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Neonatal specialist care [QS4]

Measuring the use of this guidance

Statement: 2

Networks, commissioners and providers of specialist neonatal care undertake an annual needs assessment and ensure each network has adequate capacity.

Quality standard measure: Proportion of mothers whose babies required specialist neonatal care and who were booked to deliver in the network who received all their perinatal care within the network area (standard 95% as per DH toolkit [2009]).
What was measured: Transfers out of a unit where babies were kept within their own network area
Data collection end: December 2014
83%
Number that met the criteria: 10206 / 12335
Data collection end: December 2015
82%
Number that met the criteria: 11450 / 14038
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.


Statement: 4

Neonatal transfer services provide babies with safe and efficient transfers to and from specialist neonatal care.

Quality standard measure: Proportion of newborn babies who receive specialist neonatal care who have an admission temperature of less than 36°C.
What was measured: Proportion of babies with a gestation at birth <32 weeks, admitted with a temperature of less than 36°C measured within an hour of birth, to neonatal units in England, Scotland and Wales.
Data collection end: December 2015
8.9%
Number that met the criteria: 651 / 7351
Data collection end: December 2016
7%
Number that met the criteria: 562 / 8044
Data collection end: December 2017
5.56%
Number that met the criteria: 446 / 8019
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.


Statement: 5

Parents of babies receiving specialist neonatal care are encouraged and supported to be involved in planning and providing care for their baby, and regular communication with clinical staff occurs throughout the care pathway.

Quality standard measure: Evidence of local arrangements to involve parents in decision-making processes.
What was measured: Proportion of people who answered 'Yes always' to the question 'Did the neonatal staff include you in discussions about your baby’s care and treatment?'
Data collection end: September 2014
62%
Number that met the criteria: 3694 / 5902
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of local arrangements to involve parents in decision-making processes.
What was measured: Proportion of people who answered 'Yes always or nearly always' in response to the question 'When a ward round was taking place, were you allowed to be present when your baby was being discussed?'
Data collection end: September 2014
72%
Number that met the criteria: 3591 / 5037
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of local arrangements to involve parents in decision-making processes.
What was measured: Proportion of people who answered 'Yes always or nearly always' to the question 'If you asked questions about your baby's condition and treatment, did you get answers you could understand?'
Data collection end: September 2014
79%
Number that met the criteria: 4682 / 5898
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of local arrangements to involve parents in decision-making processes.
What was measured: Proportion of admissions to a neonatal unit with a documented consultation with parents by a senior member of the neonatal team within 24 hours of admission.
Data collection end: December 2015
88%
Number that met the criteria: 51300 / 58077
Data collection end: December 2016
90%
Number that met the criteria: 54422 / 60148
Data collection end: December 2017
92%
Number that met the criteria: 54891 / 59655
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Evidence of local arrangements to involve parents in decision-making processes.
What was measured: Proportion of admissions of more than 24 hours where at least one parent attended a consultant ward round at any point.
Data collection end: December 2017
60%
Number that met the criteria: 43230 / 71622
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Evidence of local audit demonstrating active involvement of parents in providing care for their baby.
What was measured: Proportion of people who answered 'Yes always or nearly always' in response to the question 'Were you able to speak to a doctor about your baby as much as you wanted?'
Data collection end: September 2014
45%
Number that met the criteria: 2543 / 5687
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of local audit demonstrating active involvement of parents in providing care for their baby.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'Were you involved as much as you wanted in the day-to-day care of your baby, such as nappy changing and feeding?'
Data collection end: September 2014
81%
Number that met the criteria: 4768 / 5852
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of local audit demonstrating active involvement of parents in providing care for their baby.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'Did you have as much skin-to-skin contact with your baby as you wanted?'
Data collection end: September 2014
60%
Number that met the criteria: 3070 / 5106
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of local audit demonstrating active involvement of parents in providing care for their baby.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'Did staff help you feel confident in caring for your baby?'
Data collection end: September 2014
81%
Number that met the criteria: 4752 / 5876
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care


Statement: 6

Mothers of babies receiving specialist neonatal care are supported to start and continue breastfeeding, including being supported to express milk.

