In England, a taskforce established by the Department of Health produced a Toolkit for High-Quality Neonatal Services in 2009 which:
- outlined the quality principles required of services providing specialist neonatal care
- provided a consistent definition of three categories of neonatal care
- described three types of units working in a network of units
- described a set of quality metrics
- gave examples of how to address Quality, Innovation, Productivity and Prevention (QIPP)
In England, Neonatal services since 2013 have been managed within Operational Delivery Networks. There are now 11 of these and they provide a network to provide the different levels of care for their population. A high proportion of care for newborn babies, either healthy babies or those with lesser problems, is carried out at the district hospital where they are born. Complex and intensive care, particularly of very preterm babies, is carried out in tertiary centres – see: National Programmes of Care and Clinical Reference Groups - Neonatal Critical Care.
As foetal and neonatal care has developed, pre-term birth is now more common and the survival rate of sick newborn babies continues to improve. The NHS England Long Term Plan aims to reduce stillbirths, maternal mortality and serious brain injury – see: NHS England Long Term Plan - Maternity and neonatal services. Actions identified by the Neonatal Critical Care review include expanding critical care services to improve the effectiveness and safety of service provision.
In Wales, around 9-10% of babies born each year need admission to a Neonatal Unit – see: Wales Neonatal Network. The key principles of the Department of Health Toolkit for High Quality Neonatal Services are relevant across the whole of the United Kingdom, with Wales also establishing standards expected of neonatal service providers. Wales recently standardised neonatal nurse competences. All neonatal nurses in Wales will have the same level of education, skills and competence.
In 2017 a national review of Maternity and Neonatal Care in Scotland resulted in recommendations and a five year plan to improve care standards and service provision – see: Scottish Government - The best start: maternity and neonatal care plan executive summary and Scottish Government - The best start: five-year plan for maternity and neonatal care. Scotland led the way in developing Neonatal nurse education and all neonatal nurses educated and trained in Scotland follow the same curriculum and programme of education.
Northern Ireland does not currently have specific national standards for neonatal service provision.
