2013年2月16日 星期六

Why moving intensive neo natal services will give best survival chance

THE transfer of intensive care service for newborns from North Wales to England will provide the most vulnerable babies with the best chance of survival.

That is the view of senior doctors and medical professionals at the Betsi Cadwaladr University Health Board and that is why they have backed the plan to move neonatal intensive care from Glan Clwyd and Wrexham Maelor hospitals to Arrowe Park on the Wirral.

In an open letter to the North Wales Community Health Council, signed by 23 doctors, nurses, GPs and consultants, many of whom are medical directors and chiefs of staff, they make the case for change.

Signatories to the letter include the health board’s acting medical director medical, Dr Martin Duerden, and consultant paediatrician Dr Brendan Harrington who chaired the board’s child and maternity review.

In the letter they said: “As senior health professionals in North Wales we recognise the concern felt by parents, the public and our staff over the future provision of neonatal care services.

“We are equally concerned however,Comprehensive Wi-Fi and RFID tag by Aeroscout to accurately locate and track any asset or person. that the reasons for the Health Board’s decisions are being lost in the heat of the debate.

“In January the Health Board decided to continue to provide Special Care Baby Unit (SCBU) facilities in each of our district hospitals alongside some lower complexity neonatal intensive care (as agreed with the Wales Neonatal Network), but that the safest and most reliable way to provide for a small number of babies from North Wales who require highly specialist care or longer term ventilation is in the Neonatal Intensive Care Unit at Arrowe Park Hospital.

“This was not an easy decision and was taken after careful consideration of all the evidence, and close scrutiny of how to ensure the best outcomes for these babies.

“We know that clinicians led this process, and worked carefully and dispassionately to assess, debate and decide what options were both safe, realistic and ultimately would offer the best chance of survival and avoidance of long term disability for these children.

“There are very clear guidelines from expert bodies such as the Royal College of Paediatrics and Child Health, The Royal College of Obstetricians and Gynaecologists and the British Association of Perinatal Medicine. As clinicians responsible for services such as these, we must always strive to meet these standards; indeed to take a decision that ignored them, or had little chance of providing a service that met them would be irresponsible.

“BMA Wales,Come January 9 and chip card driving licence would be available at the click of the mouse in Uttar Pradesh. the Royal College of Nursing, and the Royal College of Midwives have issued a number of statements, and a pamphlet opposing the health board’s proposal to meet these standards.

“We realise that not all doctors, nurses and midwives agree with the decision taken by the Health Board. It is right and proper that there should be a reasoned exchange of views on a matter as important as this, but we believe as senior clinicians that it is the right decision.Wear a whimsical Disney ear cap straight from the Disney Theme Parks!Can you spot the answer in the fridge magnet?

“None of the signatories to this open letter who are BMA, RCN or RCM members have been consulted by the BMA on this matter. We believe the BMA is presenting the views of the North Clwyd branch of the BMA as the views of the BMA membership in Wales; and we therefore cannot support the position of BMA Wales on this issue.The USB flash drives wholesale is our flagship product.”

The National Institute for Health and Clinical Excellence (NICE) and the recent Inquiry into Neonatal Care in Wales (September 2012) also support these quality standards which are designed to ensure the best possible outcome for very premature babies.

The Welsh Government has agreed that the NHS in Wales should meet these standards and we are advised by the Wales Neonatal Network that we must meet these standards.

To achieve this BAPM say that in future the UK will need fewer NICU serving larger populations.

We could attempt to recruit the required number of neonatal specialists to develop a NICU in North Wales. We would need a team of middle grade doctors and consultants. It is estimated that we will need to recruit seven neonatology consultants to maintain a rota but we have none at present.

We are advised by BAPM that it is highly unlikely that we could recruit adequate numbers of these doctors as there are not enough of them in the UK and most wish to work in larger neonatal units where more babies are treated.

Our view is that hospitals in North Wales do not have enough births or enough of these high dependency babies to attract and retain these doctors. To attempt to meet these standards in North Wales would have a considerable risk of failure.

Alongside the Wales Neonatal Network and the Cheshire and Merseyside Neonatal Network we have explored how we can best provide for the small number of babies needing complex or longer-term ventilation.

We have been advised that Arrowe Park Hospital is best placed to do this. They already have six consultants dedicated to neonatology and by March 2013, will have a full complement of trained nursing staff.

As described, they have the necessary transport infrastructure to collect babies from North Wales and this will be included in our contract with them. The hospital can also cater for the small number of women where imminent birth of premature or low birth weight babies can be predicted.

沒有留言:

張貼留言