This morning has been full of action. I dropped little 'un off at nursery - a 42 mile round trip! Then I drove to Leicester's Royal Infirmary to meet with the Neonatal unit's lead consultant. We started with an informal chat about what I was doing for Bliss before getting into the nitty-gritty of the current situation faced by Leicester and other hospitals in the midst of the budget cuts to public services, including the NHS.
The unit at the Leicester Royal is in quite a fortunate position having recently opened a new unit, which is currently offering the same cot capacity but has the capability to offer more. As with everything it comes down to money. The new cots are for the most part already in place in a room full of impressive high tech medical equipment, but at present they do not have enough nurses to staff it. This would require extra funding, which at present is hard to come by. My consultant contact admitted that like the majority of hospitals in the country, they do not meet the recommended nurse to baby ratios that The NHS and Department of Health decided on in their 2003 report: Toolkit for High Quality Neonatal Services.
Even if extra funding were to become available, there is a national shortage of qualified Neonatal nurses. It takes approximately 5 years to become fully qualified in neonatal care which means that there is no quick fix to hiring new or even replacing old staff. In the past hospitals have run recruitment drives oversees, and indeed Leicester Royal benefited from recruiting a number of excellent nurses from the Philippines and would ideally look to do this again if they manage to secure the funding to staff the extra rooms that are sat waiting. However, hospitals face extra pressures due to the new immigration caps that the Coalition Government agreed at the end of last year. Having been set at 21,700 skilled workers, this represents a cut of 6,300 on the equivalent figure for 2009
Source: BBC. This is a real threat to the future staffing levels within neonatal care and it is difficult to see what can be done about it. That is why charities such as Bliss (see link below) are so important in raising the profile of the needs of sick and premature babies and acting as a pressure group of sorts to persuade the government to honour commitments already made.
Currently the country's hospitals are run on a network system, which means that should you give birth to a baby who needs to be transferred, there will be a network of hospitals within a geographical area that have formal lines of communication. Practically, for me this meant that when I gave birth at the George Eliot (who do not have full intensive care facilities) I stood a very good chance of being transferred to a hospital within the network. Indeed my baby was transferred to Northampton, which although 39 miles from my home, was far preferable to being transferred out of the Midlands altogether.
Leicester's Head Consultant confirmed that this system works very well and it would be unthinkable to return to the days pre-2003 where nurses could spend hours phoning around the country's hospital's hoping to get lucky in finding a spare cot. That still happens as capacity within every hospital is a major issue, but it occurs much less than it used to.
There were other issues that we discussed, such as in-unit provision of other necessary medical personnel, for instance specialist dietitians, physiotherapists and pharmacists - as well as parent accommodation. But I'll deal with these on another occasion, after all, I have gladly committed to at least of year of Bliss campaigning. My career as a volunteer activist is only just beginning, and there is a long road ahead for the whole campaign team in securing from politicians what sick and premature babies desperately need. It's not simply about maintaining current agreements and budgets, but arguing the case for better provision all around in every aspect of neonatal care. That will of course take extra money that can't be given to other worthy public services, but every cause must argue its case in the dog-eat-dog climate of budgetary slashing. The politicians argue that funding is still actually rising for the NHS, but the reality is that front line jobs are in danger (
Guardian data) and the estimated loss to nursing and other front line non-admin staff is worrying indeed.
Back to my visit, I was extremely impressed with what I saw at the Leicester Royal. Once I had gotten over the personal shock of hearing those darned monitors again, and of course seeing the incubated babies that were as tiny as my Charlotte had been, I was able to appreciate how the hospital has done its utmost to make the babies and parents as comfortable as possible - extremely important at such a traumatic and stressful time. The staff look every bit as committed to their duties as those who looked after my baby and I back in 2009; and the unit itself is bright, clean, modern, and excellently designed from an architectural point of view. They have really thought about the needs of not only the babies themselves, but of staff and parents also. The parents room is comfortable, nicely decorated and has good facilities. There are 3 large refrigerators in a designated breast milk kitchen, and the expressing room is arranged so that mothers can have privacy or chat to each other, at what many mothers will possibly agree is the most tedious part of caring for a breastfed baby who cannot yet latch on. There are also rooms for parents to sleep in, though not nearly enough for the units capacity. There are plans to build a designated hotel of sorts, but again this requires funding.
The part of the tour which really broke my heart though was seeing the quiet rooms where babies who are about to die can do so in dignity, surrounded by their parents and loved ones. My host explained to me that for him this was one of the most important aspects of the redesign. He wanted somewhere which wasn't going to add to the distress and misery for the parents at such a tragic time. He explained that there shouldn't really be curtains, but there was. That the pictures on the wall had been specially selected. That there was an en suite facility so that the parents didn't have to contend with moving away from their baby who could die at any time. They had even made the walls double thickness to block out any outside noise so that parents would not be exposed to chatting or laughter of passing staff, parents or visitors. As a parent you don't expect this level of care from the NHS, but wouldn't it be fantastic if every neonatal unit, and indeed hospital ward, were designed with such care? It doesn't take a massive amount of money to add these small details, but it means everything to the parents who have so much to contend with. But the main message of course has to be maintaining the network system and enabling adequate staffing levels, and from here we can ensure that unnecessary and avoidable risk to babies who are born too soon, too small, and too sick is stamped out.
Link:
Bliss: For baby's born too soon, too small, too sick
