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.
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