• Intensive Care Units, Neonatal
• Neonatology
• Technology

The capacity to provide intensive care for newborns became a reality in the 1970s.1 Subsequently, neonatal intensive care units (NICUs) were established in major perinatal centres or children’s hospitals as part of regionalised perinatal care. While in utero transfer guidelines were successful in ensuring most preterm babies were delivered in centres with NICU facilities, it became apparent that in utero transfer was not always possible. This group of outborn preterm babies, together with babies who became unexpectedly critically unwell soon after birth, necessitated the development of interhospital ambulance transport capability that took account of the specific needs of the sick newborn. It was known that transporting sick babies using standard ambulance capability was associated with significant neonatal mortality and morbidity. Thus, neonatal transport became a specialty.

Initially, most neonatal transport services were developed alongside NICUs but, in many regions, are now becoming independent, reflecting the complexity of networks and the development of retrieval medicine as a subspecialty. There are a range of models to support neonatal transport services. These reflect service demand and geographical considerations. For services with relatively low numbers of neonatal transfers, combined with paediatric retrieval, it provides a critical mass of activity that justifies a standalone service with the appropriate retrieval-related infrastructure. The latter includes a call centre with call conferencing and recording capacity, customised ambulances and a range of equipment required for transport. These sophisticated services form a vital element of a system of regionalised perinatal care. They …