West Midland Neonatal Transfer Services

Overview

Birmingham Women's NHS Foundation Trust (BWH) is a specialist health care provider for women and their families in Birmingham and the West Midlands. Established in 1994 the trust focuses on a range of services that include maternity and neonatal care, providing excellent healthcare for women and their babies.

As part of the service there is a need to convey the highly specialist West Midland Neonatal Transfer Service (WMNTS) to collect newborn babies from hospitals within and outside the West Midlands area and take them to one of the 16 neonatal units, where they will receive a higher level of care or to return to their home unit.

In 2008, with 7000 babies being born annually and over 1200 transfers required, some under blue light conditions, the choice of provider for this activity would make a difference to the way the service operates. The response time would improve and the transfers performed in a timely manner.

The Challenge

In 2008, funding was secured to provide a dedicated ambulance service for the WMNTS. The tender process for a new provider commenced in April 2008 and was completed 12 months later.

Any new provider had to provider transfers that fell into one of two categories, either 'Emergency' where ambulances have to be on call within an agreed timeframe to transfer under blue light conditions, or 'Planned' where transfers are pre-booked within 24 hours.

Staff had to be highly trained and ambulances equipped to the highest standards, to meet the risks associated with the loading and unloading of incubators, and handling the specific needs of the NTST team. And a provider would need to ensure that there was an audited process of ensuring all staff had standard CRB clearance.

Importantly, there was a need to ensure there was no abuse of the blue light system, so any provider would have to intelligently provide assurance that this would not happen.

And there has to be an easy way for the WMNTS team to make contact and organise transfers.

The Solution

NSL Care Services solution tackled head on the issues that were identified with the existing provider.

We developed a robust audited system of automatic email alerts that were generated as soon as a vehicle put on its blue lights, within our state of the art vehicle tracking systems. This email identified both vehicle and its location, and provided a transparent system that ensured that no driver oversteps their authority. Furthermore we initiated our blue light training in Birmingham and planned routes that would take in as many as the common locations as possible to familiarise our staff with the area.

Our solution recommended that BWH were involved in the staff selection process to provide reassurance that the people representing the trust were of the highest calibre. We ensured that staff were checked to the higher level 'enhanced' CRB status. In addition we recommended additional training from the trust itself, so that our staff became familiar with how the medical teams worked and would understand their role in case of an incident with a baby.

We build open and transparent partnerships with trusts and this allowed us to seek exceptionally positive references from them, highlighting NSL Care Services customer focussed approach to patient care, but more importantly providing reputational reassurance to BWH.

Our solutions always seek to look at things from a client and patient perspective. We therefore involved WMNTS in the design of the ambulances to ensure that they were totally happy with the vehicles. This involvement allowed us to tailor the ambulances exactly to the needs o the WMNTS team, from the provision of blinds in the ambulances to enhance privacy, to the adjustments of seats to allow extra observer in the ambulance.

And we took on board comments about the risk associated in loading and unloading incubators, designing the ambulances with adjustable rear suspension and extra wide ramps to present the smallest incline.

And from a technology viewpoint we included the latest technology solutions to ensure that bookings are simple and effective, and our drivers have continual visibility and connectivity with both the trust and the control centre. In high dependency cases there is little room for error, and we have recognised this so that our system generates transfers that are effectively monitored and timely dispatched.

Results

The contract launch suggested a staged mobilisation and NSL Care Services worked flexibly to ensure that this was successful. The staged handover started in June 2009 and complete take over was in July 2009.

We have developed a close working relationship with WMNTS, meeting with them as required but also formally every quarter. This allows us to tweak and evolve the service as necessary to meet changing needs.

The NSL Care Services contract was set up on Key Performance Standards that included arrival times for planned and emergency journeys, compliments and complaints, issues and activity and of course financial performance.

As a primarily 'on demand service we continue to exceed the expectations of BWH. The number of journeys per month has averaged at 120, and our scalability has meant that we have been able to flex to the expected 1500 journeys this year.

We have also altered our staff shift patterns to mirror changes to the NTST team without issue, such is the close working relationship at both management and front line. At the contract start staff were assigned for a minimum of 6 months to ensure continuity. Even though the role comes with immense pressures and responsibility not one member of staff has asked to be reassigned, showing the quality and commitment of the staff.

If you want to discuss your patient transfer service requirements in a care environment please contact us