Neonatal Care in Scotland: A Quality Framework

2.0 Neonatal Care in Scotland: A Quality Framework

The neonatal staff of NHSScotland are committed to delivering a high quality service.

This framework identifies quality dimensions which have been shown to deliver high quality in healthcare. It highlights the journey an existing service will need to travel to ensure a sustainable high quality service. This journey requires the commitment of staff to make a positive difference and the support of stakeholders to achieve the best possible outcomes.

2.1 Person-centred

Neonatal units in Scotland are committed to providing a high-quality service that focuses on the needs of the baby^[2] and family by responding to the families' cultural and religious preferences, needs and values.

This commitment will be demonstrated through ensuring quality of communication; involvement in decision-making and planning of care; ensuring treatment with dignity and respect; access to professional support; and in the level of facilities available.

2.2 Safe

Public assurance regarding the quality and safety of care will be supported through a robust governance structure which is focused on the safety of patients. The service will monitor and act upon data and information gathered from quality outcome measures, clinical outcomes and other audit methodologies. This will demonstrate a culture of continuous service improvement and sustainability. This care will be underpinned by child protection policies and recommendations of patient safety initiatives.

A high quality service will provide care in line with approved patient pathways; ensuring staff with the appropriate skills are available; treating babies in units with facilities appropriate to their needs; undertaking regular audit of practice and ensuring staff have appropriate training.

2.3 Efficient

A high quality neonatal service in Scotland will provide an efficient service which maximises the resource available to patient care through the avoidance of waste and reducing duplication. This will be demonstrated by regional collaboration to develop service models which maximise the use of available clinical expertise; and supporting units to provide an appropriate level of care. The use of telehealth and e-health solutions wherever possible will also contribute to the improvement of efficiency.

2.4 Effective

A high quality service with an effective governance structure will demonstrate the use of quality indicators to monitor and improve outcomes and will produce an annual report evidencing the planning and delivery of continuous improvement in the service for each regional MCN. This will include information from each unit; the collection and management of data and appropriate leadership and management arrangements the development, implementation and regular review of evidence-based guidelines and quality indicators; benchmarking activity to compare the efficacy of the Scottish service with others; contribution to research work and access to appropriate developmental care. This will be supported by active engagement with staff at all levels.

2.5 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.

2.6 Timely

Neonates will be cared for in the right place, at the right time and by the right people with the right skills.

A high quality neonatal service will demonstrate timely provision of clinical care, minimised delays in emergency transfer and access to care; effective deployment of teams for planned transfers; a sustainable transport infrastructure to support the service and effective and timely communication with obstetric staff.