title: Workload and costs associated with providing a neonatal surgery service.
abstract: OBJECTIVE
  To identify the workload related to provision of a neonatal surgical service in a UK neonatal network in order to inform local and national service commissioning.
  
  
  METHODS
  Data relating to neonatal surgical admissions to a level 3 perinatal centre serving a network with 36,000 births per year collected prospectively over a 5-year period were analysed to identify annual activity. Daily dependency was assessed prospectively over a 6-month period and service costs calculated using existing local tariffs. Admissions from outside the network were excluded from analysis, and allowance was made for refused network admissions.
  
  
  RESULTS
  On average 140 admissions required 2137 cot-days per year. At 80% occupancy, the service requires seven neonatal cots suggesting that there is a national requirement for one neonatal surgical cot per 5000 births. Intensive care, high care (HC) and special care accounted for 37%, 46% and 17% of cot-days, respectively. This equates to an annual service cost of £2m, about £250,000 per 5000 births.
  
  
  CONCLUSIONS
  This assessment of the facilities and costs required to provide a neonatal surgical service in a level 3 perinatal centre in the UK may be used to inform network and national commissioning.
authors.affiliation: Paediatric Surgery, University Hospital Southampton NHS Foundation Trust, UK. david.burge@uhs.nhs.uk
authors.forename: David M
authors.initials: DM
authors.lastname: Burge
authors.forename: Melanie
authors.initials: M
authors.lastname: Drewett
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology / Q000601:surgery; D004739:England / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007224:Infant Care / Q000191:economics / Q000458:organization & administration*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000601:surgery*; D007363:Intensive Care Units, Neonatal / Q000191:economics / Q000458:organization & administration; D011446:Prospective Studies; D012041:Regional Medical Programs / Q000191:economics / Q000458:organization & administration; D016526:Workload / Q000706:statistics & numerical data*