Referrals

Which babies to refer (or not)

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 moving babies from paediatric wards to paediatric wards where the illness type/presentation is one which 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 a period of time, presenting post-term corrected GA with signs of bowel obstruction requiring transport from a paediatric ward to 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 to 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.

It is imperative that parallel referrals to different transport teams are NOT 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