Plans for changes to neonatal services in Chichester
Some services could be moved out of the city's hospital
Councillors have been told that plans to make changes to neonatal critical care at a Chichester hospital are about safety and quality, not money.
A report to a West Sussex County Council scrutiny committee, which met on Monday (March 7), said the local neonatal unit (LNU) at St Richard’s Hospital, in Spitalfield Lane, cared for an average of nine babies per year born at less than 32 weeks’ gestation.
Of the ten cots it has for intensive care and special care, on average only 53 per cent were being used in 2020.
With staff needing to deal with more premature tots than that to keep their skills and expertise up to scratch, NHS England proposed a change.
If taken forward, it would see St Richard’s re-designated as a special care unit (SCU), with some babies being cared for in the neonatal intensive care unit (NICU) in Portsmouth – a service it already provides for the smallest and sickest.
LNUs provide short-term intensive care for premature babies who are over 27 weeks’ gestation.
SCUs are for those over 32 weeks’ gestation who need help with issues such as jaundice or whose breathing and heart rate need continuous monitoring.
And NICUs tend to the tiniest and sickest babies, those under 27 weeks of gestation or weighing less than 800g.
A report to the meeting said the change would bring the neonatal service at St Richard’s in line with national standards guidelines.
It added that the re-designation would ‘more accurately reflect the needs of most babies that require care there’.
The change was largely supported by the committee – whose views will be fed back to NHS England.
Dr James Walsh (Lib Dem, Littlehampton East) said: “The numbers involved are very small and, if I was the parent of one of those nine or ten babes, I would want the very best treatment for my youngster.
“I think having the knowledge that they’re going to an extremely specialised unit where the care that can be offered is of the very best and the highest quality, is what most parents would desire.
“It’s an inconvenience, yes, but I think when you weigh in the balance, it’s the best outcome with the best specialised team you can find.”
Chairman Garry Wall agreed, adding: “If I was a parent or grandparent of one of these newly born or yet to be born babies, where would I want them to be looked after?
“I would want the best possible care for them.”
While the committee was told that staff had been aware of the proposals ‘for some time’, questions were asked about whether St Richard’s would lose its appeal as a training centre.
Gina Outram, of University Hospital Southampton, said staff had raised concerns about maintaining their skills and knowledge.
Skills such as resuscitation, intubating tiny babies, putting even tinier lines into their veins, and taking care of their feeding.
She told the meeting that the hospitals in Chichester, Portsmouth and Southampton were all part of the same network and were working on a service-level agreement for the education of staff – encouraging them to work in each other’s units to maintain those vital skills.
Tracie Bangert, of Chichester District Council, voiced concerns that the proposals were part of a downgrading of St Richard’s.
She said: “Having a premature baby causes tremendous strain on families which travelling will only exacerbate.
“The loss of the LNU will have a knock-on effect to the residents of our area who, in the past, have feared that their hospital will be downgraded.
“We need reassurance that this is a step that needs to be taken rather than the beginning of a significant reduction of the services at St Richard’s.”
While the downgrading or not of the hospital was not up for discussion during the meeting, firm assurances were given that the change to the neonatal unit was necessary.
Carol Wood, of NHS England, said: “At the moments the units do not meet the national standards.
“If the service remained as it currently is, then we would continue to not meet the standards.”
She added that NHS England would be working with the Maternity Voices Partnership – an NHS working group – to ask former and current service users for their views.
Summing up, Mr Wall said: “Like a lot of hospitals across Sussex, there’s been significant changes based around how care is delivered.
“But ultimately, those hospitals are needed and they do have their own centres of excellence within those hospitals.
“I’m sure that the people looking at St Richard’s and how it supplies care and provision to the community will take all these comments on board.
“This is particularly about delivering the best possible outcomes for the small number of babies that are affected by the neonatal and the special care unit.”