Lack of neonatal retro transfer service ‘a drain on resources’

The lack of a retro transfer service for neonatal critical care units is causing a “major drain on scarce resources”, according to an internal document from the National Ambulance Service Critical Care Retrieval Service (NASCCRS). An efficient non-acute/retro transfer programme is required to augment the existing acute neonatal transfer service, it stated.

“This will facilitate the timely and safe access to tertiary centres for acutely ill infants and provide return transfer of infants post tertiary care to their local hospital (care of neonates and children closer to their home) when they are stable.

“A continuation of the current situation, where there is a dependence on local hospital and frontline ambulance services to collect these infants, is not sustainable. It is a major drain on these scarce resources and is leading to lengthy delays in transferring and discharging babies from tertiary units.”

The National Neonatal Transport Programme also required an increase in consultants to provide a dedicated consultant transport neonatologist rota, greater nursing capacity, and administrative support.

For 2019-2021 these developments were costed at €1.341 million, while funding of €1.956 million was sought to develop the Adult Mobile Intensive Care Service and €0.823 million for the Irish Paediatric Acute Transport Service.

A HSE spokesperson said none of the requested development funding was provided.

Meanwhile, there were 12 “dangerous occurrences” in the NASCCRS from 1 January 2018 to 18 February 2019, which all concerned non-availability of medical or nursing staff to the retrieval service. Four incidents did not affect service provision, while in eight incidents the service was cancelled.

Due to in-house critical care capacity demands, staff were unable to be released to provide the service on behalf of NASCCRS. In such circumstances, the NAS allocates an emergency ambulance and the hospital’s medical team will travel with the patient “to ensure optimal care”.