Mission Statement

Service Philosophy

The primary aim of The London Neonatal Transfer Service (NTS) is to provide neonatal patients in our Operational Delivery Network (ODN) timely access to safe transfer between hospitals.

Interdependencies

i.            In order to deliver our primary role to babies we rely on excellent collaborative working with clinical staff across all the ODN neonatal services. This facilitates smooth referral processing, stabilisation care and interaction with parents. London NTS delivers team training in the form of our NESTT (Neonatal Emergencies Simulation Team Training) and support for the STAN (Stabilisation and Transfer of the Acutely Unwell Neonate) courses. We also undertake hot ‘deep dive’ debriefs with service users for particularly challenging cases for learning and improvement purposes. An outreach programme covers all neonatal units in our ODN in a series of half days aimed at case review, practical procedures, transport data and simulation. We offer experience days with the team and ambulance ride-outs to give service users, students or those interested in working on the team a taste of how London NTS functions

ii. Liaison and mutual aid arrangements with neighbouring transfer teams is often needed at times of high activity in order to achieve a timely patient response

iii. Many neonatal patients need access into or out of paediatric critical care units. London NTS undertakes many of these transfers in collaboration with these units and our regional paediatric retrieval teams

iv. Some of our patients need to travel long distances. London NTS works very closely with Capital Air Ambulance and Lucy Air Ambulance for Children charity to facilitate aeromedical transfers for a small but significant number of babies

v. London NTS also works with the Maternity Clinical Network to support the regional In-Utero Transfer Service. This provides a vital role in ensuring mothers at risk of extreme preterm birth are transferred antenatally to have their babies in a specialist centre with expertise to manage such cases

vi. Although as a transfer service we have time limited exposure to our patients we recognise the need to support parents at a very vulnerable time. To that end we endeavour to meet with parents at the time of transfer, convey them with their baby unless there is a medical contraindication, provide information to them about our service as well as the hospital their baby is going to

vii. London NTS works closely with our ODN, NHS England and St John Ambulance when planning service delivery, strategy and development

viii. Patient care and service user experience doesn’t stand still. London NTS is committed to Quality Improvement, Audit and Research to keep pace with ever changing needs and expectations

Summary

London NTS is here to provide expert care to babies undergoing inter-hospital transfer. To do that well we constantly strive to do the basics better and push the boundaries of improvement. Working with key stakeholders in the wider system is essential to smooth working and better for patients and families. We welcome feedback and look forward to working with you.

Emergency Uplift

We will undertake emergency uplift transfers in or out of a London neonatal units where there is a clinical need for escalation of care, for urgent surgery or specialist review, and exceptionally for capacity reasons if a unit is over their cot capacity or has severe staff shortage.

We do not usually undertake transfer of babies into Great Ormond Street Hospital for cardiac care or ECMO, this is usually done by CATS.  Transfers into PICU units are usually done by STRS South of the Thames and CATS North of the Thames.  If we receive a referral that we feel falls under the remit of another team, we will do our best to liaise with the other team and hand over the case rather than refusing the referral.

Repatriation

We will undertake repatriation transfers from any London unit, with any distance inside mainland UK considered. Transfer of babies for routine investigations (e.g. EEG, EMG) and tertiary outpatient clinics would also fall under the elective remit.

Sister Teams

Kent, Surrey, Sussex (KSS)- based at Medway Maritime Hospital, Ashford St Peters and Royal Sussex County Hospital respectively.  These operate as a team to provide 24 hour cover and can be contacted via EBS London.

PaNDR – based at Addenbrooke’s Hospital Cambridge, covering East of England including Essex and Hertfordshire.  ANTS can be contacted via East of England EBS on 01223 274 274.

CATS  (Childrens Acute Transport Service) – based at Great Ormond Street Hospital, providing paediatric transport services usually into PICU units, but also covering neonatal transfers into GOSH for ECMO or cardiac surgery.