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The Northern Neonatal Transport Service (NNeTS) was established in 2016. Before this, the Northern Neonatal Network had two transport teams working closely together (one based at the RVI, and one at James Cook University Hospital). NNeTS has a fully staffed tier of dedicated Specialist Transport Nurses and 24-hour access to advice from a Consultant Neonatologist. The service model for acute transports is currently delivered by the Specialist Nurse Team in conjunction with doctors trained and experienced in neonatal medicine. Over the next five years, the aim is to move to a Transport (Advanced Neonatal) Nurse Practitioner-led acute service as this will be more sustainable in the future. NNeTS is hosted by the Maternity Services Directorate within Newcastle Hospitals NHS Foundation Trust and co-located with the Neonatal Intensive Care Unit (Ward 35) at the RVI.
NNeTS report quarterly to the Northern Neonatal Network board and works closely with our service users to enhance and improve the experience of babies in the Northern Neonatal Network who need to move between specialist units. Our work directly supports the overall Network ethos of providing the highest quality, most appropriate care as close to home as possible.
Referrals
NNeTS are primarily a road transport team but do have experience of rotary air transport in certain circumstances. The remit of what babies we will move is very broad, with very few exclusion criteria (see below). If babies do not fall into the following categories then we will transport them. Exclusion criteria (which preclude NNeTS transport):
- >6kg
- >6m old (corrected age)
- ‘Non-neonatal’- scope of illness or reason for transfer (e.g. fulminant meningococcal sepsis or polytrauma)
The first two criteria relate to physically being able to fit the baby in the NNeTS equipment. The third relates to the clinical expertise being deployed to the baby: a paediatric intensivist will be more skilled at looking after a polytrauma victim than a neonatal team member.
By definition, NNeTS will almost exclusively be the service most appropriate to move babies who are being transferred into or out of a NICU or SCBU (regardless of destination if moving out). However, this does NOT preclude NNeTS from moving babies from paediatric wards to paediatric wards where the illness type/presentation is seen in the scope of neonatal practice and the baby meets the physical transport criteria outlined above. An example of an appropriate referral that NNeTS would complete might be an ex-24 weeker, home for some time, presenting post-term corrected GA with signs of bowel obstruction requiring transport from a paediatric ward to a surgical centre or PICU.
NNeTS provides transport of babies between hospitals and services for all reasons, including (but not limited to): acute intensive care; repatriation closer to home; uplift for resource/capacity reasons; planned surgery and outpatient review; and palliative/end-of-life care.
Single Point of Contact principle
NNeTS operates a Single Point of Contact principle for referral telephone calls received, that is to say that the referring unit should only have to make one referral to a transport service and this will then set in motion the correct pathway that will lead to transport happening when required. Where possible, call conferencing will be utilised to bring required participants into the referral call, but the referrer may also be asked to wait for a return call after details are taken if the required participants cannot conference with the original referral.
In the unlikely event that NNeTS cannot fulfil a transport request, the responsibility will lie with NNeTS to liaise with another transport team (e.g. NECTaR, EMBRACE) to fulfil the request. This team will then directly contact the referring centre for onward planning. A referring team would not be asked to contact a different transport team themselves by NNeTS except in certain exception circumstances.
Parallel referrals to different transport teams mustn't be made by referring centres as this can cause confusion and delay in arranging transport. If different services are dispatched simultaneously to a single patient, this may compromise the safety of other patients in the region requiring uplift. If there is any concern that an agreed prioritisation for any given transport is not correct, then upgrading the priority of transport can be discussed between the referring Consultant and the NNeTS Consultant on call. This already happens as routine in circumstances where a patient’s condition worsens and the planned uplift becomes more urgent.
Referral telephone number
NNeTS Transport hotline number is: 0191 230 3020
Liaison Work
NNeTS works to the principle of transparent, honest, accountable practice and there are several ways in which this interlinks with other units and services within the wider Northern Neonatal Network:
Governance
NNeTS governance activity takes place every day. there is an NNeTS governance lead in conjunction with the Medical and Specialist Nurse service leads listed. We have a formal, open-invite, bimonthly governance meeting and the wider team governance activities (including guideline development, audit and training) are embedded within the overarching governance process of the host directorate and Trust. NNeTS both participate in (and where required provide a chair for) debriefings and case/mortality reviews at SCBUs/NICUs around the region in those cases which have involved the transport service. Any requests for a NNeTS representative to attend a case/mortality review, debrief or other meeting where transport input is required should be directed to Dr. Tinnion in the first instance as far in advance of the meeting date as possible. Learning from NNeTS governance will be shared with Network organisations where appropriate and relevant to improving the experience of babies requiring or undergoing transport in the region.
Feedback
NNeTS welcomes any feedback or queries about clinical interaction with the team and team members. This can be in any of the usual modalities (a telephone call, email or written) and should be directed to the relevant NNeTS team lead. Please note: NNeTS specifically has one medical and one nursing liaison contact within each unit/organisation in the region that are service users through which feedback and contact should be made to keep the flow of information streamlined and avoid (for example) multipartite email trails. Critical clinical incidents can also be reported by the Datix system, directed externally to NNeTS (within Newcastle Hospitals NHS Foundation Trust).
Visits
The NNeTS team leads will visit NICUs/SCBUs around the region on an annual basis to offer teams an opportunity to meet the senior NNeTS staff and discuss issues about NNeTS-delivered transport face-to-face.
Charitable Fund
NNeTS has a charitable fund associated with the service. It exists to enhance and improve the experience of those babies and families undergoing transport in the region and donations can be made directly to this fund. Anyone with specific ideas for fundraising activities or events should contact the service leads who will direct them to the appropriate charity contacts for the fund before undertaking the fundraising, as we may be able to help with the promotion of any events.
