National Audit Office report on neonatal care finds training, recruitment and retention issues add to problems of staff shortages

Problems in training, recruitment and retention has aggravated the significant shortage of nursing staff leading to below-standard care for neonatal babies, it has emerged.

A National Audit Office report, Caring for Vulnerable Babies, published yesterday, found that more than three-quarters of intensive care neonatal units in England are operating with dangerously low levels of nursing staff.

Not one of the UK nations met the Department of Health’s recommended BAPM guidelines, which recommend that for intensive care units, the nurse-to-baby ratio should be 1:1, increasing to 1:2 for high dependency care

The review – the first of its kind since the Department of Health reorganised neonatal services into 23 regional networks in 2003 – found 76% of units did not meet the standard for intensive care, and just half met the standard for high dependency care.

The study blames a deficiency in effective training as a major cause for staffing problems.

“Twenty out of 23 networks [across England] noted that there was a large shortfall of trained staff in their areas, either against the BAPM 2001 standards or against their funded posts. In this context, several networks also noted the difficulties in getting access to allied health professionals such as dieticians and physiotherapists and others made reference to the difficulties in releasing staff for additional training.

“Deficiencies in the provision of specialist training, particularly for nurses, are compounding the overall problem of understaffing,” it said.

Budget constraints and a decline in qualified staff were also blamed: the proportion of nursing staff that were qualified in speciality declined from 64% to 61% between 2005 and 2006.

Edward Leigh MP, chairman of the Public Accounts Committee was shocked by the findings. He said: “There are still too many organisational difficulties and resource shortages that they have to overcome and which can and do compromise care.

It is shocking to hear that the safety of ill and defenceless babies is being compromised by a significant shortage of nursing staff.”

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