211 Ccg's Dilemmas

According to the World Health Organization (WHO, 2016), preterm birth are the birth that happened before 37 ended weeks of pregnancy and is one of the number reason of newborn deaths and the second prominent cause of deaths in children below five. The preterm babies have chances of an amplified risk of illness, disability and death. In the first weeks, the complications of premature birth may include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, metabolism problems, immune system problems. Long-term complications includes cerebral palsy, impaired cognitive skills, vision problem, hearing problems, dental problems, behavioral and psychological problems, chronic health issues.

After the serious shortcomings within the Mid-Staffordshire NHS Trust came to light, The Francis Report (Francis, 2013) investigated how the conditions of inexcusable care could prevail within the trust. The Francis Report proposed several extensive changes that could improve the National Health Service (NHS). Garner (2014) informs that these changes include that leaders need to be effective and accountable, staff should be empowered to work in partnership, each trust should aim to improve innovation and quality, whilst putting the patient first. The Department of Health (DH) reflected on the findings and in response to The Francis

The delivery of health care through Clinical Commissioning Groups (CCG’s) is another strength. CCG’s were created in 2012 following the passing of the Health and Social Care Act, to replace primary care trusts in 2013(NHS England, 2013). Their strength lies in their authority and purpose to provide health care that is responsive to a geographical area and set patient number. They are clinically led, often by local

The NSF and NICE create a means by which NHS trusts ensure the provision of quality standards by making NHS employees accountable for setting, maintaining and monitoring standards of care (DoH 1997). The National Institute for clinical excellence was founded in 1999 and consists of a number of specialized organisations: the NHS centre for reviews and dissemination, national prescribing agency, medical devices agency and institutes of public health. All aimed at creating and maintaining national standards through effective management and cost effectiveness, through audits and reviews of health policies. The commission for health improvement (CHI) aims to monitor the delivery of these standards provided by NICE and NSF through national surveys of the patients experience (Freedom D, 2002). This commission (CHI) sets out to review all NHS trusts including community care. Each NHS trust will be visited over three to four years and be reviewed to decide whether or not national standards are being met and NICE guidelines are being adhered to.

There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.

Giving birth to a baby is the most amazing and miraculous experiences for parents and their loved ones. Every woman’s birth story is different and full of joy. Furthermore, the process from the moment a woman knows that she’s pregnant to being in the delivering room is very critical to both her and the newborn baby. Prenatal care is extremely important and it can impact greatly the quality of life of the baby. In this paper, the topic of giving birth will be discussed thoroughly by describing the stories of two mothers who gave birth in different decades and see how their prenatal cares are different from each other with correlation of the advancement of modern medicine between four decades.

Defining premature birth is much more than just a denotative phrase. It is not just a preterm birth, or a baby born early. It is a life-changing event, and something that affects millions of people worldwide. The intense quiet room with heart monitors beeping, as parents see their baby and are devastated. Loved ones can not feed them or kiss them nor, can they not hold them or hug them. They do not get the same experience as others. Little miracles lay inside these cubes where multiple wires are help keeping them alive. A place where prayers happen, and where all hope for the best. Nobody knows the true pain and struggle behind a preterm birth and it needs to be discussed. Prematurity is a serious conflict; therefore, it needs more awareness as many families are facing this tough situation.

The National Health Service (NHS) was planned as a three-tier structure. With the Minister of Health at the top and below were the three tiers designed to interact with each other to suit the needs of the patient. These tiers were voluntary and municipal hospitals supervised by Regional hospital boards, family doctors, dentists, opticians and pharmacists who were self-employed professionals contracted to the NHS to provide services so that patients did not pay directly and local health authorities like community clinics that provided services such as immunisations, maternity care and school medical services controlled by a local authority Medical Health. The NHS in England is undergoing some big changes, most of which took effect on April 1 2013. This included the abolition of primary care trusts (PCTs) and strategic health authorities (SHAs), and the introduction of clinical commissioning groups (CCGs) and Health watch England.

