Serious pressures facing care for the sickest and most premature babies in Wales’ biggest hospital have been revealed, with units regularly running over capacity and increasing numbers of mothers having to be transferred miles away to other units in Wales or England.
Board papers published by Cardiff and Vale University Health Board (UHB) paint a stark picture of the extent of the problems facing neonatal intensive care in Cardiff’s University Hospital of Wales (UHW).
The papers outline how, as result of cot closures and increased demand for services, there are “daily capacity problems at UHW”.
Since December 2011, the neonatal intensive care unit has been at or over capacity for around 32% of the time, with the greatest pressure said to be at critical care level.
The papers say that this has an impact on neonatal and obstetric delivery, and results in mothers and babies being transferred out of Cardiff to other units in Wales or over the border. In the six months prior to March 2013, 14 women were transferred out to another unit, with the papers stating that a need to repatriate this activity “not least for patient safety reasons”.
The British Association of Perinatal Medicine recommends that neonatal units should operate at around 70% capacity to be safely managed and says that levels above this will result in a deterioration of clinical outcomes.
But according to the board papers, each units providing different levels of care have been operating between 79% and 94% occupancy.
Helen Kirrane, campaigns and policy manager for neonatal charity Bliss, said: “Bliss has been campaigning for more nurses to care for babies born in need of specialist hospital care, better facilities and support for families in Wales for some time.
“While there have been some welcome improvements in recent years, there has been a steep increase in the number of extremely pre-term babies being born in South Wales in recent years and neonatal services have not kept up with this increase in demand.”
Proposals to change the way neonatal care is delivered in South Wales are currently under public consultation as part of the South Wales Programme, which health officials will say will help to deal with the pressures as resources are currently being spread too thinly.
The plans will see at least one hospital from a choice of Bridgend’s Princess of Wales, Llantrisant’s Royal Glamorgan and Merthyr Tydfil’s Prince Charles lose consultant-led neonatal and maternity care, inpatient children’s services and top-tier AE services.
Health bosses have said the “best fit” option, which scored most highly on issues such as safety, quality and access, would be to remove the services from the Royal Glamorgan.
But Ms Kirrane said that investment was still needed in neonatal care in order to provide a safe service.
She said:“Whatever the outcome of the current consultation in South Wales, it is clear that investment is much needed in the region.”
Serious concerns about neonatal care in Wales were raised by the National Assembly’s Children and Young People Committee in September last year when they published the results of their inquiry into the issue.
The committee was told the lives of babies were put at risk by a severe lack of staff and resources in Wales’ neo-natal units.
Last year, during a meeting of the Welsh Medical Committee, Dr Richard Penketh, a consultant obstetrician and gynaecologist at UHW said babies had died as a result of cot shortages and described the neonatal cot crisis in Wales as a “distressing situation” that was “getting worse”.
Cardiff and Vale UHB’s medical director, Dr Graham Shortland, said the health board acknowledged the problems within the neonatal service and was working closely with the Wales Neonatal Network to address the deficiencies.
He said:“The health community across South Wales recognises the urgency of dealing with these long-standing issues and have been working closely together as part of the South Wales Programme to develop sustainable and safe long term models of care for these most vulnerable of patients.
“However, Cardiff and Vale is also taking urgent action to improve matters and is working hard to improve both levels of staffing and infection control procedures, while looking at options for longer term investments in the service, including environmental improvements.”