Chamber
Meeting of the Parliament 28 November 2013
28 Nov 2013 · S4 · Meeting of the Parliament
Item of business
World Prematurity Day 2013 and Neonatal Care
I congratulate Rhoda Grant on securing time for the debate on an area of extremely specialist healthcare provision in NHS Scotland. I welcome Cara Hilton to the chamber, as this is the first debate in which I have had the opportunity to hear her speak. I thank her for sharing her experience, which has given us a personal insight into the matter.
I take this opportunity to acknowledge the support that is provided across the country by organisations such as Bliss Scotland to parents of sick and premature babies. They do a tremendous amount of work to raise awareness of premature birth matters.
The Scottish Government is committed to ensuring that sick and premature babies receive the highest possible quality of care by the most appropriate professional at all times. We recognise the vital role of our neonatal units in providing intensive and specialist care for sick and premature babies. Only on Monday this week, I was in the Victoria hospital in Kirkcaldy visiting the neonatal unit, which I am sure is a significant improvement on the previous facilities there. The level of neonatal care from the staff is first class. I also had the opportunity to see a BabySam system in operation there: a small camera is located above the incubator so that a mother can observe her baby on a tablet device from her hospital bed at any time. Parents have found that facility to be tremendously useful.
I am pleased that Rhoda Grant’s motion welcomes “Neonatal Care in Scotland: A Quality Framework”. We are extremely fortunate in Scotland to have a high level of expertise available to us, which was provided in the form of the neonatal expert advisory group that we established to develop the framework. The group included key experts from the health professions and other services, and stakeholders from across the country including support groups Bliss and Sands. The expert group also played a vital role in engaging with the managed clinical networks that were established in 2010 to ensure that we had agreed pathways of care and protocols for maternity and neonatal surgical services, and that services, staff and facilities meet the predicted demand from the population.
The framework outlines NHS Scotland’s commitment to providing the highest possible quality of neonatal care for babies. It aims to be a dynamic framework that supports staff in order to allow them to improve services at local level. The framework has been regularly reviewed by neonatal staff throughout its development.
I believe that the framework is ambitious. It needs to be, in order to secure the best form of care for premature and sick babies. We know that implementation of the framework will take time. I acknowledge that Cara Hilton and others are anxious to see things happen as quickly as possible, but I am also sure that members appreciate the complexity and the specialist nature of some of these matters, and understand that health boards need time to implement the framework effectively. We will make sure that that happens.
We have heard mention of workforce issues. Those issues are not unique to neonatal care, despite the specialist nature of the work, but the framework offers boards opportunities to move to a much more modern and stratified service that focuses on the provision of safe care and ensures that the sickest babies are cared for by the right staff with the right skills at the right time and in the right place. A neonatal nursing workload and workforce planning tool that identifies the nursing needs of sick and premature babies has been implemented across NHS Scotland through our neonatal units, so we are making progress. The tool takes into account the staffing recommendations of the British Association of Perinatal Medicine, which Rhoda Grant and Nanette Milne mentioned, and it captures actual nursing workload in real time so that we can see clearly the level of work that is being undertaken.
Many of the requirements that are set out in the framework to deliver high-quality, safe and person-centred neonatal care are already in place at units across the country. The framework makes it clear, however, that boards must put in place plans or pathways to repatriate babies to the unit that is closest to their home as soon as is clinically appropriate for the level of care that they require, and parents should be supported to help them to understand the situation and the choices that they face.
Mark McDonald mentioned the challenges that exist when babies are transferred and parents have to transfer to other units. That is why we need to ensure that boards are working in a co-ordinated way so that we have the right staff in the right place to provide the right care to parents at that point, and then to allow babies to return to more local units, when possible.
We are also working to provide more information to parents. We are undertaking a patient leaflet programme in partnership with Bliss to support and inform parents of what the framework means for them, and what they should expect.
In drawing my remarks to a close, I reassure members that, where any service change is considered as an option to meet the high standards that the experts set out in the framework, boards should work in consultation and in partnership with their local communities. Scottish Government officials are reviewing the implementation plans that have been received from NHS boards and we will meet the three managed clinical networks to go over them in more detail. Facilities for parents, workforce issues and other points that have been raised in today’s debate will be highlighted and discussed at that meeting, as will potential funding opportunities.
I hope that I have reassured members that we are determined to ensure that the framework is implemented across the country so that babies who require such specialist care receive it at the right time.
13:05 Meeting suspended.
I take this opportunity to acknowledge the support that is provided across the country by organisations such as Bliss Scotland to parents of sick and premature babies. They do a tremendous amount of work to raise awareness of premature birth matters.
The Scottish Government is committed to ensuring that sick and premature babies receive the highest possible quality of care by the most appropriate professional at all times. We recognise the vital role of our neonatal units in providing intensive and specialist care for sick and premature babies. Only on Monday this week, I was in the Victoria hospital in Kirkcaldy visiting the neonatal unit, which I am sure is a significant improvement on the previous facilities there. The level of neonatal care from the staff is first class. I also had the opportunity to see a BabySam system in operation there: a small camera is located above the incubator so that a mother can observe her baby on a tablet device from her hospital bed at any time. Parents have found that facility to be tremendously useful.