Now, medical advances make it possible for even the most severe premature babies to survive. Preterm babies as young as 22 to 23 weeks gestation can survive, but the costs associated with them is high (Kornhauser & Schneiderman, 2010). The higher cost is attributed to the extended hospital stay of micro preemies in Level 3 NICU (Bird, 2014). Level 3 NICU offers a wide range of neonatal services that include special imaging techniques, advanced ventilation

Premature birth occurs at a time of rapid fetal growth and nutrient accumulation and therefore establishing postnatal nutrition is essential to achieve appropriate growth and maintain biochemical normality. There are significant risks with parentral nutrition like infection, cholestasis, hepatic dysfunction, thinning of gut mucosa and impairment of enzyme production. A delay in reaching full enteral feeding is linked to poor outcome in preterm neonates including postnatal growth restriction and failure to thrive issue especially in extremely low birth weight neonates. An increased length of time to reach full enteral feedings is also significantly associated with a poor mental outcome in preterm neonates at 24 months corrected

The premature infants organs are not fully developed resulting in further specialized care and possible problems. Premature infants cannot suck or swallow before 34 weeks, so a premature baby may have a small, soft feeding tube placed through the nose or mouth into the baby’s stomach. In very premature or sick infants, nutrition may be given through a vein. Preemies are also more at risk for illnesses such as: anemia, bleeding into the brain, low blood sugar, neonatal respiratory distress syndrome, newborn jaundice, severe intestinal inflammation, etc. The extent of the preemie’s condition may result in unique treatment specific to their needs (example: surgery, longer stay in hospital

Medical and technological advances in maternal and neonatal care have significantly reduced maternal and infant mortality and medical interventions have become commonplace and arguably routine. Used appropriately, they can be lifesaving procedures. Routine use, without valid indication though, can transform childbirth from a natural physiologic process and family event into a medical or surgical procedure. Every intervention presents the possibility of unwanted effects and subsequent risks that can potentiate more interventions with their own inherent risks.

In this essay the writer will outline the possible reasons for premature birth, how it could be prevented by both the mother and health care professionals, as well as the possible health outcomes of a baby that has been born prematurely. This includes both short and long term health complications and the possibility of developing mental or physical disabilities . Finally the writer will look at the costs associated with the care of premature babies that is funded by the National Health Service (NHS) and the government.

Approximately 5.6 million children under 5 died in the year of 2016 alone, having 2.6 children die in their first month of birth. The primary causes of premature death among children are common preventable symptoms such as malaria, pneumonia, birth asphyxia, diarrhoea, and preterm birth complications. Now, the child mortality rate is 29 times greater in unindustrialized countries, compared to industrialized nations. This result is 175 per 1000 children, compared to the number of deaths in developing developed nations which is 6 per 1000 deaths per year. 80% of the global number of deaths come from the regions of Sub-Saharan Africa, as well as South Asia. It is necessary to address the fact that not only are children affected by this issue, however mothers also play a vital aspect in this issue. Due to the chronic obstructive diseases, high consumption of alcohol, hyperlipidemia (high levels of fat in the blood), etc. being the main causes of illness for women, pregnant women often are not in the best condition when having a child. Both mothers, and children, play a vital aspect in this issue, as the importance of care must be addressed to pregnant women. The survival chances for a newborn child is not significantly high. A child’s risk of dying is most prominent is their neonatal period, which is the first 28 days of birth. As mentioned before, 2.6 million babies die every year in their

Having premature birth is not good for your health or the baby it can have many affect once it start you may have headaches being dizziness nausea and star vomiting . Every sence 2012 premature birth have affected more than 450,000 babies that was one of 9infants that was born in the United States. Any time you have a baby before 37 weeks that’s premature birth it related to the cause of death together 35% of all infants deaths was in 2010, it lead to the cause of long-term neurological disabilities in the children. In the year 2005 it cost the U.S health care system about $26 billion that was a lot of money but at least it was used on a very good reason such as good health.