Neonatal care improving, but key measures show variation in care

Published on : 21 September 2017

The work of the ihub's Maternity & Children Quality Improvement Collaborative (MCQIC) is mentioned in the latest National Neonatal Audit Programme report (NNAP), published today by the Royal College of Paediatrics and Child Health (RCPCH). The report shows improvements in care for preterm babies in England, Scotland and Wales, but also reveals variations in service delivery which means many babies are still not getting the care they need.

Commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and patient Outcomes Programme (NCAPOP)*, the NNAP report assesses whether babies requiring specialist neonatal care receive consistent high quality treatment. It is an annual audit which this year assessed the care given to nearly 100,000 babies, with 98% of neonatal units responding.

The report highlights progress on a number of audit measures including ensuring that babies’ eyes were screened to minimise the risk of premature visual loss, maintaining a baby’s temperature within the recommended range, and that parents received a timely consultation with a senior member of the neonatal unit team. Specifically:

  • More babies born at less than 32 weeks, 4,868/8,044 (61%) in 2016 compared to 4,537/7,864 (58%) in 2015, have a temperature recorded on admission within the recommended range of 36.5 – 37.5 degrees C
  • More babies are being screened on time for Retinopathy of Prematurity 8,597/9,131 (94%) in 2016 compared to 8,226/8,821 (93%) in 2015
  • More parents are documented as having a consultation with a senior member of the neonatal team with 24 hours of their baby's admission, 54,442/60,148(90%) in 2016 compared to 51,300/58,077 (88%) in 2015

This is the second year that data has been collected for Scotland, with 12 out of 15 units responding. (up from 8 last year) . The audit found improvements in some measures, including:

  • 93% of mothers in Scotland who delivered their babies between 24-34 weeks received a dose of antenatal steroids (among the highest in the UK) with the aim of improving outcomes for these babies.
  • Babies born at a gestational age of <32 weeks should have their temperature taken within the first hour of birth – Scotland’s rate of 96% adherence to this standard compared to 88% in last year’s report, which brings them in line with the national average.
  • 89% of parents/carers were seen by a senior member of the neonatal team within 24 hours of admission. This represents an increase from 78% in last year’s report though the aim is to achieve 100%.

This is the second year Scottish units have taken part in the NNAP. Caution must also be aired when comparing Scottish data with English and Welsh data as the three countries neonatal networks operate differently.

 

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