NNAP report highlights issues with staffing levels on neonatal units

The National Neonatal Audit Programme (NNAP) has published its annual report 2019 on 2018 data. The report highlights the key findings and recommendations from the analysis of the data provided by neonatal units on the admissions of babies for neonatal care in England, Scotland and Wales in 2018.

For the first time, the report measured staffing levels at neonatal units and found that just 64% of shifts are staffed according to national guidelines and only 44% of all nursing shifts have sufficient specialist staff to care for the babies present.

According to the findings only 21 out of 53 NICUs had half or more of their shifts with sufficiently qualified specialist staff.

The other key messages that emerged from the NNAP's dataset in 2018 included:

- Rates of mortality in very preterm babies (less than 32 weeks gestational age) until discharge home or 44 weeks post menstrual age, whichever occurs sooner, vary widely by network of care from 4.9% to 9.8% adjusted rate. Adjusting for background characteristics does not explain the variation.

- Processes such as administration of antenatal magnesium, screening for retinopathy of prematurity and measures of parental partnership in care show widely divergent practices between different neonatal units and networks.

- Neonatal outcomes such as bronchopulmonary dysplasia, necrotising enterocolitis and late onset neonatal infection vary between neonatal units, in a way that is unlikely to be explained by differing patient characteristics.

- Outcomes for very preterm babies are improved when they are cared for in a NICU from birth; 74.3% of babies born at less than 27 weeks gestational age were born in a NICU. This is a slight improvement on 2017, when the rate was 73.9%. Three of the 15 neonatal networks achieved the developmental standard of 85%.

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