BLISS, a charity working to improve the care and survival of babies born prematurely and/or sick has today published a highly critical report[1] on failings within Neonatal care units in the UK today. The report, which has been researched and funded by BLISS, is based on surveys returned by 101 neonatal units (63 per cent of the neonatal units in England) and 14 neonatal transport services (100 per cent of the transport services in England). Key organisations such as the Care Quality Commission and the Royal College of Obstetricians and Gynaecologists have commented in the press today on concerns they have at the impact understaffing has onthe quality and safety of care in these units.
Report Findings
- 64% of Neonatal units do not have enough nurses.
- 33% do not have enough doctors
- How many more nurses do we need? They estimate 2140.
- Insufficient funds to also train and support the staff already employed
- Because of these shortfalls in staffing and training the quality of the care being delivered is not good enough and does not consistently meet national standards.
To put this report and its findings into context, in the UK we have a set of National Standards[2] that make recommendations for the safe staffing of Neonatal Care Units, and a highly developed "Toolkit[3]" that provides a way for managers to assess the needs of their units at any given time. Amongst those recommendations are that units should have a ratio of one nurse to one baby, but there are either not enough specialist nurses available to staff the units, or they are not being hired.
The Care Quality Commission (CQC) also has concerns about staffing shortages affecting care levels, and that some Trusts may not be focusing on the quality of care, patients' safety and efficiency when looking at staffing levels and have commissioned their own review of neonatal services, to be published in Spring 2016.
Babies in neonatal care often require the most intense and specialist nursing and clinical care to survive, and the job that our doctors and nurses do is inspiring. They are providing that care 24/7. However good they are and however committed they are, failing to ensure that those on duty are not working back to back shifts to cover staffing shortfalls, and that they are given time out to do the training that keeps them providing safe quality care will inevitably lead to increases in mistakes in medical treatment. Mistakes in medical treatment can and often do lead to serious injury or death; and those mistakes don’t just affect the baby treated but her whole family and the medical staff treating her. The financial and social cost of caring for babies seriously injured by avoidable mistakes has implications for our whole society which bears that burden.
We sadly see too many of those cases here, where families ripped apart by the impact of caring for seriously disabled children feel they have no choice but to sue the Trust that had had the potential to be their child's saviour. The report highlights a growing problem for provision of safe medical care in the UK; we don’t have enough doctors and nurses and the reasons are multiple. A lack of funds, a lack of skilled practitioners we can draw on, a growing population, and changing and expanding health needs of the populace as a whole. Whilst this report highlights the shortfalls and points to what is needed to provide good enough care, it has no answers to this ongoing problem of where we are going to find our nurses and doctors to care for us in the coming years. Whilst a solution to staffing problems is sought, patients will continue to suffer avoidable injuries, staff will continue to leave the profession as they feel under supported and under resourced, and money that could go into providing the safe and effective quality care will be needlessly expended on bank staff and litigation.
By Senior Associate Caron Heyes