A regionalised transport service, the way ahead?

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Abstract
Units in the United Kingdom are now concentrating on improving the transport of neonates and children. The aim is to have a transport process that can offer a level of care akin to that of a neonatal or paediatric tertiary centre at the point of retrieval. Studies point to a high number of adverse events when inexperienced staff move children.1 2 There have been articles on neonatal3 and paediatric transport.4 We describe our transport model, which implements a combined neonatal and paediatric transport service for the State of New South Wales, Australia coordinated by a telephone triage mechanism. The New South Wales newborn and paediatric Emergency Transport Service (NETS) has been an integrated service covering the State of New South Wales since 1995. It is responsible for coordinating the transfer of sick infants and children throughout the state. Before this, separate paediatric and neonatal transport services existed in a number of units. From the outset the service has evolved to suit local needs. Clinical guidelines have been developed, transport equipment modified, and vehicles purpose built. The goal has been to make intensive care available in the referring hospital before transport as well as during it. NETS retrieves patients from hospitals in New South Wales or, when a town is too small for a hospital, from general practitioners’ clinics. The area of New South Wales, and thus NETS coverage, is 801 428 square kilometres (10.5% of Australia’s total area). The population in this state is 5 543 500 (32.6% of the total Australian population). Sixty per cent of this population live in the Sydney area. On occasion, NETS undertakes international retrieval from South East Asia, Pacific Islands, and beyond. There are three paediatric intensive care units and nine neonatal intensive care unit hospitals in New South Wales. Another neonatal intensive care …