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We examined claims made against the National Health Service (NHS) involving neonatal jaundice in order to determine whether there were lessons that could be learnt from common themes.This was a retrospective anonymised study using information from the NHS Resolution database for 2001-2011.Twenty cases (16 males) had sufficient information for analysis. Fifteen had confirmed cerebral palsy and two young children had damage to the globus pallidus without confirmed CP. In three cases, the outcome was uncertain. Two were extremely preterm, five were born at 34-36 weeks' gestation. Jaundice was typically present very early in life; in four cases, it was noted at less than 24hours of age, and in 14 cases, it was first noted on the second to third day. There was a lag between recognition and readmission, with a range of 26-102 hours. The peak serum bilirubin level was over 600 µmol/L in all the babies born at term. An underlying diagnosis was found in all but two; six had glucose-6-phosphatase deficiency (one also had Gilbert's syndrome); five were diagnosed with ABO incompatibility; three with Rh haemolytic disease; one with spherocytosis and three preterm. The total cost of these claims by August 2017 was almost £150.5 million. This figure is likely to rise.These data show that, in the group who litigate, babies who develop kernicterus generally have an underlying diagnosis. We recommend adherence to theNational Institute for Health and Care Excellence guideline that recommends measuring the bilirubin level within 6 hours in all babies who are visibly jaundiced. [ABSTRACT FROM AUTHOR]

A care bundle to reduce the incidence of necrotising enterocolitis (NEC) was designed and implemented across the 17 neonatal units in the East of England Perinatal Network with the ultimate aim of reducing the incidence of NEC. The project called for significant changes in practice across a wide geographical area and involved neonatal, midwifery and allied healthcare professionals. This article describes the care bundle development process and implementation strategies required to bring about the changes involved. Data collection is continuing to determine whether implementation has been successful in reducing the incidence of NEC. [ABSTRACT FROM AUTHOR]

A National Patient Safety Agency alert to promote the safe use of gentamicin in neonates was issued in February 2010. The mandate included the requirement for implementation where all neonatal patients are treated in England within one year of the alert being issued. Implementing the alert required significant changes in practice involving a number of disciplines and departments. This article describes how the East of England Perinatal Network adopted a region-wide, network approach to implementing the alert. [ABSTRACT FROM AUTHOR]