Following their NNA NI Neonatal Team of the Year win, we had the chance to visit SWAH in Northern Ireland to find out more about their approach to FICare. Karen Weir, NI Neonatal Nurse of the Year and NNA FICare SIG national representative for Northern Ireland, has kindly put together a blog post to delve deeper into how the unit’s FICare journey unfolded.
The Neonatal unit in the South West Hospital (SWAH) began its journey with FICARE (Family Integrated Care) in February 2023.
We are a small level 3 unit, based in a rural part of Northern Ireland, one of 2 hospitals serving the Western part of the province. We work in partnership with our colleagues in the NI Neonatal Network, who deliver neonatal services in a total of 7 units. We have 6 commissioned spaces for babies born after 34 weeks gestation.
Our decision to choose the FICARE model of care was precipitated by difficulties securing Senior Medical and Nursing staff. We had an options appraisal meeting involving Neonatal and Critical Friends from within and outside the Neonatal Network, and opted for the FICARE model as the most sustainable and achievable model.
We tend to call this FICARE model of care ‘Next to me’, as something the families immediately understand and can identify with. It promotes an equal partnership between families and staff, so that parents are enabled to care for their own babies, and be recognised as primary care givers. The role of the nurse is to facilitate instead of ‘do’.
In choosing a new model of care, we recognised that this might create anxiety within the MDT about any potential change of role or perceived loss of control. Fortunately our decision to move to this model of care coincided with the appointment of a new, dynamic ward manager, who was able to show us how we were in a unique position to lead and set an example to other neonatal units in how we could implement and develop the FICARE model and showcase excellence.
Any reservations the team had about FICARE were mitigated when it became apparent how much the babies and their parents were benefiting from this new model of care. We had underestimated how much they wanted to do, and how much satisfaction they would get from being fully involved.
We redesigned our admission booklet so that parents were aware from their first introduction to the team of how we valued their role alongside us.
We rewrote our parent information leaflet on tube feeding, inviting all of our families to participate, something we had only previously introduced to those who were taking their baby home with a feeding tube. Very quickly it became the norm for parents to be tube feeding, even if it was only required for a matter of days.
Parents were included in ward rounds and had their voices heard, so decision making was shared.
We changed our protocols for weighing babies and measuring head circumferences, so it was something we did with parents.
We moved babies from incubators to cots when parents were with us, so they had the opportunity to dress their baby for the first time.
Similarly, we always tried to let the family offer the first bottle feed if the baby was feeding this way.
We found it easier to initiate and establish breastfeeding, especially in those mothers who had previously not intended to choose this method of feeding.
Parents told us they felt more confident, less anxious, and better prepared for discharge.
The financial savings made from being able to stay in the unit were also significant, especially for our families from rural communities.
Our MDT team became more cohesive and told us they felt more satisfaction in their role. Team morale was boosted by being at the forefront of a new initiative. We developed better relationships with our obstetric colleagues, had a renewed sense of purpose and could demonstrate that we were helping to secure the future of our unit.
No new project is without its challenges. We are unable to accept babies who are still undergoing ROP treatment as we have no current ROP services available. We have no funding for psychological support. Delayed capital works to redesign the unit have restricted our opportunity to offer dedicated FICARE to only 5 families. Opportunities for training are difficult due to ongoing staffing issues. We have identified we need to update our policies, and this will take time to put in place.
However, we now have dedicated funding and have recently appointed a project manager to lead FICARE in our unit, so the future is really exciting for the team and we anticipate we will be able to make significant progress in implementation.
We conclude with a video we recorded with Conor and Michelle, who have generously shared the story of their baby Darragh born at 34 weeks. They tell us about his antenatal and postnatal care, and shared experiences of receiving FICARE in our unit, and how they felt it benefited them as first time parents. We hope you will find it as encouraging as we do.
I’m Lora Alexander, one of the Quality Improvement coaches in a busy Level 3 NICU. QI is all about understanding problems, thinking of solutions, implementing ideas and analysing the results. 
My name is Adedoyin Yissau, also known as Dee. I am the Education and Workforce Lead for the London Operational Delivery Network. I came into post as a Network Educator in 2019 and have since developed nursing education region wide, with the current focus on developing a nursing career pathway for London.
