Technology and refinements in clinical practice have reduced the mortality and morbidity rates in sick babies. As a result intensive care is directed increasingly towards the management of extremely pre-term babies and a smaller number of very sick mature babies. The overall demand for neonatal intensive care has risen and at the same time there is increasing public pressure on the healthcare system for the delivery of care provided by professionals whose level of specialised training is appropriate to the clinical situation*.

Approximately 10% of babies require some form of specialist support at birth. Evidence suggests that babies weighing <2000g, born at a hospital with a regional Neonatal Intensive Care Unit (NICU) are associated with a lower risk-adjusted mortality than babies born at a hospital with no NICU, intermediate NICU of any size, or small community NICU*.

'The Strategy for Improvement' was developed as a result of a national review of neonatal care within England. It suggests standards for the different levels of care, where that care might be delivered, how services can be developed and the support and information parents are likely to need.

Following publication of the 'Strategy for Improvement' the London Specialised Commissioning Group (LSCG) endorsed recommendation from the London Perinatal Care Steering Group (LPCSG) to establish neonatal networks across London as the necessary first step of a wider strategy to improve neonatal services.

In May 2003, decisions made for the South West London Sector included:

- The establishment of a single network across South West London encompassing the neonatal services at St George's Healthcare NHS Trust, Epsom and St Helier NHS Trust, Mayday Healthcare Trust and Kingston Hospital NHS Trust.
- The Level 3 unit was identified as St George's Healthcare NHS Trust.