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Services for Wales’s sickest babies under pressure

Neonatal services in Wales are overstretched and under incredible pressure, putting the safety of the sickest babies at risk. Findings of new research published today in the Bliss baby report 2016: time for change, show that there is a severe shortage of neonatal nurses and doctors, meaning units are not able to meet national standards on safety and quality of care for premature and sick babies (1).
 
The report is being launched today at an event in the Welsh Assembly for AMs, clinicians, policymakers and families.
 
Key findings
·         Only two out of ten neonatal units had enough nurses to staff all of their cots in line with national safety and quality standards. This is due to a combination of insufficient investment in neonatal nurse posts and a shortage of children’s nurses across Wales.
·         Only two out of 11 neonatal units were funded to have enough nurses with a specialist qualification in neonatal care. All neonatal units identified difficulties with at least one aspect of nurse training and development.
·         Over half of units did not have enough medical staff to meet national standards, with shortages often present across all levels of seniority, posing a particular risk to units being able to provide a safe level of care.
·         None of Wales’ neonatal intensive care units, which provide the most specialist care to the sickest babies, have enough overnight accommodation for parents to meet national standards, leaving many unable to stay close to their critically ill baby. It is vital that parents are able to stay close to their baby as research shows that when parents are involved in their baby’s care it significantly improves their development and recovery.
·         At over half of units parents have no access to any psychological support.
 
The report, published by Bliss, the premature and sick baby charity, makes the following recommendations:
 
·         The Welsh Government and Health Boards must ensure that national standards for neonatal services are met
·         In order to meet these standards and give babies the best chance of survival and improved long term health, investment in staffing is desperately needed
·        The Welsh Government must fund more nurse training places in child health and provide much needed leadership to address the critical medical workforce challenges facing neonatal services in Wales.
 
Caroline Davey, Chief Executive of Bliss, said: “It is clear that neonatal services in Wales are under extreme pressure, and staff are being spread too thin. Without urgent action, the gap between the standards required and the care provided will widen even further. Whilst there has been some welcome progress in the development of neonatal services in Wales in recent years, it is clear that units are still struggling to meet standards due to shortages of staff and barriers to training. 
 
“Bliss’ new findings serve as a stark warning to the Welsh Government and Health Boards that they must provide additional investment to ensure that national standards for neonatal services are met. This investment must be made urgently to avoid neonatal services in Wales reaching breaking point, and to give premature and sick babies the best possible chance of survival and quality of life.”
 
Responding to the Bliss Baby Report, Dr Mair Parry, Officer for Wales for the Royal College of Paediatrics and Child Health (RCPCH), said:
 
“The NHS as a whole is coming under increasing amounts of pressure due to worsening staff shortages, chronic underfunding and fragmented services. From our own research, we know that gaps and vacancies on rotas remain high and paediatricians are concerned at the ability of services to cope. So this, coupled with the findings from today’s report, is great cause for concern.
 
“Babies in neonatal units are extremely vulnerable - they need and deserve the highest level of care. To do this, all neonatal units must meet the required service standards. This is only possible if they have adequate staffing levels allowing them to cope with the demand placed upon them. Therefore, we fully support all the recommendations made within Bliss’ report and urge Welsh Government to act now and protect these vulnerable babies.”
 
·         Bliss spokespeople are available for comment / interview from Wednesday 6 July.
 
 
Mum in Aberdare with experience of neonatal services: April Davies lives in Aberdare and is available for further interview/comment:
 
·         Gave birth to twins at 27 weeks (Isaac and Jacob) on 17 March 2015, after a month in hospital after waters broke at 23 weeks
 
·         They had severe under-developed lungs, haemorrage, infection, difficulty maintaining blood sugar levels and other health issues (see further info below)
 
·         After 3 months in NICU they were moved to Merthyr (local hospital) SCBU
 
·         Now both doing well, if with some minor health issues to overcome.
 
·         Really positive experience of staffing and support from nurses.
 
·         Biggest challenge for her was the complete lack of psychological support. Leant on nurses, but there were no dedicated professionals she was referred to.
 
·         She adds: I have 4 other children, who were without me throughout and were not able to go into NICU, and although nurses give suggestions around taking lots of photos, and children sending photos in of them for incubator, there was no one for them or my husband to talk to, and has such an effect on whole of family.
 
·         I myself have needed a lot of support psychologically and have been diagnosed with post traumatic stress disorder, and now receive counselling. I cannot praise the staff enough, but an expert in this area to refer to or someone to just sit  and talk to at the unit, would be very beneficial I'm sure for many families.
 
NB: April is also taking part in a Bliss Little Heroes fundraising walk/buggy push event @ Cyfartha Park, Merthyr Tydfil on 24 July, starting at 1100.