A prospective survey of activity in neonatal nurseries associated with 17 specialist maternity units delivering some 38,700 babies in the Northern region was undertaken during 1991. Data were collected concerning the numbers of babies requiring various forms of neonatal care, using a nursing dependency scale validated by work study. Facilities for prolonged high dependency care are partially decentralised in the Northern region, with a network of five units operating on a flexible and collaborative basis. The data collected suggest that, with such arrangements, even peak demands for non-surgical high dependency nursing care can be met by the provision of 1.0 cot per 1000 births. The requirement for high dependency cots would increase by some 50% if the referral centres were required to function independently for administrative or financial reasons. Because neonatal units act independently in providing low dependency care, allowance must be made for day to day variations in the pattern of admission of infants requiring such care. These variations will have a lesser impact in larger obstetric units than in those with small caseloads. Within an apparent average regional requirement for only 2.1 cots per 1000 births, a unit with 6000 births per year would need 4.5 cots per 1000 births to accommodate low dependency neonates, apart from those admitted for no other reason than relatively low birth weight; for a unit dealing with only 1000 births, this level of provision would need to be increased to 9.0 cots per 1000 births.(ABSTRACT TRUNCATED AT 250 WORDS)
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