Quality standard measure: Evidence of a written local policy on breastfeeding and expressing milk for babies receiving specialist neonatal care.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'If you wanted to express breast milk for your baby, were you given the support you needed from neonatal staff?'
Data collection end: September 2014
78%
Number that met the criteria: 3699 / 4735
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of a written local policy on breastfeeding and expressing milk for babies receiving specialist neonatal care.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'When you were in the neonatal unit, were you given the feeding equipment you needed for expressing, such as a breast pump and sterilisation equipment?'
Data collection end: September 2014
83%
Number that met the criteria: 3908 / 4721
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of a written local policy on breastfeeding and expressing milk for babies receiving specialist neonatal care.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'Were you given enough privacy in the neonatal unit for expressing milk and/or breastfeeding your baby?'
Data collection end: September 2014
77%
Number that met the criteria: 3606 / 4682
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Evidence of a written local policy on breastfeeding and expressing milk for babies receiving specialist neonatal care.
What was measured: Proportion of people who answered 'Yes definitely' to the question 'If you wanted to breastfeed your baby, were you given enough support to do this from neonatal staff?'
Data collection end: September 2014
75%
Number that met the criteria: 3454 / 4602
Area covered: England
Source: Picker Insitute Europe Parents’ experiences of neonatal care

Quality standard measure: Proportion of babies born at less than 33 weeks of gestation who receive specialist neonatal care who are breastfed when discharged from hospital.
What was measured: Proportion of babies <33 weeks gestation who were discharged home receiving any of their own mother's breast milk.
Data collection end: December 2014
60%
Number that met the criteria: 3570 / 5942
Data collection end: December 2015
58%
Number that met the criteria: 3693 / 6323
Data collection end: December 2017
60.2%
Number that met the criteria: 3866 / 6418
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Proportion of babies born at less than 33 weeks of gestation who receive specialist neonatal care who are breastfed when discharged from hospital.
What was measured: Proportion of babies <33 weeks gestation who were discharged home receiving any of their own mother's breast milk.
Data collection end: December 2016
59%
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.


Statement: 8

Providers of specialist neonatal services maintain accurate and complete data, and actively participate in national clinical audits and applicable research programmes.

Quality standard measure: Evidence of participation in national clinical audits and benchmarking.
What was measured: Proportion of English and Welsh neonatal units that submitted data to the National Neonatal Audit Programme.
Data collection end: December 2014
100%
Number that met the criteria: 174 / 174
Data collection end: December 2015
100%
Number that met the criteria: 179 / 179
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Evidence of participation in national clinical audits and benchmarking.
What was measured: Proportion of English, Welsh and Scottish neonatal units that submitted data to the National Neonatal Audit Programme.
Data collection end: December 2016
98%
Number that met the criteria: 181 / 184
Data collection end: December 2017
98.35%
Number that met the criteria: 179 / 182
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.


Statement: 9

Babies receiving specialist neonatal care have their health outcomes monitored.

Quality standard measure: Proportion of babies born at less than 30 weeks of gestation who received specialist neonatal care who have a 2-year outcome form completed.
What was measured: Proportion of eligible babies born at a gestational age of <30 weeks for whom a two-year (corrected post term) health status follow up has been partially or fully completed.
Data collection end: December 2014
54%
Number that met the criteria: 1973 / 3656
Data collection end: December 2015
60%
Number that met the criteria: 2252 / 3744
Data collection end: December 2016
61%
Data collection end: December 2017
62.6%
Number that met the criteria: 2531 / 4043
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Proportion of babies who received specialist neonatal care who have had a culture-positive infection of blood or cerebrospinal fluid prior to discharge from hospital.
What was measured: Proportion of all babies who had a positive blood culture result recorded with a pure growth of a pathogen.
Data collection end: December 2014
0.5%
Data collection end: December 2015
0.5%
Data collection end: December 2016
0.5%
Number that met the criteria: 455 / 99849
Data collection end: December 2017
0.95%
Number that met the criteria: 985 / 104183
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Proportion of babies who received specialist neonatal care who have had a culture-positive infection of blood or cerebrospinal fluid prior to discharge from hospital.
What was measured: Proportion of all babies who had a positive cerebrospinal fluid culture result recorded with a pure growth of a pathogen.
Data collection end: December 2015
0.01%
Data collection end: December 2016
0.01%
Number that met the criteria: 11 / 99849
Data collection end: December 2017
0.01%
Number that met the criteria: 14 / 104183
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

Quality standard measure: Proportion of babies born at less than 30 weeks of gestation who receive specialist neonatal care who have no functional impairment at 2 years when corrected for gestational age.
What was measured: Proportion of babies born <30 weeks gestation with health data entered at two-year follow-up who had no neurodevelopmental impairment.
Data collection end: December 2014
45%
Number that met the criteria: 889 / 1973
Data collection end: December 2015
43%
Number that met the criteria: 963 / 2252
Data collection end: December 2016
50%
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.



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