THE UK’S SPECIALIST AIR AMBULANCE OPERATOR
Rapid response UK, EU and global medical repatriations with a guaranteed bed-to-bed service.
Capital Air Ambulance is pleased to announce the relaunch of our international neonatal intensive care transfer service. With our fleet of aircraft we are able to provide repatriation or emergency transfer of neonatal patients by fixed wing air ambulance from across the UK and internationally. We can also arrange commercial repatriation for longer distances, including transatlantic, using our stretcher-based BabyPod mini incubator, or in an airline bassinet with medical escort.
Our team includes consultants and senior specialists, advanced neonatal nurse practitioners and neonatal intensive care nurses. All of our team work for NHS neonatal intensive care units and neonatal transport and retrieval teams where assessment, stabilisation and transfer of extremely sick neonatal patients is their everyday job. Our clinicians are highly experienced in the risk assessment of babies for emergency transfer and repatriation via road and air with a proven track record of safety, compassion and professionalism.
We are proud to work alongside Lucy Air Ambulance for Children to provide charity-funded flights for NHS babies within the UK. Through this collaboration we are able to access the charity’s state of the art flight incubator and offer our service to the private sector and give back to the charity at the same time.
Our neonatal intensive care team can transfer babies receiving almost all levels of neonatal intensive care and provide full support aboard the air ambulance for a long distance transfer. We can provide mechanical ventilation with a modern ventilator that adapts to the patient’s response, noninvasive BiPAP/CPAP and High Flow Humidified Oxygen (also known as Vapotherm or Optiflow). We can provide IV infusion therapy and full monitoring including invasive or noninvasive blood pressure.
In the changing world following COVID-19 and Brexit, families will be more keen than ever to have rapid repatriation back to the UK as soon as it is medically feasible. Our service offers this hope to families, and at the same time offers cost containment to the insurance provider at a time when medical billing for British patients in the EU is a rising cause for concern.
We would welcome the opportunity to discuss any neonatal patient and connect you with one of our team of experts to advise on the best window of opportunity for repatriation. Our specialists can also review treatment plans and liaise with UK NHS neonatal units to arrange emergency transfer for babies requiring urgent treatment.
Neonatal Fact Sheet
Neonatal transport in the UK
Within the UK, there are over 15,000 neonatal transfers conducted each year by NHS teams across the country – around 22 transfers per 1000 live births.
This means that for many babies requiring neonatal intensive care, some sort of interfacility transfer is a normal part of their neonatal experience – either uplift to a tertiary facility, repatriation to a local unit, or both.
The UK neonatal units are assigned to Operational Delivery Networks (ODNs) spanning each country with formal agreements for a “home” unit ready to accept any baby born out of area plus an associated tertiary centre for advice and treatment if unwell.
Capital’s neonatal track record
Capital is a EURAMI accredited fixed wing air ambulance provider with endorsement in Neonatal Critical Care.
Since 2016, Capital Air Ambulance has safely transferred many babies by fixed wing air ambulance to and from the UK and France, Spain, Morocco, Cyprus and Malta.
In 2020 we arranged two transfers between the UK and California, one via BabyPod stretcher and another by airline bassinet, managing to repatriate both babies just ahead of the COVID shutdown.
Our charity-funded UK flights and privately or insurance funded international flights for babies have had consistent positive feedback from parents and health professionals.
Frequently asked questions from health professionals
How will an air ambulance transfer affect the baby?
Babies generally tolerate flight transfer very well, and the effects from acceleration during take off and landing are similar to a road ambulance  whilst occurring less frequently. Regarding altitude, our experience over hundreds of neonatal transfers is that babies often need a small amount of supplemental oxygen once at cruising altitude, which is carefully titrated by the medical team. Once in level flight we can give baby a feed via nasogastric tube, and we will have the mother or carer sit with their baby to talk and touch through the incubator portholes. With an experienced team and appropriate equipment, neonatal flight transfer is safe and comfortable for the baby .
Is it better to wait for babies to be term before transfer home?
