There was also dedicated allied healthcare professional provision. 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.
The assessment and inspection took place in response to concerns regarding systems and processes within the neonatal service.
The service was in breach of regulations relating to managing risk, staffing, safe environments, infection prevention and control and medicines management.
The unit was a designated special care baby unit providing level 3 care for level 1 babies. There is a nationally recognised criteria for special care baby units. During inspection we found that there were a number of occasions when babies required level 2 care, for example, high dependency care requiring admission into a level 2 unit. We found that the unit staffing levels were managed to support these babies needs, for example where 1:1 or 1:2 care was needed this would be provided by appropriately skilled staff. However, this meant that sometimes babies had to be moved around the unit to ensure the right skill mix was available in each bay area.
Whilst we found that staffing was managed accordingly, we found that the equipment provision on the unit did not meet the requirements for high dependency or intensive care and therefore, there was a risk of harm to babies placed on this unit requiring care above the level of a special care baby unit.
We raised this concern with the trust through a letter of intent to take further action. 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 4 parents and carers of babies on the neonatal unit and 2 parents on the transitional care unit. Those we spoke to during the inspection felt they had been involved in the care of their baby, 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.
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.