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Tracking national neonatal transport activity and metrics using the UK Neonatal Transport Group dataset 2012–2021: a narrative review
  1. Andrew Leslie1,
  2. Catherine Harrison2,
  3. Allan Jackson3,
  4. Susan Broster4,5,
  5. Eileen Clarke4,5,
  6. Sarah L Davidson6,
  7. Colin Devon3,
  8. Beverley Forshaw7,
  9. Alex Philpott8,
  10. Robert Tinnion7,
  11. Jo Whiston2,
  12. Alan C Fenton9,
  13. Don Sharkey1
  1. 1 Centre for Perinatal Research, School of Medicine, University of Nottingham, Nottingham, UK
  2. 2 Embrace, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
  3. 3 ScotSTAR Scottish Neonatal Transport Service, Glasgow, UK
  4. 4 Paediatric and Neonatal Decision Support and Retrieval Service (PaNDR), Cambridge, UK
  5. 5 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  6. 6 Southampton Oxford Neonatal Transfer service (SONeT), Southampton University Hospitals NHS Trust, Southampton, UK
  7. 7 Northern Neonatal Transport Service (NNeTS), Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
  8. 8 Kids Intensive Care and Decision Support/Neonatal Transfer Service (KIDS-NTS), Birmingham, UK
  9. 9 Neonatology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
  1. Correspondence to Prof Don Sharkey, Centre for Perinatal Research, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; don.sharkey{at}nottingham.ac.uk

Abstract

There are no internationally agreed descriptors for categories of neonatal transports which facilitate comparisons between settings. To continually review and enhance neonatal transport care we need robust categories to develop benchmarks. This review aimed to report on the development and application of key measures across a national neonatal transport service. The UK Neonatal Transport Group (UK-NTG) developed a core dataset and benchmarks for transported infants and collected annual national data. Data were reported back to teams to allow benchmarking and improvements. From 2012 to 2021, the rate of UK neonatal transfers increased from 18 to 22/1000 live births despite a falling birth rate. Neonatal transfers on nitric oxide increased until 2016 before plateauing. The proportion of transport services able to provide high frequency oscillation and servo-controlled therapeutic hypothermia increased over the study period. High-flow nasal cannula oxygen use increased, becoming the most frequently used non-invasive respiratory support mode. For infants <27 weeks of gestational age, transfers for uplift of care in the first 3 days of life have fallen from 420 (2016) to 288 (2020/2021) and for lack of neonatal capacity from 24 (2016) to 2 (2020/2021). The rate of ventilated infants completing transfer with CO2 out of the benchmark range varied from 9% to 13% with marked variation between transport services’ rates of hypocapnia (0–10%) and hypercapnia with acidosis (0–9%). The development of the UK-NTG dataset supports national tracking of activity and clinical trends allowing comparison of patient-focused benchmarks across teams.

  • Neonatology
  • Data Collection

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Footnotes

  • Twitter @Alldoj, @SarahDavidsonL, @DrDonSharkey

  • Contributors This review was conceived and led by DS who is the guarantor of the study. AL led the development of the dataset, analysed the data (2008–2018) and prepared the manuscript. ACF co-led the development of the dataset and analysis of data (2008–2011). AJ led the data analysis (2019–2021) and with CH contributed to interpretation of findings and manuscript preparation. CD analysed the data (2019–2021). SB, SD, RT, JW, EC, BF and AP contributed to dataset development and reviewed the draft manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.