Infant care transfers: simulating neonatal infant pathways and transfers across a neonatal network

Neonatal care for preterm and sick babies is organised into local areas around the United Kingdom, called Operational Delivery Networks. These networks coordinate between providers to ensure babies have the required care, close to home. There are three types of Neonatal Units offering distinct levels of needs-based care. The networks need to ensure that each unit operates at optimal cot levels, and the best quality care is provided. The possible impact of any changes to a network’s configuration on transfers and infant care, must be considered before any changes are implemented. Our simulation model reflects the infant pathways within a network allowing users to evaluate a variety of possible changes within the network. The model builds on previous literature by incorporating the ability to move an existing infant from a unit to release capacity as well as moving new arrivals between units. We also consider the potential environmental impact of the additional travel for parents visiting infants who have been transferred. We demonstrate how the model can be applied with a case network within which approximately 60,000 babies are born annually, a tenth of whom requiring some Neonatal Care. Of these infants, approximately 12% are transferred to another unit.