Optimising neonatal service provision for preterm babies (27-31 weeks)

  • Research type

    Research Study

  • Full title

    OPTIPREM: Optimising neonatal service provision for preterm babies born between 27 and 31 weeks of gestation in England using national data, qualitative research and economic analysis.

  • IRAS ID

    212034

  • Contact name

    T Pillay

  • Contact email

    tilly.pillay@nhs.net

  • Sponsor organisation

    The Royal Wolverhampton NHS Trust

  • Clinicaltrials.gov Identifier

    NCT02994849, Clinicaltrialsgov; 33299, ISRCTN

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    New evidence shows that for babies born at 23-26 weeks, care in one of two types of neonatal units, i.e a Neonatal Intensive Care unit (NICU) as opposed to a Local Neonatal Unit (LNU) improves survival to discharge: this is informing policy that shapes their services. In contrast, there is no evidence to guide location of care for the next most vulnerable group (born between 27-31 weeks) whose care is currently spread between 45 NICU and 84 LNU in England. This group accounts for 4 times more neonatal unit admissions than those born at 23-26 weeks, and 12% of all preterm births in England. They utilise twice as many NHS bed days/year compared to those born at 23-26 weeks, and over a third of all neonatal unit care days.
    Our primary objective is to assess, for babies born at 27-31 weeks and admitted to a neonatal unit, whether care in a NICU vs a LNU impacts on survival and key morbidities (to age 1 year), at each gestational age in weeks. This will be achieved through analysis of routinely recorded data extracted from real-time, point-of-care patient management systems and held in the National Neonatal Research Database (NNRD),Hospital Episode Statistics (HES) and Office for National Statistics (ONS)for admissions over the period 01/01/14-31/12/17 in England.
    Secondary objectives are whether differences in clinical care exist between LNU and NICU, and whether these are associated with gestation-specific differences in outcomes; where it is most cost-effective to provide care; and parents’ and clinicians' perspectives on place of care, and how these can guide clinical decision-making.
    The information will be used to develop recommendations, in collaboration with national bodies, to inform clinical practice, commissioning and policy making.

    http://www.royalwolverhampton.nhs.uk/research-and-development/opti-prem-improving-neonatal-service-delivery/

  • REC name

    North East - Tyne & Wear South Research Ethics Committee

  • REC reference

    17/NE/0080

  • Date of REC Opinion

    17 Mar 2017

  • REC opinion

    Favourable Opinion