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Neonatal Services for the Isle of Wight
12 September 2018

A review by NHS England showed that the Local Neonatal Unit (LNU) at St. Mary’s Hospital has the lowest number of babies anywhere in England.   There are around 1,100 births a year on the Isle of Wight.  The LNU cared for 98 babies in 2017 and 92 of these were born after 32 weeks gestation.  Generally babies born after 32 weeks will be cared for in a Special Care Unit (SCU) rather than a LNU.   Babies may be transferred from the Island to a mainland unit for specialist treatment but can return to the Island as their health improves for ongoing care before discharge home.

The Neonatal service on the Island has a dedicated team of staff. But, with a very low number of babies being cared for, it is difficult to ensure the team gets enough experience of caring for babies who need short term intensive care.  Last year the unit looked after just 10 babies who needed this kind of care.  The advice of expert doctors from the British Association of Perinatal Medicine is that staff need a regular caseload of babies to ensure they maintain their skills and expertise.

Dr Barbara Stuttle CBE, Director of Nursing, Midwifery, Allied Health Professionals & Community Services said: “We recognise the difficulties presented by travel across the Solent for patients and their relatives.    The number of families affected by this move from a Local Neonatal Unit to Special Care Unit is small but we believe that this provides the best level of expertise and safe care for babies who require specialist support. Improved networking between the neonatal services on the mainland and the Island will help to ensure that where a babies health improves and a lower level of care is required they are returned to the Island at the earliest opportunity.”

Neonatal services are planned by NHS England based on local needs. The service is very specialised and, thankfully because only small numbers of babies need this kind of treatment, the service is provided through a network of hospitals with doctors and nurses working together across the Isle of Wight, Hampshire, the Thames Valley and Dorset.  NHS England has been undertaking a national review of all Neonatal Units following recommendations in Better Births, A Five Year Forward View of Maternity Services.  The research into the health needs of the local population shows a gradual fall in births.

There are three levels of care for babies in need of extra support, as follows:

  • Level 3: Neonatal Intensive Care Unit (NICU)) is for the smallest, sickest babies with complex needs or who are at less than 27 weeks gestation
  • Level 2: Local neonatal unit (LNU) is for babies needing short term intensive care. Generally those born after 27 weeks gestation
  • Level 1: Special Care Unit (SCU) for babies who need continuous monitoring of their breathing or heart rate, treatment for jaundice and convalescence from other care. Generally those born after 32 weeks

There are a variety of schemes in place – Healthcare Travel Costs, reduced fares provided by the cross Solent operators and support from charities on the Island – to help with travel costs.  However not everyone will qualify for support.  There are many places in the UK where patients and their relatives have to travel for specialist treatment because expertise needs to be concentrated so that NHS specialists see sufficient patients to maintain their skills, maintain safety and quality and ensure the best possible use of resources.  

 

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