A baby boom, advances in medicine and tight NHS budgets are putting increasing pressures on neonatal services across the region. Health Correspondent Alison Dayani looks at how specialists are coping with rising demand and why they are developing larger, regional specialised centres over treatment closer to home.
Life-saving baby services across the region are short of at least 50 cots due to funding shortfalls and desperately need at least £2million of extra cash, according to the chief of neonatal services for the region.
Although cases of premature babies being taken on 70-mile ambulance journeys to reach an intensive care cot are decreasing, there are still too many, says Dr Alison Bedford-Russell, clinical lead for South West Midlands Newborn Network.
Dr Bedford-Russell is working with what she can to make sure the youngest and sickest babies have the best chance of life and has led an overhaul of the system, categorising neonatal units so that only certain hospitals focus on the most critical care – but the by-product of that does mean extra travel for many parents.
The South West Midlands Network is in charge of transferring and choosing which hospital across Birmingham, the Black Country, Worcestershire and Hereford a newborn should go to, according to how ill they are.
Hospitals are now graded from the less specialised, more routine services of level one (special care) to level two (high dependency) and the most specialised care of level three (intensive care), with the majority of hospitals at the lower levels.
“The level three units, where newborns are at most serious risk and need specialist intensive care, needs expertise in how to treat such small babies. The only ones in Birmingham are at Heartlands and the Women’s Hospital, where the teams get used to dealing with very ill babies.
“Because they have more of those cases coming in, the doctors get more expertise, which in turn improves the survival rate.
“A parent from Sandwell may want their baby at Sandwell Hospital but by travelling further to somewhere like the Women’s Hospital in Edgbaston, their baby will get a higher quality of care that could save their life.
“There used to be small neonatal units looking after very sick premature babies once every other month. Would you want to go to somewhere where staff are not used to dealing with it or somewhere where they deal with several critically ill babies every day?
“Sometimes babies do have to go out of the network to other hospitals further away when there are no suitable specialist cots available. It’s happening less frequently that it once was, but unfortunately it still does happen.”
That problem affected new mother Nicki-Leigh Johal in October when her baby daughter Bethany was transferred to Stoke City General Hospital from her local hospital, City Hospital, in Winson Green, due to a shortage of high dependency neonatal beds across Birmingham and the south of the Midlands.
It meant mother-of-two Ms Johal, from Smethwick, who does not drive, had to worry about making a 92-mile round trip to see her daughter at the most dangerous point in the baby’s life.
But Dr Bedford-Russell, based at Heartlands Hospital, is optimistic that these “unfortunate” cases are now the exception.
She is also pleased that the new system has helped to bring down mortality rates for stillborn and babies in their first 28 days of life, especially as the South West Midlands was shamed with the highest number of these deaths and top of the mortality league for 2005/06.
“The South West Midlands had to transfer 115 babies out of the region in 2004/05 but only 23 babies over 2007/08,” added the doctor.
“We are also no longer at the top of the mortality table, but we still have a lot of work to do to make sure each baby gets the level of care they need.”
“The rise in pregnancy rates and babies who would have died at 23 weeks or those with abnormalities and infections can now get help to survive, but all this is a strain on the NHS,” she warned.
“Making different levels of services was the only way of going forward. It wasn’t just about funding, it was about organising the care pathway better.
“There still needs to be expansions at the Women’s and Heartlands hospitals neonatal units. There has been some increase in cot numbers, but not as much as we would have liked.
“Across the network, we need 20 extra intensive care cots plus 30 more special care cots, so 50 overall. That would mean when there is a sick baby, there is always a cot available. At the moment, we still have to turn babies away when we get in trouble.
“These expansions and more staffing would need at least £2?million more than we get. We have to apply every year for more funding and see if the government has any extra grants, but if we organise care better, we are spending a small amount of funding in a better way.”