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Case Study – NHS Fife

New neonatal support worker role created by NHS Fife to improve the continuity of care for babies and parents, and improve hospital discharge processes

NHS Fife worked with role development specialists from the team here at Skills for Health to develop a new Level 3 Health Care Support Worker role for its Neonatal Unit and Maternity Service.

NHS Fife wanted to improve its continuity of care for babies and support for parents, including preparation for discharge from the hospital. It saw the need for a Neonatal Health Care Support Worker (NHCSW) role which would carry out specific care tasks for newborn babies, while allowing registered staff such as nurses to focus on more complex cases. The NHCSW would also provide a regular and familiar point of contact for parents.

Under the supervision of midwives, neonatal nurses, and other professional staff, the NHCSW will ensure the baby is able to feed and is well looked after. They would also provide support and guidance for families to assist in the smooth transition from hospital to home. The role would focus on nurturing the skills and behaviours of parents of babies that require special care, with the aim of improving care and helping parents form better bonds with their babies.

The NHCSW will be able to assist with the development and implementation of care plans for Special Care babies and families. They can operate equipment for the care of babies, and support the preparation of discharge plans. Their skills will include the ability to obtain and test blood samples, undertake hearing screens, insert nasogastric tubes, carry out emergency procedures to provide basic life support and use different feeding techniques for babies.

“We knew what we wanted to achieve with the new role, and so it was really useful to work with Skills for Health, who supported us in identifying the skills and competencies required. They were able to help us develop it as a Level 3 role and provided advice on evaluating its success. I think we’ve created a role which could be developed in other areas, in other neonatal
units, not just in Scotland.”

Jeana Arnott, Neonatal Clinical Educator, NHS Fife

Unlike registered roles in this area, the NHCSW will not be responsible for other supervisory and management duties, or compliance reporting and can dedicate their time to the babies in their care and to their parents. Implementation of the role would help registered nursing and midwifery staff to achieve and monitor a safe and secure environment for patients, staff and visitors. The role has recently been implemented, and NHS Fife hopes to assess its value through patient and workforce testimonies and questionnaires.


  • improved level of care for babies who require specialist care
  • more effective use of registered staff, freeing their time to spend on more complex cases
  • improved continuity of service as parents form a relationship with the NHCSW
  • better support for new parents in looking after their babies
  • increased confidence of parents when babies are charged from hospital
  • increased levels of satisfaction with the service.

Our team of workforce and NHS role development experts hosted a Role Redesign workshop with the Scottish Neonatal Network in Dundee, to look at the career framework level and key tasks and activities of a proposed neonatal nurse support role.

NHS Fife identified a need for a Level 3 HCSW role and worked with Skills for Health to develop and refine it. NHS Fife also developed learning to prepare candidates for the role. A range of learning activities has been agreed, encompassing informal learning, mentorship, clinical supervision, reflective practise and “shadowing”. In addition, a set of resources has been developed to support the implementation and induction of the new role including a workbook which new post holders will work through to demonstrate they have achieved the level of competence for each skill required.

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