Scope Of Care
- Advanced Ventilation including oscillation and NO (Nitric Oxide) therapy.
- All maternal care services (diabetes, renal, spinal, cancer, HDU, ITU etc).
- Cardiology Clinics.
- Cardiology Diagnosis.
- Community Neonatal Nursing Service
- Dedicated High Risk Infant clinic.
- Functional Echocardiography.
- MRI and ultrasound brain Imaging with paediatric radiologist reporting.
- Neonatal Surgical Airway service with neonatal bronchoscopy.
- Paediatric orthopaedics, plastic surgery, neurosurgery, dermatology, PICU and endocrinology on site.
- Paediatric/Neonatal anaesthetic service
- Perinatal pathgology.
- Regional Genetics Service.
- Specialist fetal medicine including fetal cardiology.
- Joint weekly neonatal follow-up clinic with paediatric physiotherapy, dietetics and community nursing input.
- Specialist Neuro-developmental Follow Up (BSID 3) of at risk infants & babies born below 32 weeks gestation.
- Sub regional Neonatal Ophthalmology screening and laser treatment for retinopathy.
- Therapeutic Hypothermia for Hypoxic Ischaemic Encephalopathy.
- Video 12 channel EEG and aEEG facilities with expert neurophysiology interpretation.
Northern Neonatal Network Care Pathways – December 2017
South Tees Hospitals NHS Foundation Trust – James Cook University Hospital, Middlesbrough
Scope of care
South Tees Hospitals NHS Foundation Trust provides neonatal services at The James Cook University Hospital in Middlesbrough.
The current services provided on the JCUH site are as follows :
NICU, James Cook University Hospital, Middlesbrough
Current Unit capacity
12.5 Intensive Care cots (Sept 2017 onwards).
20 Special Care cots (as from October 2014).
Annual number of deliveries
5137 mothers, 5261 babies (April 2016 – March 2017).
Annual number of admissions
458 (April 2016 – March 2017).
Current threshold for incoming ante-natal transfers
Generally obstetricians from the seven SCBUs will routinely try to transfer <30/40 gestation mothers here as one of the four receiving NICUs in the Network. This is done by direct discussion with receiving consultant obstetricians and neonatologists if a suitable Intensive care cot is available.
Current threshold for incoming post-natal transfers
Any baby requiring intensive or high dependency care postnatally for which local provision is not available. Babies <30/40 that have to delivered at one of the SCBUs are routinely transferred to JCUH for Intensive Care after using the Transfer hotline according to the appropriate Care Pathway.
Other thresholds for incoming post-natal transfer
This will be discussed with JCUH clinicians and decided on a case by case basis, but examples of babies who will generally require transfer include: any baby requiring intensive or ongoing high dependency care that is outside the gestation threshold above, babies with Hypoxic Ischaemic Encephalopathy needing active cooling, some surgical cases (see below), congenital/cardiac anomalies for further assessment if they do not require immediate transfer to the Sub-Regional Unit (RVI/Freeman), babies requiring ventilation or TPN.
Transfer services provided?
JCUH provide a full emergency transport service for all babies (including paediatric/PICU cases up to approx. 6kg) within the Network. All requests for transfers should be made via the dedicated Neonatal Transfer number.
Routine investigations/tests/screening currently undertaken
ROP screening is performed on-site. Routine ultrasounds of the cranium are also done on site, as well as MRI and CT Scans. Other services and diagnostic facilities are listed below. All babies have a saturation reading prior to discharge home.
Surgical procedures undertaken and/or post-surgical care provided?
Some defined routine/dedicated surgical services for newborns are provided at JCUH, including some specialist procedures as listed below. Laser surgery for advanced ROP (Retinopathy of prematurity) is provided by arrangement/referral through the consultant neonatologists/ophthalmologists.
Cooling for H.I.E undertaken?
Therapeutic cooling for babies with HIE is undertaken here and babies requiring this therapy can be transferred from one of the SCBUs if this is required/indicated after discussion with one of the neonatologists and subsequent transfer arranged via the Hotline. MRI imaging and 12 channel EEG available for prognostication
T.P.N. provided on-site?
Yes with paediatric pharmacist input.
Neonatal community outreach team/services provided?
JCUH provide a comprehensive neo-natal community nursing service on a Monday-Friday basis, covering babies needing home tube feeding, home oxygen therapy and where required in discussion with the Unit Discharge team. Babies with long-term problems that will require ongoing care will usually be handed over to the Paediatric Community team at an agreed age, usually 1-2 years depending upon the condition.
All discharges are reviewed at a weekly meeting with the neonatal team. Multi-disciplinary team meetings are arranged pre-discharge for selected babies with significant problems.
Transitional Care provision on-site?
Transitional care facility exists within ward 17 (postnatal wards).