There is no particular reason to choose 37 or 39 weeks postmenstrual (“corrected”) age as a safe time to transfer a baby. Some babies will be entirely stable quite early on, while other ex-preterm babies will require high dependency care well past their due date . We would recommend consultation with one of our experts in neonatal intensive care transport to advise on the best window for a transfer.
Alongside the patient’s clinical condition it is also important to consider the effects on the family and any siblings of a prolonged stay away from home as well as differences in neonatal care standards from country to country. The mental health of parents and caregivers is a significant concern for any baby having a long-term admission , which will be compounded when away from home in a foreign country. A positive family environment is essential for the baby’s long term neurodevelopmental outlook and can have a lasting impact alongside any medical concerns.
Is neonatal care the same in every country?
Many countries across Western Europe and neighbouring regions do offer neonatal care to a similar standard to the UK. Our experience from hundreds of international repatriation transfers is that whilst clinical standards may be similar, practice around developmental care and involvement of the family may vary significantly. Involving the family in care, helping to establish breastfeeding, bonding with parents and a happy and healthy family environment are extremely important , , and may be significantly hampered by the family being away from home, language and cultural barriers , with reduced contact due to restrictive visiting policies. Bringing baby and family back to the UK is a significant step in the patient’s care journey and it should not be unduly delayed.
Does flight transfer increase the risk of retinopathy of prematurity (ROP) and hence blindness?
Transport of any kind is not a recognised risk factor for ROP, rather the baby’s weight and gestational age at birth are the strongest risk factors . Exposure to oxygen is also a significant risk factor, however research and clinical practice is based on a pulse oximetry oxygen saturation target range (e.g. 90-94%) over many days and weeks of neonatal care, not on the absolute value of inspired oxygen. In fact, recent trends based on high quality research have been towards targeting higher oxygen saturation levels , . There is no reason to believe that a modest increase in inspired oxygen concentration to compensate for standard cabin altitude for a few hours, with the same target range for the patient’s measured oxygen saturation, would make a significant difference to prognosis.
2Valente ME, Sherif JA, Azen CG, Pham PK, Lowe CG. Cerebral Oxygenation and Acceleration in Pediatric and Neonatal Interfacility Transport. Air Med J. 2016 May-Jun;35(3):156-60. doi: 10.1016/j.amj.2016.01.006.
3Veldman A, Krummer S et al. Safety and Feasibility of Long-Distance Aeromedical Transport of Neonates and Children in Fixed-Wing Air Ambulance. J Pediatr Intensive Care 2021 Mar DOI: 10.1055/s-0041-1731681
4Seaton S.E., Barker L. Modelling neonatal care pathways: investigating length of stay for preterm infants. Infant 2016; 12(3): 87-90.
6Gooding JS, Cooper LG, Blaine AI, Franck LS, Howse JL, Berns SD. Family support and family-centered care in the neonatal intensive care unit: origins, advances, impact. Semin Perinatol. 2011 Feb;35(1):20-8. doi: 10.1053/j.semperi.2010.10.004.
7Russell G, Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S; “Very Preterm Birth Qualitative Collaborative Group”. Parents’ views on care of their very premature babies in neonatal intensive care units: a qualitative study. BMC Pediatr. 2014 Sep 13;14:230. doi: 10.1186/1471-2431-14-230.
8Holdren, S., Fair, C. & Lehtonen, L. A qualitative cross-cultural analysis of NICU care culture and infant feeding in Finland and the U.S.. BMC Pregnancy Childbirth 19, 345 (2019). https://doi.org/10.1186/s12884-019-2505-2
9Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018 Sep-Oct;63(5):618-637. doi: 10.1016/j.survophthal.2018.04.002.
10Choo MM, Grigg J, Barnes EH, et al. Comparative cohorts of retinopathy of prematurity outcomes of differing oxygen saturation: real-world outcomes BMJ Open Ophthalmology 2021;6:e000626. doi: 10.1136/bmjophth-2020-000626
11Sweet D, G, Carnielli V, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update. Neonatology 2019;115:432-450. doi: 10.1159/000499361