(2) if he will make a statement on the current provision of specialist neonatal services in the Province;
(3) whether he plans to increase the number of neonatal cots in hospitals in the Province;
(4) what plans there are to enhance specialist neonatal services in the Province;
(5) what assessment he has made of the findings of recent work commissioned by his Department on the current level of specialist neonatal provision in the Province.
There are currently 104 neonatal cots in Northern Ireland: 20 intensive care, 21 high dependency and 63 special care. Their distribution is shown in the following table.
Level of care RJMS Antrim Altnagelvin CAH Ulster DHH Erne Total for NI IC 9 4 3 3 1 0 0 20 HD 7 2 6 4 2 0 0 21 SC 15 10 9 8 9 6 6 63 Total 31 16 18 15 12 6 6 104 Notes: RJMS: Royal Jubilee Maternity Service; CAH: Craigavon Area Hospital; DHH: Daisy Hill Hospital.
Typically this highly specialised service is required for premature and very ill newborn babies. Demands on the service have increased in recent years; a trend also evident in other parts of the UK.
A working group, commissioned in 2005 by the Chief Medical Officer, has assessed the current provision of services across Northern Ireland. The report included a number of recommendations to sustain and strengthen services. With regard to the capacity of current services, the report indicated that an additional two neonatal cots would help meet the service demands more effectively. Other recommendations included the development of a neonatal intensive care network, improved information systems on neonatal cot usage and availability, and measures to increase the complement of appropriately trained neonatal nurses.
An additional £800,000 will be allocated for neonatal/paediatric intensive care services in 2007-08. This will allow the introduction of at least one additional neonatal intensive care cot, one additional paediatric intensive care bed and other improvements in a number of associated areas, including the establishment of a managed clinical network.
These measures to increase capacity within neonatology will also be supported by the development of a neonatal and paediatric critical care transport service. A lead consultant for the service has already been appointed and other staff are currently being recruited.
Health and social services trusts have confirmed that there are no consultant nurses in the neonatology specialty.
Staffing is a matter for individual trusts, taking into account factors such as service needs and available resources. Information is not held centrally on projected appointments to specific grades.
The information is as follows:
Trust 2002 2003 2004 2005 2006 Total Altnagelvin Group 1 — — — — 1 Craigavon Area Hospital Group — — — 1 — 1 Newry and Mourne — — — 1 — 1 Sperrin Lakeland — — — — — — Royal Group of Hospitals 1 2 4 2 1 10 Ulster Community and Hospitals — — — — — — United Hospitals — — — 2 — 2 Source: Health and social service trusts
Trust 2002 2003 2004 2005 2006 Total Altnagelvin Group — — — 1 — 1 Craigavon Area Hospital Group — — — — — — Newry and Mourne — — — — 1 1 Sperrin Lakeland — — — — 2 2 Royal Group of Hospitals1 — — — — — — Ulster Community and Hospitals — — — — — — United Hospitals — — — — — — 1 Royal Group of Hospitals Trust stated that they had not transferred any babies out of Northern Ireland in the last five years as a result of neonatal cots being full to capacity. However, they stated that they have transferred mothers in late pregnancy outside of Northern Ireland because all neonatal cots were being used. Source: Health and social service trusts.
The average transport costs associated with transferring a baby outside Northern Ireland for treatment are in the region of £5,000 to £8,000 per transport. This is with the exception of ECMO cases (Extra Corporeal Membrane Oxygenation), which is a service not provided in Northern Ireland. Babies requiring this treatment are collected by a specially equipped and staffed helicopter at a cost of approximately £20,000.
Due to the method by which reimbursement between NHS trusts has been carried out until recently it is not possible to disaggregate the treatment costs associated with transferred babies without incurring disproportionate costs in obtaining the information. The cost of treatment elsewhere in the United Kingdom, however, is comparable with provision of the same treatment locally. The additional expense lies in travel for the patient and relatives, as appropriate.