Quality statement 1: Care pathways and guidelines

Quality statement

In-utero and postnatal transfers for neonatal special, high-dependency, intensive and surgical care follow perinatal network guidelines and care pathways that are integrated with other maternity and newborn network guidelines and pathways.

Quality measure

Structure:

a) Evidence of perinatal network guidelines and care pathways for in-utero and postnatal transfers for neonatal special, high-dependency, intensive and surgical care.

b) Evidence that perinatal network guidelines and care pathways for in-utero and postnatal transfers for neonatal special, high-dependency, intensive and surgical care, are integrated with other maternity and newborn network guidelines and pathways.

c) Evidence of network arrangements to ensure that when a baby is admitted to specialist neonatal care, the mother and any multiple birth siblings can be accommodated in the same hospital during their respective admissions.

Process:

a) Proportion of babies born at less than 28 weeks of gestation who receive intensive care in a neonatal intensive care unit (NICU) within the network.

Numerator – the number of babies receiving intensive care in a NICU within the network.

Denominator – the number of babies born at less than 28 weeks of gestation within the network.

b) Proportion of babies with antenatally diagnosed fetal malformations requiring early surgery who are delivered at a designated network surgical centre.

Numerator – the number of babies delivered at a designated network surgical centre.

Denominator – the number of babies born within the network with antenatally diagnosed fetal malformations requiring early surgery.

c) Proportion of babies who are transferred back to their local neonatal unit within 24 hours of request for repatriation.

Numerator – the number of babies transferred within 24 hours of repatriation request.

Denominator – the number of babies transferred back to their local neonatal unit.

d) Proportion of babies who require neonatal surgery who receive it at a designated network surgical centre.

Numerator – the number of babies undergoing surgery at a designated network surgical centre.

Denominator – the number of babies born within the network who require neonatal surgery.

e) For singleton births: proportion of mothers who still require inpatient care when their baby is transferred to specialist neonatal care, who are transferred to the same hospital as their baby.

Numerator – the number of mothers transferred to the same hospital as their baby.

Denominator – the number of mothers who still require inpatient care when their baby is transferred to specialist neonatal care.

f) For multiple births: proportion of babies transferred to specialist neonatal care whose mother and/or multiple birth siblings are transferred to the same hospital if still requiring inpatient care.

Numerator – the number of babies whose mother and/or multiple birth siblings are transferred to the same hospital.

Denominator – the number of babies from multiple births transferred to specialist neonatal care whose mother and/or multiple birth siblings still require inpatient care.

What the quality statement means for each audience

Service providers ensure perinatal network guidelines and care pathways for transfers for neonatal special, high-dependency, intensive and surgical care are implemented and integrated with other maternity and neonatal guidelines and pathways. Ensure regular monitoring of operation and effectiveness.

Healthcare professionals ensure perinatal network guidelines and care pathways are followed when transferring babies for neonatal special, high-dependency, intensive and surgical care, and invoke a report or alert mechanism where this is not possible.

Commissioners and networks ensure all eligible patients within their health economy are covered by perinatal network guidelines and care pathways for transfer for special, high-dependency, intensive and surgical care.

Parents of babies transferred to neonatal special, high-dependency, intensive or surgical care can expect the transfer to be in line with network guidelines and care pathways. These guidelines and care pathways describe specific procedures about safely transferring babies to other hospitals.

Definitions

The DH toolkit (2009) defines a network as 'linked groups of health professionals and organisations from primary, secondary and tertiary care, working in a coordinated manner, unconstrained by existing professional and health board boundaries, to ensure equitable provision of high-quality, clinically effective services.'

Guidance on the content of guidelines and pathways can be found within the DH toolkit (2009) under Principles 4 and 7.

Data source

Structure: Local and network data collection.

Process: Local and network data collection