'Serious' neonatal nurse shortage

Each of England's 178 neonatal units had to close its doors once a week on average during 2006-07, with the MPs warning of "major implications for patient safety".

And five years after an ordered reorganisation, two areas have failed to fully implement the changes, the Commons Public Accounts Committee said.

The cross-party group of MPs announced the findings in their report 'Caring for Vulnerable Babies: The reorganisation of neonatal services in England'.

It found that the 2003 decision to reorganise the 178 neonatal units into 23 geographical networks had delivered some benefits but that more needed to be done. The committee found there were three vacancies per unit for nurses qualified in neonatal care, and said there was a need for a "national action plan to address neonatal nurse shortages".

The MPs also found that a third of units operated above the recommended occupancy rate of 70%. And they warned: "High occupancy rates could have major implications for patient safety due to increased risk of infection or inadequate staffing levels".

Only half of networks provide specialist neonatal transport services at all times, and the committee found that almost three quarters of units had experienced delays in transporting babies as a result. Some 44% believed care had been compromised in such circumstances.

The reorganisation had "limited impact" in reducing variations in mortality rates across the country, the committee said, though this was down to a "complex range" of factors and better understanding was needed.

The MPs also criticised "variations and mismatches" in the costs of care between neonatal units.

Tory Edward Leigh, who chairs the committee, said: "There was widespread support for the reorganisation of neonatal services five years ago, resulting in the creation of 23 clinical networks. However, this change has had limited effect in reducing regional variations in mortality rates of babies born prematurely or suffering an illness needing specialist care."