1 February 2024

When late preterm babies go home earlier it can increase parent-infant bonding, result in better breastfeeding rates and have a positive impact on the mother's mental health.

Around one in 13 babies in England are born prematurely, with most born between four and six weeks early. These babies are considered late preterm.

Late preterm babies can be in a hospital far from home, placing significant and unexpected financial and social burdens on families, particularly the least advantaged – however, a lot of this care could be delivered safely at home, with the right support for families from healthcare professionals.
When babies go home earlier, it can increase parent-infant bonding, result in better breastfeeding rates and have a positive impact on perinatal mental health.

With these benefits in mind, NIHR Applied Research Collaboration for the North West Coast (ARC NWC), Health Innovation North West Coast and the North West Neonatal Operational Delivery Network (NWNODN) collaborated on a research project looking at neonatal outreach services across the North West.

Insights from this study can help inform the creation of new neonatal outreach services, or improve existing services, both locally and nationally. 

The two-year research project has now released a summary report, entitled “Recommendations for the expansion of neonatal outreach interventions. It includes information from an audit of 20 neonatal units and interviews with staff and parents from 5 of those units.

The report also features the findings from a “rapid insight session” on 12 December 2023, which captured thoughts from an informed audience of 42 neonatal professionals in the North West and nationally. View the slides and watch the recording from that session:

The research found that a number of Trusts in the North West have some very good practices in place, including Lancashire Teaching Hospital’s NEST@Home (Neonatal Early Supported Transfer Home). NEST@home involves transferring the care of late preterm babies, who need enhanced feeding support, to the home setting under the support of neonatal outreach nurses.

The research found that parents greatly valued neonatal outreach. Other insights included:
  • A coordinated, system-thinking approach to service design is required, including a defined service specification and standard reporting.
  • Sustainable investment is required to fund safe staffing, digital infrastructure and devices, and governance.
  • Fully resourced outreach may alleviate hospital capacity issues whilst keeping babies safe, and achieve a workforce savings. 
  • We need to share best practice from other innovative approaches such as NEST@home, Liverpool Women’s home phototherapy offer and Blackpool Victoria’s tongue tie clinic.
  • Neonatal Transitional Care (NTC) should be thought of as a service, not a physical location, enabling Trusts to pay for outreach with the transitional care tariff.
Participants from the Rapid Insight session reflected that neonatal outreach services are key to the sustainability of neonatal services. Overall, the project team is encouraged by the findings of the research, but more work is required, including a deeper look at costs.

Laura Boland, Head of Innovation Pipeline, Evaluation and Insights at Health Innovation NWC, said: “This report summarises the findings of a two-year collaboration between the ARC NWC and our local neonatal operational delivery network. Working closely with our local neonatal teams we mapped the diverse neonatal services across our region. We worked to understand the barriers and facilitators to expanded outreach services that will enable well, early babies to safely go home sooner. Our findings and recommendations make the case for further investment and development of outreach services in the future.”
Dr Richa Gupta, Clinical Lead for the Lancashire and South Cumbria Neonatal Network, sayssaid: "Conducting the neonatal outreach project with Health Innovation North West Coast was a great opportunity to collaborate with different organisations on a large-scale. We were able to gather parent and staff perspectives that identified service variations and gaps that had not been well articulated and documented in the past. The insights helped raise awareness of this important aspect of neonatal services at a time when there are transformation opportunities.

The summary report complements a full research report. If you would like to discuss the full report with a member of the project team, please contact Louise Houghton, project manager. This project was a part of the National Insights Prioritisation Programme (NIPP) managed by the Health Innovation Network and funded by the Accelerated Access Collaborative and the National Institute for Health Research (NIHR), which has oversight of a network of ARCs. NIPP programmes vary across the country. Please visit the NIPP programme link for the full list.

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