The NWNODN has a comprehensive work programme which reflects both local and national directives. Please find below a brief overview of some of the work undertaken.

The NWNODN recognises the number of babies being discharged home from hospital receiving some or all of its mother’s milk need to improve. The National Neonatal Audit Programme (NNAP) has shown that lower than average results for rates of infants receiving their mother’s milk at discharge are being achieved across the NWNODN.  This is based on data for 2015, however network dashboard data supports this level of performance. The NWNODN are committed to addressing and improving these figures and as a result has made improving breast feeding/expressing rates part of our 2017/18 work programme.

Providing breast milk for premature or sick babies is especially important as they are more vulnerable to infection, and mother’s milk provides an important line of defence through the protective antibodies that it provides. These significant health benefits include a reduction in infection and gut pathologies, as well as improved longer-term health and neurodevelopmental outcomes for the infant, as well as health benefits for the mother.

The NWNODN recognises breast feeding/expressing milk for a sick or premature baby can be highly challenging and in order to help mothers and improve rates of breast feeding/ milk expression within all our neonatal units we have founded a Breast Feeding Specialist Interest Group. The group is made up of highly knowledgeable and motivated clinicians from across the whole network, as well as parent representatives, who are working together to develop a Breast feeding/expressing  best practice framework that will be available for use by all our neonatal units.

The NWNODN actively supports and encourages neonatal units to be involved with national initiatives to improve breast feeding rates working in close collaboration with national charities and organisations. Sixteen out of our twenty-two neonatal units are either undergoing or have completed audit 1 or 2 of the BLISS Baby Charter and similarly sixteen units have  full Baby Friendly Initiative (BFI) accreditation with a further four currently working towards it.

Useful resources for professionals supporting lactation:

Baby buddy app: https://www.bestbeginnings.org.uk/using-baby-buddy
Heart Mummy: heartmummy.co.uk   (info for parents and clinicians)
UNICEF: https://www.unicef.org.uk/babyfriendly/what-is-baby-friendly/the-benefits-of-breastfeeding/
Breast feeding network: https://www.breastfeedingnetwork.org.uk/
Nice http://publications.nice.org.uk/specialist-neonatal-care-quality-standard-qs4
Best beginnings http://www.bestbeginnings.org.uk/small-wonders

The ‘Small wonders’ DVD is a useful and inspiring resource to use when training neonatal staff. The Baby Friendly neonatal standards include the requirement to implement a family centred approach to care and to ensure parents are involved as partners in care. Each unit will decide locally how best to ensure these standards are implemented in their area.

Breast feeding support, information and advice for parents:

BLISS: http://www.bliss.org.uk/breastfeeding
Baby buddy app: https://www.bestbeginnings.org.uk/using-baby-buddy
Heart Mummy: www.heartmummy.co.uk   (info for parents and clinicians)
UNICEF: https://www.unicef.org.uk/babyfriendly/what-is-baby-friendly/the-benefits-of-breastfeeding/
NHS Choices: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/benefits-breastfeeding.aspx
NCT https://www.nct.org.uk/parenting/about-breastfeeding
Breast feeding network: https://www.breastfeedingnetwork.org.uk/
For more information please contact:

Meeting Dates

forth coming Breast feeding specialist Interest  group meetings:

Tue 12th September 10-1pm
Weds 8th Nov 10-1pm
Weds 13th Dec 10-1pm
Weds 24th Jan 18 10-1pm

All to be held at Venue: NWTS Head Quarters, Newton House, Farraday Street, Birchwood Park, Warrington

The Health and Social Care Act (2012) emphasises the importance of integrated care across the National Health Service (NHS). ‘Integrated care is not about structures, organisations or pathways – it is about better outcomes and experiences for services users’ (NHS Future Forum, 2016). Integrated care is growing in momentum across the whole NHS and neonatal care is no exception with the introduction of Family Integrated Care (FiCare) into its neonatal units.

FiCare is a relatively new model of care started in 2013 by Dr Shoo Lee who was intrigued about the feasibility of introducing a care by parent model of care to his NICU in Canada. Unlike previous family centred care approaches, this new parent model of care places parents at the heart of care giving, being based on the Humane Care Model already widely operational in neonatal units in Estonia. The FiCare model is an extension of the principles of Family Centred Care. The goal of FiCare is to facilitate a partnership and collaboration between parents and the NICU staff, to promote parent-infant interactions, and to build parent confidence. FiCare represents a paradigm shift in thinking about the way in which healthcare is delivered. FiCare invites parents in to become part of the primary care team, moving away from traditional care delivery by only highly trained healthcare professionals.

