Introduction The majority of UK neonatal care occurs in SCUs and LNUs with a smaller volume of highly complex care delivered by NICUs. Whilst the significant shortfall in nursing numbers nationally has been highlighted, medical staffing has received little attention.

Aim To determine levels of medical staffing in UK LNUs/SCUs, days of respiratory support provided and admissions weighing <1.5 kg.

Methods Questionnaire sent to every LNU and SCU requesting details of medical tier staffing. ODNs provided the number of respiratory care days (RCD – invasive and non-invasive mechanical respiratory support) delivered 2013–15 and numbers of admissions weighing <1.5 kg.

Results 78 (86.7%) LNUs and 38 (95%) SCUs responded. 11/90 LNUs delivered <365 RCDs annually. Of these 9 admitted <25 infants weighing <1.5 kg. 6/40 SCUs delivered >365 RCDs annually.

Significant numbers of LNUs and SCUs employed non-training grade medical staff and ANNPs to cover rotas; neonatal CST holders or equivalent support many units (Tables 1 & 2).

The 8/11 low-activity LNUs who responded provided partially separate Tier 1 staffing from paediatrics, consistent with SCU staffing recommendations only. Half of the high activity LNUs and all high activity SCUs did not achieve staffing standards for NICUs or LNUs respectively.

Conclusions A wide range of activity is undertaken by UK LNUs and SCUs, with moderate overlap of workload between unit types. These data should inform potential unit re-designation as part of the current national reviews. Current medical and ANNP staffing is a major barrier to implementing change.