Improving maternity and neonatal care

Three specialist intensive care neonatal units for babies born at highest risk will be based in Aberdeen, Edinburgh and Glasgow.

Care for babies born at less than 27 weeks,  lighter than 800 grams or who need complex life support, will be provided by Neonatal Intensive Care Units (NICU) at Aberdeen Maternity Unit, Edinburgh Royal Infirmary and Queen Elizabeth University Hospital.

The new model of neonatal intensive care was recommended by The Best Start Report and is based on evidence that care for babies at highest risk is safest in units which can treat a high volume of patients.

Neonatal units in Ninewells in Dundee, Princess Royal Maternity in Glasgow, Wishaw General, Victoria Hospital in Kirkcaldy and Crosshouse Hospital in Kilmarnock will continue as local neonatal units to provide neonatal care for their populations.  

Women’s Health Minister Jenni Minto said:

“These three Neonatal Intensive Care Units will offer the most specialist and complex care in fewer centres for the most pre-term and sickest babies. Local neonatal units will continue to offer care to babies who need it, including a level of neonatal intensive care, and no neonatal units are closing as part of these plans. This decision has been made in line with advice from expert clinicians.

“I would like to thank all of those who have worked with us to look at how we can best deliver the changes recommended by the Best Start Report and will offer increased care for those who need it most, before they are able to return to one of our other excellent local neonatal units across the country.”

Lesley Jackson, Clinical Lead for the Scottish Neonatal Network and a Consultant Neonatologist in NHS Greater Glasgow and Clyde said:

“I very much welcome this change to the provision of neonatal intensive care, which will enable clinical teams to deliver the best outcomes for the smallest and sickest babies born in Scotland. The neonatal community is committed to working collaboratively to deliver the new model of neonatal care for our patients and families.”

Caroline Lee-Davey, Bliss Chief Executive said:

“At Bliss, we believe the proposed changes have the potential to improve the quality of neonatal services in Scotland, as well as improve the care provided to babies and their families. Reconfiguring services will help to make sure that the smallest and sickest babies requiring highly specialist intensive care every year will receive the best and safest care at a unit fully equipped for their needs.

“It is crucial for parents to be by their baby’s side in hospital, playing a hands-on role as partners in care with the medical team. When babies have to be transferred further from home to receive the best care, appropriate support must be provided to enable their parents to be at their cot side as much as possible, including through the Young Patients Family Fund, which enables families to claim financial assistance to support them during their baby’s neonatal stay.”

Background

The Neonatal Intensive Care Options Appraisal Report , led by expert NHS clincians and service user representatives, summarises the approach to identify the three neonatal intensive care Units in Scotland, including the process for moving forward with implementation on a Scotland-wide basis. 

The Scottish Government accepted all 76 recommendations in The Best Start (2017), which included the establishment of a new model of neonatal intensive care, which would see the most preterm and sickest babies receive specialist complex care in fewer centres on the basis of evidence that shows improved outcomes for those babies. 

In Scotland there are approximately 50,000 births a year. Of these, approximately 5,000 babies a year are admitted to neonatal care. The vast majority require care which will continue to be delivered in local neonatal units, and on postnatal wards. 

Approximately 110-130 babies are born under 27 weeks gestation in Scotland each year, and this change will affect 50-60 of those babies a year.