Scope Of Care
Northern Neonatal Network Care Pathways – December 2017
Northumbria Healthcare NHS Foundation Trust – Northumbria Hospital CRAMLINGTON
Scope of care
Northumbria Healthcare NHS Foundation Trust provides neonatal services on its Northumbria Specialist Emergency Care Hospital (“The Northumbria”) site in Cramlington. It is unique in that it is a nurse-led Unit staffed primarily by a tier of dedicated Advanced Neonatal Nurse Practitioners (ANNPs) who provide the first line medical cover and rotate separately from the nursing staff, operating on a medical basis in that role. They provide all the initial stabilisation, diagnosis and treatment for babies admitted to the SCBU and oversee the delivery suite and post-natal ward providing the cover neonatal SHOs would normally give. They also prescribe drugs and IV fluids and will arrange transfers as necessary for any baby needing more intensive care. The ANNP team are supported by consultant paediatricians from the children’s unit and are available for advice support 24/7 as well as twice weekly ward rounds to the SCBU.
The current services provided on this site are as follows;
SCBU, Northumbria Hospital, Cramlington
Current Unit capacity
14 Special Care cots.
Annual number of deliveries
3171 in 2016/17.
Annual number of admissions
340 in 2016/17, (excluding Transitional Care activity). Babies from Trust’s 3 midwifery-led units (at Alnwick, Berwick and Hexham) may also receive special care at Cramlington.
Current threshold for routine ante-natal transfers
Generally obstetricians will routinely try to transfer <30/40 gestation mothers to a Level 3 NICU hospital.
Current threshold for routine post-natal transfers
Babies < 30/40 are routinely transferred to a Level 3 NICU for Intensive care. 30-32 week babies born at Wansbeck will usually be managed there if they are stable on CPAP. Babies < 1.5Kg are transferred out if they require TPN.
Other thresholds for routine post-natal transfer
Babies who can be cared for and requiring investigations that can be undertaken at Northumbria will usually not be transferred. Examples of those who we will require transfer include: Surgical referrals. Other main thresholds for transfer are babies with a need for long-lines, parental nutrition or active cooling for H.I.E. Babies with tracheotomies would also not be cared for within the SCBU at Northumbria.
Routine investigations/tests/screening currently undertaken
ROP screening is performed on-site by the consultant Ophthalmologist from Newcastle. Routine ultrasounds of the cranium, kidneys and hips are all done on site.
Surgical procedures undertaken or post-surgical care provided if not?
No surgical services for newborns are available at Northumbria.
Cooling for H.I.E undertaken?
The SCBU is currently passively cooling babies for HIE prior to transfer to a NICU for active cooling if required/indicated and in discussion with the RVI, Newcastle.
T.P.N. provided on-site?
No. There are no on-site facilities for care of indwelling long lines and/or TPN.
Neonatal community outreach team/services provided?
Northumbria SCBU does not provide a neo-natal community nursing service, but there is a County-wide community children’s nursing service provides home care O2/tube feeding/palliative care.
Transitional Care provision on-site?
The adjacent postnatal ward offers all women en-suite rooms and partners are actively encouraged to stay overnight. Northumbria do provide some transitional care facilities on their post-natal ward with oversight by the neo-natal team. This would include babies needing phototherapy, IV antibiotics and also the management of NAS (Neonatal Abstinence Syndrome). Babies requiring regular tube feeds are admitted to SCBU. These are all under the care of the ANNP team.