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Supporting preterm babies to go home earlier

Around one in 13 babies in England are born prematurely, with most born between four and six weeks early. These babies are considered late preterm.

Preterm babies can be in a hospital far from home, placing significant and unexpected financial and social burdens on families, particularly the least advantaged – however, a lot of this care could be delivered safely at home, with the right support for families from healthcare professionals.

When babies go home earlier, it can increase parent-infant bonding, result in better breastfeeding rates and have a positive impact on perinatal mental health.

With these benefits in mind, NIHR Applied Research Collaboration for the North West Coast (ARC NWC), Health Innovation North West Coast and the North West Neonatal Operational Delivery Network (NWNODN) collaborated on a report looking at neonatal outreach services across the North West.

Insights from this study can help inform the creation of new neonatal outreach services, or improve existing services, both locally and nationally. 

The report, entitled “Recommendations for the expansion of neonatal outreach interventions”, includes information from an audit of 7 neonatal units and interviews with staff and parents from 5 of those units.

The report also features the findings from a “rapid insight session” on 12 December 2023, which captured thoughts from an informed audience of # neonatal professionals in the North West and nationally. View the slides and watch the video recording from that session.

A number of Trusts in the North West have some very good practices in place, namely Lancashire Teaching Hospital’s Nest@Home (Neonatal Early Supported Transfer Home). Nest@Home interventions are based on the most common reasons for babies’ prolonged lengths of stay and interventions are applied according to the individual baby/family needs and available resources.

The report found that parents greatly valued neonatal outreach. Other insights included:

  • A coordinated, system-thinking approach to service design is required, including a defined service specification and standard reporting.
  • Sustainable investment is required to fund safe staffing, digital infrastructure and devices, and governance.
  • Fully resourced outreach may alleviate hospital capacity issues whilst keeping babies safe, and achieve a workforce savings. 
  • We need to share best practice from other innovative approaches such as NEST@home, Liverpool Women’s home phototherapy offer and Blackpool Victoria’s tongue tie clinic.
  • Neonatal Transitional Care (NTC) should be thought of as a service, not a physical location, enabling Trusts to pay for outreach with the transitional care tariff.

Participants from the Rapid Insight session reflected that neonatal outreach services are key to the sustainability of neonatal services. Overall, the project team is encouraged by the findings of the report, but more work is required, including a deeper look at costs.

Laura Boland, Head of Innovation Pipeline, Evaluation and Insights, at Health Innovation NWC, said: “This report was a real collaborative effort. We learned how diverse neonatal services are across our region, and that there are some really wonderful, motivated staff who wanted to shape this report into something that would be useful both regionally and nationally. We want to thank the North West Neonatal Operational Delivery Network for their involvement and continue to work with them in the future.”

Linked to this article is a summary report, which was complements the full research report. If you would like to discuss this with a member of the project team, please contact Louise Houghton, project manager. The project was a part of the National Insights Prioritisation Programme (NIPP) funded by the Accelerated Access Collaborative. It is managed by the Health Innovation Network and the National Institute for Health Research (NIHR), which has oversight of a network of ARCs. NIPP programmes vary across the country.

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