TRANSPORT FROM A NEONATAL UNIT TO
CARE AT HOME OR HOSPICE
Transfer logistics need to be agreed between NICU, hospice, palliative care team and family:
Date and time of transfer. Aim to transfer during normal working hours.
Dedicated doctor and nurse team required for transport (no other clinical duties and ideally not on transport cover) unless family planning to transfer alone or with hospice support.
St. John Cymru ambulance: St. John’s ambulance service is able to provide a suitable ambulance (with driver) for neonatal palliative care transfers including transfers with transport incubators. Commissioning for palliative care transfer needs to be agreed by the referring NICU prior to transfer. Bookings should be made at the earliest opportunity (usually at least 24 hours in advance) as St. John’s are unlikely to be able to provide a service at very short notice.
For quotations and bookings contact: 02920 449631
Dedicated regional neonatal transport team: South Wales: Cymru inter-Hospital Acute Neonatal Transfer Service (CHANTS):
CHANTS is the dedicated acute neonatal transfer service for South Wales. The service is provided by neonatal staff in Cardiff, Newport and Swansea working a 1-week-in-3 in rotation. CHANTS are unlikely to be able to support transfers of palliative patients as these should be carried out by teams knowing the patient and the family and CHANTS need to be available to provide timely emergency transfers of unwell infants. Please refer to the CHANTS Wales Neonatal Network guideline on palliative care transfers for further information.
For discussion of any infants please contact the duty team on service:
Hours of Duty 8am – 8pm, 7 days a week; change over on Monday 8am;
Swansea Team 01792 285278
Cardiff Team 02920 742680
Newport Team 01633 234844
North Wales: CHANTS – North: In North Wales the acute neonatal transport service is provided by Ysbyty Glan Clwyd and the Cheshire & Merseyside Neonatal Network Transport Service (CMNNTS).
For discussion of any infants please contact:
Hours of Duty 8am - 8pm, Monday to Friday :Ysbyty Glan Clwyd 01745 534686
Due to the highly sensitive and emotional nature of palliative care transfers and the need for careful planning of such transfers, consideration should be given to alternative options before planning to use a 999 ambulance.
Welsh End of Life Ambulance Service:
For neonates requiring transfer who DO NOT require transport in a transport incubator and/or intensive care during transport, the end of life ambulance service can provide transport to the preferred place of care. The service operates across the whole of Wales and is run by the Welsh Ambulance Service. Crews are non-medical so neonates requiring nursing or medical support will need to be accompanied by appropriate staff. Only some ambulances have power points. There is no suction or gas supply on board.
The service operates during the following hours: Hours of duty: Monday – Friday 09.30 – 21.30, Saturday 09.00 – 19.30, Sunday – closed;
For referral please contact 03001239210 between these hours.
Bookings can be placed in advance and as this is a dedicated end of life service this is often the most flexible and reliable transport option for rapid response or pre booked transport.
General notes for transfer
A PAC Plan or letter detailing actions to be undertaken in the event of cardiopulmonary arrest should be completed and accompany the infant on discharge.
Ambulance transfer staff must be aware of the plan and agree to follow it prior to transit.
If an infant dies in transit the transfer staff will proceed to the discharge destination rather than commencing cardiopulmonary resuscitation and/or diverting to the nearest Accident and Emergency Department.
Parents must be included in the decision making
Medical personnel are able to confirm death and will document accordingly in their own records.
The arrangements made prior to discharge for completion of the death certificate should be followed.
If the chosen mode of transfer is an ambulance then earliest referral to Ambulance services will enable this to be carried out as a semi-planned transfer, at the most appropriate time
Transfer in Family’s own Transport
If the infant dies in the family’s own transport the infant should be transported to the planned destination.
The GP should then be contacted to confirm death.
The arrangements made prior to discharge for the completion of the death certificate should be followed.