Neonatal Network Nurse Educator
My name is Dr. Julia Petty, and I am a nurse lecturer specialising in children’s nursing with a particular interest in neonatal care. My nursing career in paediatric and neonatal clinical nursing practice began after a BSc Hons degree in Psychology at Warwick University, when I moved to Great Ormond Street Hospital, London. Here, I trained in children’s and adult nursing before working there for many years in children’s and neonatal surgical care. I then gained my neonatal nursing qualification at St George’s NHS Trust London and worked at the Whittington NHS Trust NICU before moving back to Great Ormond Street for a senior education role on NICU where I worked until 2001. I then worked as Senior Lecturer at City University, London for 12 years leading the neonatal nursing education portfolio. I studied for a MSc, a PGCE and MA in academic practice during this time, In 2013, I moved to the University of Hertfordshire where my role is Associate Professor (learning and teaching) and Senior lecturer child nursing. I teach on the BSc Hons nursing and master’s degree programmes including leadership of modules, face-to-face/online teaching, assessing and supervision of students at all levels up to doctorate level. I am also research active and have completed a Doctorate in Education. As a nurse, educator and post-doctorate researcher, my interests focus on parents’ premature birth experiences, supporting parents in the transition home from NICU, exploring communication needs of neonates and their carers and studying the educational value of digital storytelling. This combination and variety of roles enriches my working life and brings together my experience as a child / neonatal nurse, educator and researcher. My role and related activities enable me to engage in both education and research while supporting students on their nursing career and education pathway, which is a privilege to be part of.
Hello my name is Claire Richards and I’m the Lead Nurse for the Wales Maternity and Neonatal Strategic Network. This covers nursing leadership but also Neonatal transport. I also have a clinical honorary contract in one Health Board.
Hello, my name is Kim Edwards, and I am a Neonatal Nurse. I am currently the Lead Nurse and Workforce, Education Lead for the Thames Valley and Wessex Neonatal Operational Delivery Network (ODN)
Hello, my name is Jean and I am a registered children’s nurse with 27 years experience. I qualified with a DipHE after struggling academically due to dyslexia. Over my career I have worked mainly in PICU, NICU and children’s cardiac critical care. I am dual qualified in speciality (QIS) for both Neonatal and Paediatrics. The QIS program is a post graduate modular course completed at level 6/7. To be considered QIS you must successfully complete 4 separate modules, each have an academic and practical component. Only on completion of the QIS course can you apply for a band 6 role. In addition to the above qualifications it is expected you would have several years proven experience in speciality at Band 6 and 7 prior to applying for a Matron’s role.
My name is Lisa Baker, I’m a Ward Manager on a Level 2 Special Care Baby Unit in South Wales and I’ve been in this role since 2020. 
Hello, my name is Wesell, and I am currently a trainee Advanced Neonatal Nurse Practitioner (ANNP) at Great Western Hospital, which is a Local Neonatal Unit (LNU). Prior to this, I gained substantial experience in a tertiary neonatal unit where I completed my QIS course at master’s level. This course, alongside my role as a senior nurse, provided me with the expertise required to develop my career further in neonatal care.
My name is Hannah Wells, and I am a Neonatal Surgical Clinical Nurse Specialist (CNS).
Hi, I am Amanda and work as the Neonatal Infant Feeding Coordinator for a NICU and a SCBU within one service. While the role is not standardised, many neonatal units now have dedicated posts.
Hello, my name is Daniela Machado, and I am proud to be a Developmental Care Specialist/Lead Nurse and a sister/charge nurse, working across two different trusts. I am originally from Porto, Portugal, and have spent 14 years building my nursing career in the UK. My role involves applying and advancing neuroprotective/developmental care practices for our preterm and neonatal patients/families.
Hello! I am Renjita Raju , a Neonatal Junior Sister working in London. After completing my BSc nursing degree in India, I moved to UK, and completed NMC OSCE to get registered and QIS course to become specialised in neonatal care. I recently qualified as an NLS instructor with the support from NNA scholarship programme. My role involves caring for premature and critically ill newborns, ensuring their safety and health with a highly collaborative multidisciplinary team. I also teach in NLS courses as an instructor following my passion in neonatal resuscitation. I love witnessing infants grow stronger each day and supporting their families through this journey. I’m grateful for the opportunity to provide meaningful compassionate care to the tiniest, most vulnerable patients. 