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Evaluating the potential impact of implementing the nice quality standards on neonatal out-patient services
  1. J Behrsin1,
  2. J Dorling1,2
  1. 1Nottingham City Hospital, Nottingham, UK
  2. 2Trent Perinatal Network, Nottingham, UK

Abstract

Background The National Institute of Health and Clinical Excellence (NICE) have published quality standards for specialist neonatal care recommending that babies that receive this require their health outcomes monitored at 2 years of age.1 2

Current follow-up criteria within our network are: <31 weeks gestation, birth weight <1000 g, and encephalopathy of any aetiology.

Aims To compare the number of babies who currently qualify for neonatal follow-up with the NICE quality standards.

Methods Network admission data (January 2008–December 2009) was extracted from BADGER.3 This allowed us to determine the number of babies needing each level of care4 as well as gestation and weight in order to calculate the number requiring follow-up using each set of criteria.

Results There were 4040 babies admitted with the network and 721 (18%) required follow-up under the current scheme. The NICE follow-up criteria relate to levels of care. 1242 (31%) babies received intensive care and 1493 (37%) received either intensive or high dependency care. 3750 (94%) babies had special care.

Discussion Implementing the NICE quality standards mean that more babies will require follow-up at 2 years of age. The precise number depends of which level of care is determined as follow-up criteria: 521 babies additional if intensive care used, 772 if intensive or high dependency and 3029 if special care is included. An estimation of cost is approximately £120 per outpatient visit or £60 per patient if a questionnaire based method of follow-up is used. To follow this NICE quality standard will incur greater expense.

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