ATAIN IN THE South West The role of the SW NEONATAL NETWORK TIMELINE 2016-2017 – Term Admission CQUIN; 7 Trusts in the SW 2017-2018 – Local ATAIN QIPP Scheme 2018-2020 – National 2 Year QIPP Scheme ROLE OF THE ODN To lead the QIPP scheme on behalf of NHSE in SW To compile data reports on progress for region To engage Trusts in the programme To work with AHSN and Maternity Network to promote engagement. Engage with LMS’s

ATAIN IN THE South West RESOURCES SW Neonatal Website; All SW related documents Relevant guidelines Names of all the leads Swneonatalnetwork.co.uk SW Neonatal Network Facebook page – A closed group where units can connect with each other to share best practice and ask for support/advice TRUST RESPONSIBILTIES Identified leads in all Trusts Reporting line to ODNs Trusts to be at or below 5% admission rates by March 2019 Trusts at 6% to complete audit report for ODN Pathways in place for Hypothermia, hypoglycaemia and jaundice All trusts to have TC facilities in place All trusts to refer to BAPM Framework for Practice and NHSI safety improvement pack Gauge support and input of Maternity Safety Champions

Origins of Atain – The National Picture

Term Admissions in the South West Cumulative percentage change in South West births and term admissions from 2012 and 2016 In 2016 Term admissions in the SW reached the highest peak at 6.2% of live births

Term Admissions in the South West Quarterly term admissions as a percentage of live births between Jan-Mar 2016 to July-Oct 2018 in the SW SW Unit Spread in Term Admissions Comparing: Jan-Mar 2016 and July-Oct 2018

Term Admissions in the South West Change in HRG 3 & HRG 4 Days

Term Admissions in the South West Change in the number of term admissions per 1000 live births between 2016 and 2018 (year to date), by admission reason

Top 5 Most Common Admissions Reasons from 2016 to 2018 (to date) in the SW

The SW ODN team would like to know…

How Should we Define An NNU Admission? One of the most regular criticisms of Atain has been that the reduction seen in percentage of live births admitted to NNU is not a change to actual practice but rather a change in BadgerNet recording. This has particularly been from units where babies coming to NNU perhaps for initial assessment or for antibiotics, but do not have an NNU cot assigned are having that days location of care recorded as NNU. We have suggested that these babies should really have location of care assigned as PNW (or TC ward). But this got us asking how other units are defining location of care as NNU and we realised that there are many different ways ranging from the example just mentioned to units that do not record the baby as an NNU admission until they have been assigned a cot here for a set amount of hours. This will mean that even within the network we will be seeing quite a variation in admission numbers purely because of differences in practices here, so we thought it might be useful to have a standard network guideline for this. Our starting suggestion would be that once a baby is assigned an NNU cot and nurse then they should be recorded as location of care NNU for that day – but we would really like to hear others thoughts /current practices / concerns / ideas around this and there is a poster on the wall where people can lease their thoughts on this during the day

Why Are HRG 1 and HRG 2 Days Increasing? HRG Days Per 100 term admissions to NNU

Why are SW Suspected HIE Admission Rates Higher than those in Other Regions? Regional Term Admissions for Suspected HIE per 1000 live births