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‘Nurse practitioners could help solve staff shortage in neonatal care’

University College London professor tells Nursing Children and Young People Conference 2017 that more premature babies are surviving, but neonatal units cannot recruit enough specialist staff

More premature babies than ever before are surviving and living without disabilities, but neonatal services are short staffed, a leading doctor has warned.


One area in London has a 38% vacancy rate for neonatal nurses, professor of neonatal medicine Neil Marlow told the conference. Picture: Neil O’Connor

Speaking at the Nursing Children and Young People Conference 2017 in Liverpool, University College London professor of neonatal medicine Neil Marlow highlighted concerns about a shortage of neonatal specialist nurses and doctors.

‘There is one area in London that has a 38% vacancy rate for neonatal nurses,’ he said. ‘How can you manage with that?’

Professor Marlow suggested a number of possible solutions, including non-neonatal nurses working alongside specialist neonatal nurses to provide necessary cover, and families being trained to be more hands on.

Recruitment problems

He said major hospital centres, where outcomes for premature babies are normally much better, could not feasibly run ‘a proper neonatal intensive care unit’ without two resident doctors at any time. ‘We owe that to babies – but actually, that doesn’t always happen,’ he said. ‘Then when you go to local neonatal units it’s even worse.’

Professor Marlow said it was becoming more difficult to recruit doctors to paediatrics, with a 28% fall in applications for training this year.

He suggested training the ‘brightest and best’ nurses to become nurse practitioners to help tackle a shortage of junior doctors.

Despite these staffing concerns, Professor Marlow said neonatal care is safer than before, more inclusive and more parent friendly.

He said most neonatal units can now expect a 60% survival rate for babies born at 23 weeks.

More babies surviving

‘The need for more nurses is partly due to more babies surviving and therefore remaining in intensive care cots for longer,’ he said.

‘We have seen a dramatic increase in the proportion of survivors without impairment. There was a 15% increase in survival between 1995 and 2006.’

However, regional variations for outcomes continue to be a concern, he said.

The RCN warned in September that the shortage of nurses was contributing to a ‘postcode lottery’. Professor Marlow said the critical care clinical reference group for neonatal services, which he chairs, has set up a group called Action on Neonatal Mortality to look at why regional disparity exists in neonatal care, with social deprivation not thought to be a factor.


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