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The most recent version of this article was published on 1 May 2007

Arch. Dis. Child. Fetal Neonatal Ed.. Published Online First: 9 November 2006. doi:10.1136/adc.2006.105098
Copyright © 2006 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

Original articles

The impact of service changes on neonatal transfer patterns over 10 years

Jonathan M Cusack 1*, david john field 2 and Bradley N Manktelow 2

1 University Hospitals of Leicester, United Kingdom
2 University of Leicester

* To whom correspondence should be addressed. E-mail: jonathan.cusack{at}uhl-tr.nhs.uk.

Accepted 30 October 2006


Abstract

Introduction: There have been many changes to the staffing and organisation of neonatal care in the UK in the last 10 years. We wished to assess the extent to which these had affected the transfer of babies between different parts of the service.

Methods: We used the Trent Neonatal Survey, an ongoing study of neonatal intensive care activity in the former Trent Health Region of the UK, to analyse neonatal inter-hospital transfers over a 10-year period, from 1st January 1995 to 31st December 2004. We looked at the number of transfers, the type of transfer and we analysed trends in gestation and disease severity over the study period. Rates of "inappropriate transfer" were also identified.

Results: There were a total of 8105 babies transferred over the period. 2294 babies underwent urgent postnatal transfer and this equates to approximately 2 such transfers every three days. The maximum number of journeys by any one baby was 8. Intensive care activity rose during the 10 years but the number of inappropriate transfers remained persistently high.

Conclusions: Organisational changes in neonatal care during the 10-year period have been insufficient to deal with the rising demand, as reflected by the persistently high rate of inappropriate transfers.

Keywords: centralisation, neonatal networks, transport


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