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Publication - Advice and guidance

Maternity and neonatal services - neonatal intensive care plan: options appraisal

Published
25 July 2023
Directorate
Children and Families Directorate
Topic
Children and families, Health and social care
ISBN
9781805255208

This report describes the options appraisal process undertaken, and the feasibility analysis and testing to identify which out of Scotland’s current eight neonatal intensive care Units should be the final three Units as proposed by Best Start.

View supporting documents Supporting documents

Annex A - Agreed Criteria and Weighting for Options Appraisal Process

Criteria Definitions Source/Evidence Weighting
1. Co-located neonatal general surgery, including: 1. Acute provision of surgery for necrotising enterocolitis (NEC) 2. Surgical insertion of central lines 3. Repair of diaphragmatic hernia 4. Repair of oesophageal atresia and tracheo-oesophageal atresia (TOF) 5. Repair of abdominal wall defects Maximum score: Full range of neonatal surgery is performed on site. Minimum score: No neonatal surgery is performed on site. [Possible range in between based on comparative levels of neonatal surgery provided.] BAPM 25
2. Co-located paediatric medical sub specialist services, including: 1. Respiratory paediatrics and ENT airway service 2. Neurology & neurosurgery 3. Paediatric gastroenterology 4. Genetics 5. Ophthalmology 6. Paediatric critical care (intensive care and high dependency care) Maximum score: All paediatric medical sub speciality care and paediatric critical care on site. Minimum score: No paediatric medical sub specialities or paediatric critical on site. [Possible range in between based on comparative levels of services provided.] BAPM 25
3. Co-located Fetal medicine sub speciality services, providing detection and treatment of fetal malformation including: 1. Cardiac 2. CNS and/or facial 3. congenital diaphragmatic hernia 4. Abdominal wall defect 5. Twin pregnancy with complications (e.g. ultrasound identification of twin-twin transfusion 6. Fetal infection 7. Skeletal Maximum score: Full range of fetal sub speciality services available on site provided by consultants trained in subspecialist maternal and fetal medicine. Minimum score: No fetal sub speciality services on site. [Possible range in between based on comparative levels of service available and staff training.] RCOG Framework for Maternity Standards EGAMS 20
4. Co-located Maternal medicine sub speciality services, including:
  • Cardiology service with expertise in adult congenital heart disease
  • Haematology
  • Neurology and neurosurgery
  • Renal disease including renal failure and dialysis
  • Organ transplant (heart, lung, liver, kidney)
  • Genetic disorders (e.g. Marfan’s syndrome, Ehlers Danlos syndrome)
  • Adult intensive care
 Maximum score: Full range of maternity sub speciality services and adult ITU available on site provided by consultants trained in subspecialist maternal and fetal medicine Minimum score: No maternity sub speciality services or adult ITU on site. [Possible range in between based on comparative levels of maternity sub speciality services and/or adult ITU provided and staff training.] The Best Start p79 RCOG Framework for Maternity Standards MBRRACE Confidential Inquiry EGAMS 20
5. Co-located 24/7 paediatric radiology service Maximum score: 24/7 paediatric radiology service on site capable of providing full range of investigations. Minimum score: No 24/7 paediatric radiology service on site. Expert group 10
Total: Max 100

Contact

Email: thebeststart@gov.scot

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