title: Impact of service changes on neonatal transfer patterns over 10 years.
abstract: BACKGROUND
  Many changes have been made to the staffing and organisation of neonatal care in the UK in the past 10 years. This study assessed the extent to which these changes had affected the transfer of babies between different parts of the service.
  
  
  METHODS
  Data from the Trent Neonatal Survey, an ongoing study of neonatal intensive care activity in the former Trent Health Region of the UK, were used to evaluate neonatal inter-hospital transfers over a 10-year period, from 1 January 1995 to 31 December 2004. The number of transfers and the types of transfer were analysed and trends in gestation and disease severity over the study period were assessed. Rates of "inappropriate transfer" were also identified.
  
  
  RESULTS
  8105 babies were transferred over the period; 2294 babies underwent urgent postnatal transfer and this equates to approximately two such transfers every three days. The maximum number of journeys by any one baby was eight. Intensive care activity rose during the 10 years but the number of inappropriate transfers remained persistently high.
  
  
  CONCLUSIONS
  Organisational changes in neonatal care during the 10-year period have been insufficient to deal with the rising demand, as reflected by the persistently high rate of inappropriate transfers.
authors.affiliation: Neonatal Unit, Kensington Building, Leicester Royal Infirmary, Infirmary Road, Leicester, UK. jonathan.cusack@uhl-tr.nhs.uk
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cusack
authors.forename: David
authors.initials: D
authors.lastname: Field
authors.forename: Bradley
authors.initials: B
authors.lastname: Manktelow
mesh_terms: D004739:England; D005865:Gestational Age; D006300:Health Services Misuse / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000458:organization & administration / Q000592:standards* / Q000639:trends; D010360:Patient Transfer / Q000458:organization & administration / Q000592:standards* / Q000639:trends; D018743:Perinatal Care / Q000458:organization & administration / Q000592:standards* / Q000639:trends; D011364:Professional Practice; D012307:Risk Factors; D014187:Transportation of Patients