Neo natal unit transfer queries: FOI release

Information requested

1. How many babies were transferred from Neo natal units in Queen Elizabeth Universal hospital Glasgow, Simpsons Children's hospital Edinburgh due to lack of capacity in the NICU, over the last 5 years?

2. The best start report states parents were consulted. I am interested to know

• Who carried out the consultation?
• Which areas were parents from?
• How many parents were involved?
• How many had experience of their child being in Neonatal care?
• To what extent were Bliss involved in consulting with parents?

3. With regards to the Neo Natal care options appraisal,

• Who carried out consultation with parents?
• Which areas were parents from?
• How many parents were involved?
• What was the timeliness, inc dates?
• What were the results?
• To what extent were Bliss involved?

4. In the last 5 years,

• How many mothers had to be moved so their baby was born in a level 3 unit?
• Where were these mothers moved from and to?
• How many mothers needed to be moved from maternity units in QEUH, Simpsons Edinburgh and Aberdeen maternity hospital due to capacity in maternity and or NICU, and where were they moved to?

Response

Whilst our aim is to provide information where possible, in this instance the Scottish Government does not hold some of the information you have requested.

This is the information in relation to questions 1 and 4 - how many babies where transferred from Neo natal units in Queen Elizabeth Universal hospital Glasgow, Simpsons Children's hospital Edinburgh due to lack of capacity in the NICU, over the last 5 years; and In the last 5 years, how many mothers had to be moved so their baby was born in a level 3 unit? Where were these mothers moved from and to? How many mothers needed to be moved from maternity units in QEUH, Simpsons Edinburgh and Aberdeen maternity hospital due to capacity in maternity and or NICU, and where were they moved to?

The reason we do not have the information is that it is the responsibility of the Scottish Perinatal Network and ScotSTAR to collate this information. As such, I hereby provide you with formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested. You may, however, wish to contact the organisations at:-

• Scottish Perinatal Network - nss.perinatalnetwork@nhs.scot
• ScotSTAR - and ScotSTAR Scottish Neonatal Transport Service – The website of the Scottish Neonatal Transport Service

With regards to your request at question 2, all of the information you have requested is available from The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland and Scottish Health Council - National Review of Maternity and Neonatal Services - November 2016.

Under section 25(1) of FOISA, we do not have to give you information which is already reasonably accessible to you. If, however, you do not have internet access to obtain this information from the website(s) listed, then please contact me again and I will send you a paper copy.

Prior to Best Start Report publication in 2017 and as outlined on page 31 - 33 within The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland, a Maternity and Neonatal Review Group was established and consisted of representatives from the key professional groups involved in managing and delivering maternity and neonatal services, representatives of the Scottish Government, staff side organisations, third sector representatives and academics working in maternal and infant health research.

The Review group established four Sub-Groups, bringing together over 100 professional and frontline staff from maternity and neonatal services, academics, the third sector and professional organisations, as well as service users.

Listening to the views of service users, staff and service providers was critical to the Review and an extensive engagement programme was undertaken in all of Scotland’s NHS territorial Board areas. A series of meetings and events was held to gather the views of wider stakeholders, including professional organisations and the third sector.

The overall process included the following engagement activities:

With service users:

• The Scottish Health Council delivered a programme of public and service user engagement, across all NHS territorial Board areas to gather views from people who had used maternity and neonatal services in the last five years. Information on this can be found at Scottish Health Council - National Review of Maternity and Neonatal Services - November 2016. Methods of engagement and numbers involved by NHS Board area can be found in the Appendix on pages 27 - 29.
• In addition, five bespoke service user events were arranged to engage service users in remote and rural areas, vulnerable groups and mother and toddler groups.
• Over 600 women and partners participated in the engagement and 16 babies were in attendance.

With third sector organisations:

• Twenty-five organisations, including pregnancy and neonatal support organisations, fathers’ groups and bereavement organisations attended a third sector event.

Survey of Service users:

• An online survey was undertaken of families with recent experience of neonatal care, with over 500 responses received.
• The Review group considered information from the Scottish Maternity Care Experience Survey: 2015 which described the experiences of maternity care of over 2000 women who gave birth in 2015.

In relation to question 3 of your request, to support parent representation in the Options Appraisal and Best Start Implementation Programme Board (IPB) decision making process the Chief Executive of Bliss, Caroline Lee Davey, was a member of the IPB and was a member of the Perinatal Subgroup who undertook the options appraisal process, representing the views of neonatal families.

Information on the options appraisal process can be found at Options appraisal report.

As previously noted, under section 25(1) of FOISA, we do not have to give you information which is already reasonably accessible to you. If, however, you do not have internet access to obtain this information from the website(s) listed, then please contact me again and I will send you a paper copy.

As outlined in the Options appraisal report in advance of these changes, we tested the model in two early implementer areas, involving four units, to ensure that we get the approach and transition right for clinicians and families. The first is in the west between Glasgow’s Royal Hospital for Children at the Queen Elizabeth University Hospital and University Hospital, Crosshouse in Kilmarnock. The second is in the east between Simpson’s Centre for Reproductive Health at the Edinburgh Royal Infirmary and the Victoria hospital in Kirkcaldy.

The Boards were asked to roll out a range of aspects of the new model of neonatal care, including the new model of neonatal intensive care, to enable better understanding of the implications for patient flow associated with other aspects of the new model. Planning Groups were established in the west and the east, which included representatives from the Perinatal Sub Group. These Early Implementer Boards reported progress with establishment and operation of the new model to the Perinatal Sub Group.

The Neonatal Care Information leaflet developed by the Perinatal Sub Group was available to women who required to be transferred. The transfers were discussed with all parents, and clinicians reported that no concerns were raised, however due to the low numbers, only one parent provided formal written feedback early on in the process, which was positive. In moving forward with plans for implementation, Boards will be expected to use local mechanisms to continue to gather feedback on operation of the model.

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