I am pleased that Rhoda Grant’s motion welcomes “Neonatal Care in Scotland: A Quality Framework”. We are extremely fortunate in Scotland to have a high level of expertise available to us, which was provided in the form of the neonatal expert advisory group that we established to develop the framework. The group included key experts from the health professions and other services, and stakeholders from across the country including support groups Bliss and Sands. The expert group also played a vital role in engaging with the managed clinical networks that were established in 2010 to ensure that we had agreed pathways of care and protocols for maternity and neonatal surgical services, and that services, staff and facilities meet the predicted demand from the population.
The framework outlines NHS Scotland’s commitment to providing the highest possible quality of neonatal care for babies. It aims to be a dynamic framework that supports staff in order to allow them to improve services at local level. The framework has been regularly reviewed by neonatal staff throughout its development.
I believe that the framework is ambitious. It needs to be, in order to secure the best form of care for premature and sick babies. We know that implementation of the framework will take time. I acknowledge that Cara Hilton and others are anxious to see things happen as quickly as possible, but I am also sure that members appreciate the complexity and the specialist nature of some of these matters, and understand that health boards need time to implement the framework effectively. We will make sure that that happens.
We have heard mention of workforce issues. Those issues are not unique to neonatal care, despite the specialist nature of the work, but the framework offers boards opportunities to move to a much more modern and stratified service that focuses on the provision of safe care and ensures that the sickest babies are cared for by the right staff with the right skills at the right time and in the right place. A neonatal nursing workload and workforce planning tool that identifies the nursing needs of sick and premature babies has been implemented across NHS Scotland through our neonatal units, so we are making progress. The tool takes into account the staffing recommendations of the British Association of Perinatal Medicine, which Rhoda Grant and Nanette Milne mentioned, and it captures actual nursing workload in real time so that we can see clearly the level of work that is being undertaken.
Many of the requirements that are set out in the framework to deliver high-quality, safe and person-centred neonatal care are already in place at units across the country. The framework makes it clear, however, that boards must put in place plans or pathways to repatriate babies to the unit that is closest to their home as soon as is clinically appropriate for the level of care that they require, and parents should be supported to help them to understand the situation and the choices that they face.
Mark McDonald mentioned the challenges that exist when babies are transferred and parents have to transfer to other units. That is why we need to ensure that boards are working in a co-ordinated way so that we have the right staff in the right place to provide the right care to parents at that point, and then to allow babies to return to more local units, when possible.
We are also working to provide more information to parents. We are undertaking a patient leaflet programme in partnership with Bliss to support and inform parents of what the framework means for them, and what they should expect.
In drawing my remarks to a close, I reassure members that, where any service change is considered as an option to meet the high standards that the experts set out in the framework, boards should work in consultation and in partnership with their local communities. Scottish Government officials are reviewing the implementation plans that have been received from NHS boards and we will meet the three managed clinical networks to go over them in more detail. Facilities for parents, workforce issues and other points that have been raised in today’s debate will be highlighted and discussed at that meeting, as will potential funding opportunities.
I hope that I have reassured members that we are determined to ensure that the framework is implemented across the country so that babies who require such specialist care receive it at the right time.
13:05 Meeting suspended.
In the same item of business
The Deputy Presiding Officer (Elaine Smith)
Lab
The next item of business is a members’ business debate on motion S4M-08110, in the name of Rhoda Grant, on world prematurity day 2013 and world-class neonat...
Rhoda Grant (Highlands and Islands) (Lab)
Lab
I am pleased to open the debate to mark world prematurity day, which fell on 17 November. I vividly remember visiting my great-nephew just over a year ago in...
Mark McDonald (Aberdeen Donside) (SNP)
SNP
I congratulate Rhoda Grant on bringing this important debate to the chamber. It has a personal note for me, as many of the children in my family spent time i...
Malcolm Chisholm (Edinburgh Northern and Leith) (Lab)
Lab
I thank Rhoda Grant for lodging the motion, which reminds us that 8,000 babies are born prematurely in Scotland each year. That is 8,000 families, all of who...
Nanette Milne (North East Scotland) (Con)
Con
I, too, commend Rhoda Grant for securing this debate on the very important—but not widely discussed—topic of premature birth and care of babies who are born ...
Cara Hilton (Dunfermline) (Lab)
Lab
I thank Rhoda Grant for bringing this important debate to the chamber to mark world prematurity day.As we have heard from Malcolm Chisholm, in Scotland 8,000...
The Minister for Public Health (Michael Matheson)
SNP
I congratulate Rhoda Grant on securing time for the debate on an area of extremely specialist healthcare provision in NHS Scotland. I welcome Cara Hilton to ...