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Chief Medical Officer visits Homerton University Hospital neonatal unit
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Last modified date:13 May 2008
Sir Liam Donaldson visiting the neonatal unit at Homerton University Hospital
On 10 April 2008, Sir Liam Donaldson visited Homerton University Hospital neonatal unit at the invitation of BLISS, the premature baby charity. The visit provided an opportunity for Sir Liam to find out more about the work of the unit and to see the specialised care it provides. After the tour of the unit there was an informal discussion, which touched on health inequalities and infant mortality in East London.
The Homerton neonatal unit is a centre of excellence for care of premature and sick babies and part of the London Perinatal Network. The hospital provides specialist care to any baby born at Homerton that requires it, and to any baby requiring specialist care for more than 24 hours from other areas within Northeast London.
The Chief Medical Officer met with consultant neonatologist Professor Kate Costeloe, who has been involved with the restructuring of neonatal care in England. Clinical units have been regrouped into local networks, designed to ensure that 90 percent of babies receive neonatal care locally.
Professor Costeloe is also a principal investigator on the EPICure study, the largest research project in the world looking at premature babies born before 26 weeks.
Also attending were Trust chief executive Nancy Hallett, medical director Dr John Coakley, Bliss chief executive Andy Cole, Jacquie Kemp of the London Perinatal Network and Olga Kurtiany, chief nurse for the London Perinatal Network.
Neonatal networks in the South-East
A baby in the neonatal unit at Homerton University Hospital
There are 24 neonatal networks across England, some are called perinatal networks and some newborn networks, but they are all distinctly similar in their goals and aims.
The networks were developed as a result of recommendations from the Department of Health's National Strategy for Improvement 2003. Following this national review of neonatal services, it was recommended by DH that Managed Clinical Networks were the way forward for neonatal care.
Networks offer families access to appropriate care as close to home as possible whilst reducing unnecessary transfers to units further away to receive intensive care. They ensure that groups of hospitals and neonatal units provide various levels of care locally.
Networks help improve the quality of neonatal care, and provide access to the appropriate neonatal unit and a seamless pathway of care across all levels. Setting up and managing neonatal care in this way improves communication, and working together as a network concentrates skills and expertise where they are needed.
The EPICure Study
Over the past decade survival has improved dramatically for babies born at 26 weeks of gestation and above, so that now over 80% survive. Normal pregnancy lasts 40 weeks, but babies may survive from as early as 22 weeks, although at these extremely low gestations (22-24 weeks) most babies will die. As with all advances in care, there is a cost in terms of disability suffered by some of the children that survive.
For parents faced with the prospect of delivering a child before 26 weeks gestation, it has been difficult to provide accurate information regarding the chances of survival and the possibility of disability or long term problems amongst survivors.
The EPICure Study was first established in 1995 to determine the chances of survival and later health status by following up children who were born in the United Kingdom and Ireland at less than 26 weeks gestational age during a 10 month period in that year.
The way that very tiny babies are cared for has changed a lot since the original study and more babies now survive. The new study will look at how effective advances in Neonatal care have been and the professional approach of different baby units will also be considered.
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