Neonatal Care in Scotland: A Quality Framework

3.5 Equitable

A high quality neonatal service within Scotland will provide equity of access and equity of care through the development of three regional Managed Clinical Networks (MCNs). Care will be provided to all groups of the population, taking account of all protected characteristic groups covered by the Equality Act 2010.

The Scottish Neonatal MCNs will support an equitable service through service agreements which ensure appropriate care can be accessed by all babies who require it; cross-boundary working between regions to ensure optimal patient care; equitable provision of support to parents and appropriate transfer and transport of babies.

3.5.1 Managed Clinical Networks

The development of three regional Managed Clinical Networks (MCNs) for the South and East, North and West of Scotland will support the delivery of a high quality neonatal service.

This will be evidenced by:

• The work of each MCN complying with the core principles for MCNs as laid out in HDL (2007) 21^[11] and subsequent Scottish Government guidance.
• Cross-boundary working where appropriate for each MCN to ensure collaboration between Board areas, which will help to sustain the service.
• An agreed governance framework including network structure, accountability, reporting and performance management arrangements to support equity of service.
• The provision of an annual meeting for all network members and development of action plans incorporating outcomes of this meeting.
• The publication of an annual report covering, as a minimum, neonatal activity for the network's population, monitoring of quality markers and progress with addressing any concerns identified.
• The provision of robust quality data to compare outcomes across units and inter-regionally, in order to ensure the quality of care provided is equitable.

3.5.2 Service Agreements

Service agreements will support the delivery of a high quality neonatal service for units that do not provide intensive care or other specialist services.

This will be evidenced by the provision of access to:

• Neonatal surgery, including details of the process for follow-up.
• Units providing care at a higher level of acuity.
• Cots when local unit(s) have reached capacity.

3.5.3 Cross-regional Working

A high quality neonatal service will be supported through facilitation of work across the regions by the MCNs. This will improve equity of care by ensuring support services are readily accessible for advice, information and review.

This will be evidenced by the provision of access to:

• Clinical genetics
• Dermatology/vascular lesions
• Endocrinology
• Laboratory services
• Neurophysiology
• Ophthalmology
• Paediatric cardiology
• Paediatric ear, nose and throat
• Paediatric gastroenterology
• Paediatric nephrology
• Paediatric neurosurgery/neurology
• Paediatric orthopaedics
• Radiology

3.5.4 Transfer and Transport

A high quality neonatal service will ensure stakeholders (including clinical personnel from network units, the ambulance service, parents and commissioners of specialist and national services) will have input into the planning, development and monitoring of the transport service to ensure equitable access to and quality of services throughout Scotland.

This will be evidenced by:

• The provision of a single point of telephone contact through a dedicated line on which cot/maternal bed availability and the transfer service can be accessed and activated at all times.
• Participation in regular joint service reviews with transport leads to reduce delays in transfers, adverse incidents and address capacity issues. Any changes in service delivery/new service developments will be discussed and taken forward demonstrating a collaborative approach and engagement with all key stakeholders.