Nurse shortage at baby units

A study from the National Audit Office (NAO) found "significant shortages" of trained nurses across England and baby units operating above capacity.

Units had to close their doors to new admissions an average of once a week during 2006/07, mainly due to these shortcomings, it said.

A third (33% or 58 units) were operating above the 70% capacity set out as a guideline by the British Association of Perinatal Medicine (BAPM). Another three units were operating above 100% capacity, meaning there were more babies in cots than there were trained staff to care for them.

The report said: "These high occupancy rates could have consequences for patient safety, for example due to the increased risk of infection or inadequate levels of care."

While most units had an adequate number of medical staff, there was a more "critical" situation when it came to nurses with "significant shortages of trained nurses across the country and wide regional variations in vacancies".

Only at the lowest level of care needed (special care) was the BAPM guideline ratio of one nurse to every four babies being met.

Only half of units had the right staff-baby ratio for high dependency care (one nurse to two babies) and just 24% did so for intensive care (one nurse to one baby). This meant that the higher the level of care a baby needed, the less likely there were to be the right numbers of staff. And over half of units were caring for babies who were ready for transfer to less specialist care, but for whom cots were unavailable. A third (32%) were caring for babies who needed a higher level of care, putting extra pressure on staff and "leading to a reduction of appropriate medical input for other babies on the unit."

A total of 16 units told the NAO that care was being compromised.

Around one in 10 babies born every year needs specialist neonatal care for reasons like being premature, low birth weight or suffering from a condition like a heart defect.