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Opposition To Moving Neonatal Unit

NOTE: This content is old - Published: Thursday, Oct 18th, 2012.

Plans to move neonatal intensive care from North Wales have been described as “lacking credibility and substance” after it emerged health board managers don’t know how many new-born babies require intensive care. Wrexham Independent Group have also published their formal response to the consultation and last week called on the Council’s Executive Board for a debate on the provision of services in Wrexham and North Wales.

Llyr Gruffydd, the Party of Wales Assembly Member for North Wales, raised the matter of lack of figures after a Freedom of Information request to Betsi Cadwaladr University Health Board about the numbers involved found that the NHS managers didn’t keep records.

Mr Gruffydd asked First Minister Carwyn Jones a question on the matter yesterday in the Senedd “In a response to my office’s request for information regarding the number of neonatal babies requiring intensive care, I received this surprising response from Betsi Cadwaladr University Health Board managers: ‘Unfortunately, the health board does not record the number of babies requiring intensive care.’

He went on to say “Instead of accurate recording, they count the number of babies born at 27 weeks or under in terms of gestation. But, as we know, there are many babies born full term that also require intensive care. This raises a fundamental point about Betsi Cadwaladr’s proposals to outsource intensive care for North Wales babies to England. Is the First Minister confident that management at Betsi Cadwlaladr have firm foundations for their business plan?”

In response, Carwyn Jones said “Of course, and it is extremely important that Betsi Cadwaladr health board ensures that it listens to the standpoint of the public and also of the doctors before coming to any conclusion on the way forward.”

Speaking later, Llyr Gruffydd said “I want to see an improved health service for Wales. The proposed changes are not an improvement at all. There are real shortages of a few specialist doctors that need to be addressed in North Wales, shortages that have been flagged up by report after report for the past four or five years. That is something I would hope the management at BCUHB would seek to address directly rather than outsource key aspects of neonatal provision.

“The response to my question suggests that the business plan is lacking in credibility and substance, which may explain why clinicians in North Wales argued against moving the intensive care service to England. The strength of feeling against this proposal, which could see families facing lengthy journeys to visit their newborn babies, is huge and growing. If this consultation is to have any meaning, then managers must listen and reject the proposal and retain neonatal intensive care in the North.

“This proposal, if combined with Hywel Dda’s proposals in Dyfed and Powys, will mean no Level 3 neonatal intensive care unit north of Merthyr or Carmarthen. Is this really the kind of vision we have for the NHS in Wales?”

Wrexham Independent Group In Opposition To Moving The Unit

Following their motion requesting a local formal debate on the issue, Wrexham Independent Group have published fuller details of their opposition in a formal response document, it is copied below:

“We oppose the moving of Neonatal Intensive Care from Wrexham to Arrowe Park on the following grounds:

  • The ratio of neonates to nurses in Arrowe Park is 2:1 whereas in Wrexham and Glan Clwyd it’s 1:1. The ratio in our hospitals is in line with the BAPM (British Association of Perinatal Medicine)
  • Arrowe Park currently only has 4 intensive care unit (ICU) cots, which it plans to double if the N Wales contract is won.
  • Glan Clwyd currently has 6 ICU cots and Wrexham has 4.
  • The current cost of caring for Welsh babies in the neonatal unit at Arrowe Park is £1024 per cot per day but Wirral University Teaching Hospital Trust will increase that to £1240 a day if the plans by North Wales NHS bosses are approved. Likelihood of further increases if service is moved.
  • Transport poverty means many will be unable to visit their sick babies so far from home. Journey time from Anglesey to Arrowe Park is three hours. No consideration of physical and mental strain on mothers and the wider family of not being able to travel.
  • Breast feeding will not be practical if mothers and babies in separate hospitals.
  • In 2011, the Arrowe Park unit was closed to new patients for 20 days
  • In the year to date (2012), 10 babies have died on the neonatal unit – a significant rise on the 6 recorded in 2011.
  • The proposal is for BCUHB to buy 791 bed days and transfer all babies expected before 27 weeks gestation AND all babies delivered at 27 weeks and all babies with a birth weight of 1000g or less. The current NIC bed days in North Wales is 1232 so around 45% of neonatal intensive care babies would stay in North Wales, although it’s unclear where.
  • Arrowe Park was designated a Level 3, i.e. neonatal intensive care, in 2007. The only other one in Cheshire and Merseyside is Liverpool Women’s Hospital. If capacity is reached at Arrowe Park, neonatal babies will be moved further out of the region.
  • BCUHB is already planning to bring back 500 births a year currently going to Chester. This will save £2m annually and increase the births at Wrexham Maelor by 20%. Babies who would also have gone to Shrewsbury from North Powys are also now coming to Wrexham. There is a growing birthrate in North Wales and this needs to be factored into any changes to service.
  • Downgrading of Chester and Shrewsbury SCBUs to Level 2 means fewer choices across the border and more opportunity for Wrexham to become a centre of excellence for the area. A Level 3 service is essential if we are to continue to be accredited to train pediatricians.
  • Availability of Ambulances and stabilization cots in the ambulances, no mention anywhere of agreement/contract with Welsh Ambulance Trust.

(Pictured at top – Brian Valentine, Ruth Drake, Llyr Huws Gruffydd (AM), Dr Eamonn Jessup at a public meeting last month).

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