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What Proportion of Transfers is ‘Time Critical’ and are we Mobilising Quickly Enough?

Presented as a poster at the Neonatal Society 2013 Summer Meeting (programme).

Rowley R1, Pedley M1, Thwaites R1,2

1 Neonatal Unit, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
2 NeTS (Solent), Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK

Background: NICE quality standard for transfer services (1) measures the proportion of teams mobilising to Time Critical Emergencies (TCEs) <60 minutes from the start of a referring call. Classification of calls is not straightforward (2) but national definitions for TCEs have been proposed (3). We reviewed our service from April 2012 to March 2013 to estimate the proportion of TCEs, whether we met NICE mobilisation standards and whether there was a difference in mobilisation times between day and night (as this was the first full year of 24 hour operation).

Methods: NeTS Solent is the neonatal transfer service covering 9 hospitals in Hampshire, Isle of Wight and parts of West Sussex, Wiltshire and Dorset and sometimes beyond. Transfers are documented on paper with key data entered on an Access® database. The records of all 514 transfers in this 12 months period were reviewed and detailed data was extracted on 156 ‘uplifts’ (Transfers for care that the referring centre does not normally offer (3). Uplifts were classified as TCEs if they fulfilled national criteria or the baby was passively cooled at the referring unit (agreed in the local neonatal network as TCEs). Some data was missing, mainly on the non-TCE transfers.

Results: There were 93 daytime and 63 night-time uplifts in this 12 month period. Forty one fulfilled TCE criteria (3 with gastroschisis, 1 Tracheo-oesophageal fistula, 9 intestinal perforations, 1 duct dependent congenital heart defect, 11 with cardio/respiratory instability not responding to treatment and 16 were being passive cooled).

Differences between rates of mobilisation in <60 minutes between day and night calls were not significant.

Conclusion: TCEs accounted for 26% of uplifts and 8% of all transfers in this period. Mobilisation times were generally within the NICE standard, with no significant difference between night and day. The proportion of mobilisations to TCEs at <60 minutes was significantly higher than to non-TCE uplifts, suggesting this is a useful classification of calls.

Corresponding author:

1., accessed 1/5/13
2. Leslie A & Fenton A, Arch Dis Child F&N 2012;97:1 F77
3. NTG BAPM National Dataset Review 2012 v3

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