The NWNODN recognises the myriad of health benefits the models promotes and as a result have established a FICare Specialist Interest Group (SIG). The SIG is made up of doctors, nurses, allied health professionals and parents who are working closely together to examine how this model can benefit all families and clinician within our network.
The SIG have agreed FiCare will be defined across the NWNODN as:
‘Family integrated care (FiCare) is a model that supports and educates parents and carers to become integral participants in their baby’s care from the time of admission to the neonatal unit in partnership with the neonatal team’

For further information about the network approach to FiCare across the NWNODN please contact:

emma.kyte@alderhey.nhs.uk
or Karen.mainwaring@alderhey.nhs.uk

Document Downloads

A review of Family Integrated Care (FiCare) – A Case for change across the NWNODN?

An independent report for the Department of Health composed by Lord Carter (2016) has identified that more could be done to improve quality and efficiency within hospitals to meet the expected efficiency target of 10-15% by 2021. In his report Lord Carter identified the unwarranted variation within procurement suggesting that with full engagement of NHS staff in relation to productivity and efficiency, this target could be met. The report identified alarming variances in the number of products and suppliers within individual trusts.

Historically clinical staff and procurement teams have worked in isolation being hindered by a lack of staff and time to lead procurement within the neonatal unit. The NWNODN realise this issue and have made Procurement part of our work programme to help overcome this obstacle and achieve cost saving within the NHS.

The Kirkup report (2015) made a recommendation to ‘seek to forge links with a partner Trust, so that both can benefit from opportunities for learning, mentoring, secondment, staff development and sharing approaches to problems’. Although this was in relation to clinical practice this statement can be transferred and applied to the inefficiencies identified within procurement. Through forming a network consortium made up of all the Trusts within the NWNODN, the network procurement team aim to standardize payment, improve transparency, save neonatal units money and ultimately reduce non-pay spend across the NHS whilst maintaining the quality of care.

For more information please contact:

Neonatal care in the North-West Neonatal Operational Delivery Network (NWNODN) is delivered by 22 neonatal units. In addition, neonatal cardiac services are provided by Central Manchester Foundation Trust (CMFT) and neonatal cardiac surgery by Alder Hey Children’s Hospital (AHCH). In 2015 within the NWNODN 76 neonates (0-28 days) & 223 infants (28 days to 1 year age) had either cardiac surgery or catheterization (North-West Cardiac Network, 2017).

In addition to the main cardiac centres the network provides many peripheral outreach clinics so cardiology follow-up is available closer to home.

Fetal cardiology expertise is currently delivered at Liverpool Women’s Hospital (LWH) and St Mary’s Hospital (SMH) in Manchester.  On both sites this involves a multidisciplinary approach of fetal cardiologists, fetal medicine specialists, neonatologists, specialist midwives and sonographers. Antenatal detection rates across the NWNODN are between 35-40% (North-West Cardiac Network, 2017).  Cardiac liaison nurses at Alder Hey Children’s and Royal Manchester Children’s Hospitals provide information, support and guidance in the antenatal period to prepare families prior to delivery.

The overall aim of developing a perinatal cardiac pathway is to effectively utilize scarce resources  to ultimately save lives by providing safe, high quality cardiac care (including surgery) to babies in line with national standards, delivered within the local neonatal network and as close to home as possible.

For more information please contact:

The National Health Service (NHS) has made it a priority to reduce the number of term admissions (infants born after 37 weeks gestation) to neonatal units, work supported by the NHS Outcomes Framework 2016-17 (Domains 1C & 5.5). Research by the National Audit Data Analysis Unit (NDAU) on behalf of NHS England in 2013, identified almost 60% of all admissions to neonatal units were term infants; with around 30% of those admission being due to avoidable factors. Between 2011-2014 term births declining by 3.6% however alarmingly the number of term admissions to all levels of neonatal unit rose by 24%, with a further rise by 6%  in 2015 (NHS Improvement, 2017).

The five main reasons for term admission are: respiratory disease, infection, hypoglycaemia, jaundice and asphyxia (ATAIN programme 2015). Following a full review of patient safety reports, litigation cases and  neonatal admission notes, NHS Improvement (2017) identify the top four ‘avoidable’ reasons for term admission to be: Hypoglycaemia, jaundice, respiratory factors and asphyxia (brain damage caused by a lack of oxygen near or after birth). The NWNODN are producing a network report utilising local data to effectively address this issue.

Useful resources relating to avoidable term admissions:

Reducing term admissions pdf

For more information please contact: