Time = Brain

Time=Brain is a regional Neonatal Therapeutic Hypothermia project devised and led by Dr. Peter Reynolds and supported by South East Neonatal Network and the Maternity, Children & Young People’s Strategic Clinical Network.

The South East Neonatal Network (SENN) Time=Brain project aims to enhance the protection of babies’ brains when there is evidence of moderate or severe encephalopathy through optimising the use of therapeutic hypothermia (cooling).

There are four key aims to this project:

1. To ensure that the decision to cool babies is consistently applied across the SEC region
2. To achieve the target temperature range safely & promptly, avoiding under- or over- cooling
3. To achieve the target temperature (33-34°C) within 6 hours of birth (or postnatal collapse event)
4. To maintain the target temperature during handover and transport of babies

The key message for Time=Brain is that there is sufficient time to examine and document the baby’s neurology, diagnose the Grade of Encephalopathy and start servo-controlled cooling for moderate and severe grades, to reach the target temperature within 6 hours of birth according to NICE Guidelines.

NICHD Scoring for HIE

The NICHD chart (downloadable/printable below) should be used to guide clinicians as to when to commence cooling. This replaces the previously used Thompson/BadgerNet scoring. The criteria for babies being at particular risk of HIE has not changed. We continue to encourage clinicians to take time to evaluate the baby on the neonatal unit, with repeated clinical examinations, use of CFM where available, and discussion with a senior clinician at the local NICU, before initiation of cooling. Starting cooling on delivery suite is not recommended.

In line with current NICE guidance, we aim for babies to be at the target temperature of 33-34 degrees C. The use of servo-controlled cooling devices will normally achieve this within an hour of commencing cooling.

TimeBrain NICHD Chart

Our Units

South East Neonatal Network covers Kent, Surrey & Sussex; there are 11 Acute Trusts and 13 units in the Network. Two acute Trusts straddle the borders with Thames Valley & Wessex Neonatal Network, we work collaboratively to ensure that patient flows are appropriate for the level of care required.

South East Neonatal Network consists of 4 Neonatal Intensive Care Units, 3 Local Neonatal Units and 6 Special Care Units. South East Coast Neonatal Transfer Service operates across the Network, undertaking both emergency retrievals and repatriation back to local units.

Hospital	Contacts
Medway Maritime Hospital Medway Oliver Fisher Neonatal Unit NICU	Lead Clinician:	Dr Aung Soe
	Ward Manager:	Anna Francis
Darent Valley Hospital Dartford Special Care Baby Unit (Walnut Ward) SCU	Lead Clinician:	Dr Abdul Hasib
	Ward Manager:	Annette Pope/Kathy Wood
Queen Elizabeth the Queen Mother Hospital Margate Special Baby Care Unit SCU	Lead Clinician:	Dr Kalu Ogbureke
	Ward Manager:	Louise Ruiz
William Harvey Hospital Ashford Neonatal Intensive Care Unit NICU	Lead Clinician:	Dr Vimal Vasu
	Ward Manager:	Louise Ruiz
The Tunbridge Wells Hospital at Pembury Neonatal Unit LNU	Lead Clinician:	Dr Hamudi Kisat
	Ward Manager:	Julia Moat & Lou Mair
Royal Sussex County Hospital, Brighton Trevor Mann Baby Unit NICU	Lead Clinician:	Dr Phil Amess
	Ward Manager:	Julia Simpson
Conquest Hospital, St Leonards on Sea Special Care Baby Unit SCU	Lead Clinician:	Dr Mani Kandasamy
	Ward Manager:	Wendy Thompsett
Princess Royal Hospital Haywards Heath Trevor Mann Baby Unit SCU	As for Royal Sussex
St Peters Hospital, Chertsey Neonatal Unit NICU	Lead Clinician:	Dr Peter Martin
	Ward Manager:	Sara Robertson
East Surrey Hospital Redhill Neonatal Unit LNU	Lead Clinician:	Dr Abdul Khader
	Ward Manager:	Ingrid Marsden
Frimley Park Hospital Frimley Special Care Baby Unit LNU	Lead Clinician:	Dr Sanjay Jaiswal
	Ward Manager:	Jennifer Lomas
Royal Surrey County Hospital Guildford Neonatal Unit SCU	Lead Clinician:	Dr Michael Hardo
	Ward Manager:	Geizel Pulanco
Worthing Hospital Worthing Beeding Ward SCU	Lead Clinician:	Dr Katia Vamvakiti
	Ward Manager	Abi Seal

South East Neonatal Transfer Service

The Kent, Surrey and Sussex Neonatal Transfer Services is comprised of three separate teams which operate to cover the entire region and offers a comprehensive planned and unplanned neonatal transfer service. This enables the movement of critically ill patients 24 hours a day, 7 days a week across the region and the elective transfer of less unwell infants.

Kent, Surrey & Sussex Neonatal Transfer Service is part of the London, Kent, Surrey and Sussex Neonatal Transport Service coordinated through the Emergency Bed Service. During the daytime two teams operate over the three regions between 08:00 – 20:00 for planned and unplanned transfers. From 20:00 – 08:00 one of the three teams offers the night cover for the region on a rotational basis.

Trevor Mann Baby Unit at Royal Sussex County Hospital
Oliver Fisher Special Care Baby Unit at Medway Maritime Hospital
Neonatal Unit at St. Peter’s Hospital