Bridging the gap: A survey of neonatal community care provision in England

BackgroundNeonatal community services can offer significant benefits for families and infants there are no national guidelines in the UK on the provision of these services.AimTo determine current provision of community neonatal services within the UK.MethodsThis was a telephone survey using a purpose-designed questionnaire of 183 neonatal units in England.ResultsThe 45% (83/183) of units surveyed had a dedicated neonatal community team. Nineteen percent (34/183) had a paediatric team which also looked after neonates. Thirty-six percent of units (66/183) had no community team provision. Of units who provided community cover 48% (56/117) had weekend cover and 16% (19/117) had an on call service after 5pm. Eighty-five percent of all units with teams surveyed felt that having a team facilitated earlier discharge of infants. Eighty percent (94/117) provided nasogastric tube feeding support within the home. Ninety-two (108/117) looked after babies on home oxygen. Additional services provided by units with community teams were phlebotomy 75% (88/117), palliative care 70% (83/117) and phototherapy 8% (10/117).ConclusionsNeonatal community teams play an integral role in managing infants within the home who would otherwise have required special care or transitional care beds. Our survey demonstrates that neonatal care in the community within the UK is provided by a wide range of nurses and subject to huge regional variation. Infants discharged from 55% of neonatal units do not have access to specialist neonatal teams There is scope for further developing these services to promote optimum ongoing care of this vulnerable population of infants.