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28 February 2018

Services for Northern Ireland’s smallest and sickest babies under pressure

A report is being launched today at an event at Stormont for MLAs, clinicians, policymakers and families outlining concerns that neonatal services in Northern Ireland are overstretched and under incredible pressure.

Findings of new research published today in the Bliss and Tiny Life Northern Ireland baby report 2018 show that there is a shortage of neonatal nurses and doctors, meaning units are not able to ensure the best safety standards and highest quality of care for premature and sick babies all of the time. This is leading staff to have to make difficult decisions, such as closing cots to new admissions, in an attempt to manage their activity safely when working with too few resources.

Key findings of the report are:

·Over half of neonatal units do not have enough nurses in post to meet minimum standards for providing safe, high quality care.

·55 per cent of the nursing shortfall can be attributed to inadequate funding for recruitment.

·Five out of seven neonatal units in Northern Ireland have difficulties with at least one aspect of nurse training and development. One issue raised by some units was that there are not enough staff to cover shifts to send nurses on enhanced training courses.

· Five out of seven neonatal units have no dedicated access to a mental health professional, and three neonatal units are unable to provide access to any trained mental health professional at all, including by referral to an external service.

·Four out of seven neonatal units in Northern Ireland do not have enough medical staff in post to meet minimum standards.

· Four out of six units are unable to provide accommodation for all parents of critically ill babies.

· No units in Northern Ireland have a neonatal community outreach service to support families after discharge.

The report, published by charities Bliss and TinyLife, makes the following recommendations:

· Funding must be made available to ensure all neonatal units across Northern Ireland are safe, well organised and properly staffed in order to ensure all babies born premature or sick receive the highest possible standards of care.

· Investment must be made in developing on-site facilities for families so they can be with their baby, including overnight accommodation.

·Urgent investment must be made to ensure every neonatal unit can provide families with access to psychological support.

· The Department of Health, Health and Social Care Board and the Public Health Agency must work together to produce, and commit to meeting, a Northern Ireland Neonatal Specification which includes measurable standards of care to reflect the specific needs of neonatal services in Northern Ireland.

Caroline Lee-Davey, Chief Executive of Bliss, said: “Neonatal services in Northern Ireland are facing a number of serious challenges which are severely affecting the care of the 1,800 babies born premature or sick in the country every year. We know that neonatal staff do a fantastic job on limited resources, but our findings show that investment is urgently needed to ensure that every baby born premature or sick can receive the best care.

“The Department of Health must invest in neonatal care so that neonatal units are able to recruit and properly train their staff. Without this investment, neonatal services across Northern Ireland will be facing a crisis in years to come, putting the most vulnerable babies at risk.”

Alison McNulty, Chief Executive of TInyLife, said: “As the premature baby charity for Northern Ireland which works directly with medical staff to support families of premature babies, we appreciate the difficult and challenging circumstances that staff find themselves in whilst working to maintain the best safety standards and quality of care. However, we also appreciate that this is a stressful and worrying time for families and the additional pressures that they face can have long term implications for the family. Investment is essential into a Care Pathway, from hospital to home that ensures the best outcomes for all premature babies born in Northern Ireland.”

Emma Wallace from Lisburn, mum to Caitlyn, gave birth via emergency c-section at 30 weeks gestation in 2015. Caitlyn spent a total of four weeks at two different hospitals.

Recalling her experiences, Emma said: “Nursing levels when we were in the neonatal intensive care unit (NICU) were always good but I was concerned when we were moved to the special care baby unit. Sometimes there were 8-10 babies in the room and only one nurse. I can’t fault the nurses for how hard they worked but they were very rushed off their feet and clearly needed more help.”

“I spent most of my time on the unit alone because my boyfriend, Michael, had to go back to work. At the first unit we were at only parents were allowed in so I couldn’t even have my mum with me for support. It would be much better for NICU parents if they were allowed to have their family with them so they wouldn’t be left sitting alone for ten or so hours a day. It would also help if special paternity leave could be introduced so that both parents could support each other through the most stressful time of their lives.”

“It cost a fortune to travel to the hospital every day because we lived about an hour away from both hospitals Caitlyn received care at. Eating at the hospital canteen every day for a month was expensive too and we ended up in debt due to putting off paying some bills just to pay for it all. The cost of clothes and tiny nappies also added up – we hadn’t taken into account that we’d have a baby so early or so small so weren’t financially prepared.”

“We both found our time in NICU stressful, I found it hard trying to be strong in hospital for Caitlyn making decisions on my own and Michael struggled with not being able to be there. By the time Caitlyn was discharged, I was more confident with holding such a tiny baby whereas Michael still feared that he would hurt her because she was so small (4lb 2oz when discharged). If he had been able to be at the hospital more instead of having to work then he would have had more support from NICU staff to overcome this fear.”

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