Seòmar agus comataidhean

I refer the member to the answer to S6W-23794 on 29 December 2023. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

As part of the next phase of the work Scottish Government have commissioned Consulting firm RSM-UK to undertake detailed modelling work to fully map the capacity requirements across the system to inform capacity building and implementation of the new model.

The Scottish Ambulance Service will be included as part of the modelling work. We expect that mothers in threatened extreme early labour, or those whose babies will need surgery, will be identified pre-birth and will birth in the maternity unit alongside the NICU. The Perinatal Network has been leading some work, and recently published guidance on transfer in these cases.

The Scottish Government does not hold this information.

The recommendations for the new neonatal model of care are underpinned by strong evidence that population outcomes for the most premature and sickest babies are improved by delivery and care in units looking after a critical mass of these babies, with experienced staff, and with full support services.

The Best Start recommended that Scotland should move from the current model of eight Neonatal Intensive Care Units (NICU) to a model of three units supported by the continuation of current NICUs redesignated as Local Neonatal Units (LNU’s).

As part of the next phase of the work Scottish Government have commissioned Consulting firm RSM-UK to undertake detailed modelling work to fully map the capacity requirements across the system to inform capacity building and implementation of the new model.

The Scottish Ambulance Service will be included as part of the modelling work. We expect that mothers in threatened extreme early labour, or those whose babies will need surgery, will be identified pre-birth and will birth in the maternity unit alongside the NICU. The Perinatal Network has been leading some work, and recently published guidance on transfer in these cases.

Scottish Government does not hold this information.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The data provided is then collated and is used to identify any sustained or acute pressure on intensive care cots. The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made.

The Best Start emphasises parents as key partners in caring for their baby and aims to keep mothers and babies, and families together as much as possible in the crucial early weeks, with services designed around them.

We have a number of measures already in place to support families who have babies in neonatal care including:

• Providing accommodation for parents to stay on or near neonatal units;
• Roll out of the Young Patients Family Fund (formerly the Neonatal Expenses Fund) to support families with the costs of travel, accommodation and food whilst their baby is in neonatal care;

And

• Repatriating babies to their local neonatal units as soon as clinically possible.

In addition, as part of Best Start, Boards have introduced Transitional Care facilities in maternity units, which keeps babies with their mothers on the postnatal ward with in-reach support from neonatal staff, and neonatal community care, which allows babies to get home sooner, supported by the community team. We continue to look to find opportunities to minimise separation, whilst providing safe care.

The Young Patients Family Fund (YPFF) helps to offset the cost of any accommodation required by eligible visitors.

The YPFF terms and conditions direct claimants to access NHS Board visitor accommodation in the first instance. Where this is not available, private accommodation (e.g. hotel) can be booked and the fund’s terms and conditions direct the NHS Board to book on behalf of the claimant where this is possible.

This process helps to ensure that most claimants avoid having to pay large accommodation bills upfront. My officials have not been alerted to an issue with this process, however, I have asked them to write to YPFF administration teams in NHS Boards to remind them of the importance of taking action to reduce unnecessary temporary financial pressures on families.

We recognise that all parents want to ensure their baby gets the safest care possible, and would expect that we organise care to ensure that this happens. The Best Start aims to keep mums and babies together as much as possible. If there is a high risk of the baby needing intensive care after birth then antenatal care will be planned with the input of a specialist maternity team, and with the expectation that the woman will be admitted to a maternity unit in a hospital with a NICU on site when it is time to give birth.

If a woman is in suspected extreme pre-term labour, she will be transferred by ambulance to a maternity unit in a hospital with a NICU on site, to deliver the baby there. If there is not sufficient time to transfer the woman before birth, the baby will be born in her nearest hospital and given immediate short-term intensive care on site to stabilise the baby, before being transferred to a NICU by the specialist neonatal transport service ScotSTAR when it is safe to do so.

The same level of care will also be provided to the mother who, once stable enough, will also be transferred to the maternity unit within the same hospital as her baby.

Under the new model of care, mothers in suspected extreme pre-term labour will be transferred to give birth in hospitals that have neonatal intensive care units. Those maternity units will have expanded capacity to receive those women.

It is recognised that it will not always be possible to transfer mothers before they give birth. In those cases, as has been established practice for many years, our specialist neonatal transfer service (ScotSTAR) will transfer those babies by air or by road in specialist ambulances equipped to care for neonates, accompanied by neonatal staff.

The Scottish Perinatal network has developed and published guidance for all Boards across Scotland to support identification and transfer of mothers in suspected extreme preterm labour. Experiences of testing the new model of neonatal intensive care showed that the vast majority of mothers in suspected pre-term labour were identified and transferred before giving birth.

Women from NHS Lanarkshire would normally be transferred to the Queen Elizabeth University hospital in Glasgow. Should that unit be at capacity, it may it be necessary to transfer those women to Edinburgh, or to Aberdeen, and parents will be involved in those discussions.

Journey times from Wishaw to Aberdeen will vary depending on the time of day and urgency of the transfer.

As part of the next phase of the work Scottish Government have commissioned Consulting firm RSM-UK to undertake detailed modelling work to fully map the capacity requirements across the system to inform further capacity building and implementation of the new model.

In the meantime discussions are underway in the regional forum to prepare and plan for the changes, which will be further informed by the modelling. The Scottish Government has provided funding to the Boards hosting the Neonatal Intensive Care units to build the capacity required in the intensive care units.

Neonatal cot capacity is managed on a network basis through a daily call attended by all Neonatal Units. The availability of beds is not solely down to the availability of neonatal cots, but also maternal beds and the availability of specialists to support both mother and baby. This ensures that for any woman or baby who requires immediate delivery, suitable arrangements are made.

The Options Appraisal Report , published on 25 July 2023 describes the process undertaken to determine the three final Neonatal Intensive Care Units. Annex D of the report outlines the cot availability for each Neonatal Unit.

Additional information can found on the hospital’s websites or requested directly.