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19.10.15

Severe clinical shortages risking babies’ lives and mothers’ mental health

Overstretched and pressured neonatal services in England mean thousands more nurses and doctors are urgently needed to ensure the safety of premature or sick babies, the charity Bliss has said.

Its report published today (19 October) found a severe shortage of neonatal nurses and doctors, which is keeping units from meeting national standards of safe staffing levels for premature and sick babies.

More than 2,000 nurses are needed to meet these standards and give babies the best chance of survival. Currently, 64% of units do not have enough nurses and two-thirds lack enough doctors.

These shortages are largely due to a severe lack of funding accounting for three-fifths of units falling short of needed nurses and half of units not having enough doctors. Training and development opportunities are also limited, with 72% of units claiming they struggle with this.

Despite national standards recommending that units cannot safely run at higher than 80% occupancy on average, over two-thirds of neonatal intensive care units are consistently going over this limit.

And at nearly half of units, parents do not have access to a trained mental health worker despite being at a far greater risk of postnatal depression compared to parents of healthy babies. One-third of units were also not able to provide overnight accommodation for parents of critically ill babies.

The charity’s chief executive, Caroline Davey, said: “This must be a wake-up call for policy-makers and healthcare commissioners to take action.

“This unprecedented shortage is putting babies’ safety, survival and long-term development at risk. If serious investment is not made, services will be facing a crisis in years to come. It needs to be addressed as a matter of urgency, so that every baby has the best possible chance of survival and of having a full and healthy life.”

Bliss recommended that the government and NHS England invest in neonatal care to make sure hospitals can recruit the nurses, medical staff, mental health workers and other professionals they desperately need. Plans must also be developed and put in place to address skills shortages.

It also recommended that trusts ensure parents are always offered free accommodation and meal vouchers to ease the financial strain of travelling and helping them stay close to their baby.

Responding to these calls, an NHS England spokesman said the standards of national neonatal care were on par with other European countries despite increasing demand.

He continued: “We will consider the recommendations of the report and continue to work closely with Bliss and others to improve neonatal services, ensuring every premature or sick baby receives the best possible care.

“NHS England’s quality surveillance team is developing specific plans to undertake a comprehensive round of peer-review visits of all neonatal services.”

Long-term and urgent investment needed

A spokeswoman from the Royal College of Obstetricians and Gynaecologists said the findings were extremely concerning and provided further evidence that pressure on these services is growing.

“Stretched and understaffed services affect the quality and safety of care provided to both mothers and babies. Patient care and safety underpin everything we do and long-term investment is needed to ensure healthcare professionals can deliver a high-quality service to all of their patients,” she said.

And Fiona Smith, professional lead for children and young people’s nursing at the Royal College of Nursing, said these shortages are especially stark considering major progress has been made in recent years in the treatment of very premature babies.

She said: “It takes a great deal of expertise, experience and training to care for premature babies, so a shortage of the right staff can have a profound effect.

“That the care of very tiny, vulnerable babies could be jeopardised by hard-pressed staff being pushed beyond their limits should be a matter of great concern for the NHS. The NHS, government and local managers must work together to find an urgent solution, ensuring that we are training and employing enough skilled staff to do this vital work.”

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