Seòmar agus comataidhean

This information is not held by the Scottish Government. All NHS Board expenditure is recorded via the Scottish Financial Returns, which provides operating costs relating to the running of all services provided to patients across NHS Scotland, however, it does not show specific costs for conditions such as thrombosis.

Evidence shows that the very smallest and sickest babies, including those born extremely premature (less than 27 weeks gestation), do best when they are cared for in larger specialist neonatal units which look after a lot of these babies, and have the right staff and services available on site to give them the very best care.

The Best Start report recommended that we move to three of these units in Scotland, to meet the needs of our population, and neonatal experts then went through a rigorous process to decide on the three NICUs.

It is important that we ensure that all babies born in Scotland receive the best and most up to date care, provided by appropriately trained staff. Outcomes in all units will be monitored following the changes, and we are developing plans for long term evaluation of outcomes of the package of changes outlined in The Best Start.

The Scottish Government commissioned independent modelling report was published on 29 May, and, following consideration of that report, we have asked the Regional Chief Executives to progress with the development of implementation plans.

We have asked that implementation plans are developed with the input of multidisciplinary clinical teams and describe service requirements for the new model and how they will be achieved.

No consulting firm has been hired or paid to oversee the implementation of the Best Start programme for maternity and neonatal care. The Best Start Implementation Programme Board (IPB), Chaired by Jane Grant, Chief Executive of NHS Greater Glasgow and Clyde was established in June 2017 to guide the implementation of The Best Start: A Five-Year Plan for Maternity and Neonatal Care in Scotland.

Members of the IPB are drawn from NHSScotland, third sector organisations, Partnership and Royal Colleges. Members are not paid; however, third sector representative have been reimbursed for travel expenses.

Neonatal clinical outcomes data is gathered from neonatal units in Scotland and routinely published by Public Health Scotland on their Scottish Pregnancy, Births and Neonatal Data Dashboard. The National Neonatal Audit Programme run by the Royal College of Paediatrics and Child Health also provides a further level of detailed comparable neonatal clinical outcomes data for units in England, Scotland and Wales on their Data Dashboard, and in their annual reports.

Scottish Government is supportive of NHSScotland sharing learning, and also learning from experience and practice of NHS England in relation to operational delivery of government policy, including neonatal policy.

The Review of Maternity and Neonatal Services was led by a review group consisting of representatives from the key professional groups involved in managing and delivering maternity and neonatal services, representatives of the Scottish Government, staff side organisations, Royal Colleges, third sector representatives and academics working in maternal and infant health research.

The full membership of the Review group can be found in Appendix E of The Best Start: A Five Year Forward Plan for Maternity and Neonatal Care in Scotland, and membership of Sub Groups and their remit in Appendix F.

Jenni Minto: The Scottish Government does hold the information on how much each NHS board spends on raising awareness of thrombosis.

Although the Scottish Government has not funded a national awareness raising campaign for thrombosis in recent years, in December 2023, Scottish Government social media health channels ran a series of online awareness-raising messages on the risks and symptoms of DVT.

In addition, the guidance available to the general public on NHS Inform on deep vein thrombosis is reviewed regularly to ensure it is up to date, with the most recent update taking place in July 2024.

To support clinicians, the Scottish Intercollegiate Guidelines Network (SIGN) are responsible for publishing new rapid guidelines, with SIGN 122 and SIGN 163(specifically in relation to the prevention and management of venous thromboembolism (VTE) and VTE in patients with COVID-19 respectively) both being available.

SIGN supports the implementation of these guidelines by; raising awareness; networking with national projects and clinical networks; and developing implementation support tools and resources alongside specific guidelines.

The Scottish Government have no current plans run a national awareness campaign for thrombosis, however we are engaging with stakeholders and intend to mark World Thrombosis Day in October via social media channels.

The expectation is that the mothers in threatened extreme preterm labour, or those whose babies will require surgery, will be identified antenatally and will birth in the maternity unit alongside the NICU. The Scottish Perinatal Network has published guidance on in-utero obstetric transfer in these circumstances.

Local Neonatal Units (LNU’s) will continue to deliver intensive care and care for babies from 27+0 weeks that need stabilisation and treatment, and both nursing staff and medical staff will continue to have experience in delivering these aspects of intensive care. We have asked Regional Chief Executives to consider arrangements for ongoing professional development of staff where required within their Regional Implementation Plans.

This information is not held by the Scottish Government.