Norfolk and Norwich team celebrates 25 years of providing neonatal outreach services

Launched in September 2000, the Norfolk and Norwich University Hospital (NNUH) outreach team is celebrating 25 years and was one of the first neonatal outreach services in the country. It facilitates earlier discharge and supports families caring for their babies with feeding tubes, home oxygen, cardiac and surgical conditions and palliative care. Team members visit nearly 300 families every year, travelling up to 20,000 miles around Norfolk.

Early discharge enables improved patient flow on the NICU but it’s not just about flow, as Senior Sister Charlotte Devereux explains: “Babies thrive at home with their families. Our priority on NICU is to support parents to learn to care for their baby at home as soon as possible. Reducing hospital admission reduces stress, improves bonding, attachment, breastfeeding and developmental outcomes”

Not all hospitals currently have outreach teams working in their neonatal units. The NNUH team is small, with just three nurses providing the service seven days a week. The team manages the caseload on NICU and liaises with the neonatal team each day. They attend nursing handover, organise discharges and endeavour to introduce the service to parents in preparation for home. Each day one nurse will make home visits within an approximately 35-mile radius. Some days they can make more than nine visits in different locations.

Families can feel very vulnerable, and the team not only carries out nursing checks on the babies but is there to support parents too. “That’s a huge part of the job,” says Deputy Sister Anna Smith. “You never know what you’re walking into. Some families are really struggling, and we do a lot of signposting onto other support services like health visitors, mental health support and the baby bank who can provide items for families in need.”

Anna adds: “The team is very good at getting together to support each other on the unit if there’s been a particularly difficult case. We’ve also got three other members of staff on the unit who are training up to cover outreach work so we can cover annual leave, and having their support is invaluable.”

The visits are crucial to identify fragile babies who could be deteriorating at home and require further hospital treatment. Joint working is paramount, with the nurses in regular touch with other outreach teams just outside the area, colleagues such as the neonatal dietitian, speech and language therapist, occupational therapist and cardiac specialists at Great Ormond Street Hospital.

For the babies who progress but still need nursing support, the team hands over the care at 44 weeks to the Children’s Community Nursing team at Norfolk Community and Health Care NHS Trust.