Neonatal care levels criteria: framework for practice

2. Purpose

The purpose of this document is to describe a clear service delivery framework across NHS Scotland for:

• The management of babies who require Intensive Care, High Dependency Care or Special Care.
• The safe and efficient transfer of babies to the most appropriate care facilities for their clinical requirements.
• The safe and effective repatriation of babies to the appropriate care facility nearest to home as soon as clinically appropriate.

To provide neonatal care in this manner requires a nationally agreed approach supported by Health Boards who are responsible for the delivery of services in their respective areas. Neonatal services are closely integrated with maternity services and as such the engagement of maternity and obstetric services in aligned perinatal pathways is pivotal to delivering this model of neonatal care. Staff providing neonatal care across NHS Scotland must be aware of the criteria that define each level of care, and the locations where each level of care can be provided, so as to ensure the right care can be delivered at the right time at a location as close to home as possible for each baby.

It is anticipated that all units will implement these criteria and pathways. However some flexibility may be needed for units who wish to further restrict their unit criteria thresholds. Examples of this are: a unit which has been designated as a Special Care Unit (SCU) may wish to provide care for babies > 34 weeks of gestation rather than 32 weeks. A Local Neonatal Unit (LNU) may wish to have a ceiling of care criteria of 28 weeks rather than 27 weeks. The need for this flexibility may be due to demographics, staff expertise and/or facilities available.

Whilst this document provides a brief summary of staffing and services required by neonatal services, current guidance and existing publications from national bodies should be referred to for specific detail. The remit of this document is not to describe individual unit specifications.