Neonatal care levels criteria: framework for practice

9. Managing Capacity

Effective management of capacity and patient flow underpins the model of care described in this document and is the collaborative responsibility of all services. Health Boards must ensure they plan sufficient capacity (a composite of physical cots and available staff to provide care at the recommended ratios) to deliver the appropriate service for their booked maternity population and anticipated referrals detailed within this framework.

All units across NHS Scotland should follow agreed guidance to determine cot availability and national processes for sharing that information to facilitate coordination of transfers (currently in development through work Healthcare Improvement Scotland is undertaking to improve workload and workforce planning as part of the the healthcare staffing programme).

• Each unit will ensure they have sufficient capacity to deliver the appropriate service for their booked maternity population.
• Unit capacity must be planned in co-ordination with Maternity and Fetal Medicine services.
• Maternal bed capacity management must consider and plan for the need to accommodate high risk women transferred antenatally who may require care for a period of time, as well as additional postnatal bed capacity.
• Capacity planning should take account of:
  • Cot availability for each level of care provided at the unit
  • Anticipated transfers both in-utero and ex-utero based on agreed pathways of care
  • Anticipated discharges from the unit
  • Pathways for patient flow including efficient use of Transitional Care Services and supported discharge facilitated by Neonatal Community Outreach
  • National and regional activity and demographics.