Innovative antibiotic project keeps families together with newborn care at home
A new initiative at the Royal Devon University Healthcare NHS Foundation Trust is transforming care for newborn babies, allowing them to go home with their families sooner.
NOAH (Neonatal Oral Antibiotics at Home) permits eligible newborns with suspected early-onset infection (EOI) to switch from intravenous antibiotics in the hospital to oral antibiotics at home after 36 hours of treatment.
This innovative approach reduces hospital stays, improves family experiences, minimises potential risk from gentamicin exposure, lowers costs to the NHS, and optimises workforce capacity. Shifting care from hospital to home is particularly important in a rural region like the South West Peninsula – where families face long travel distances to hospitals and other care services.
A six-month pilot at the Royal Devon and Exeter (Wonford) Hospital site of the Royal Devon University Healthcare NHS Foundation Trust introduced the NOAH pathway. Through the period of the pilot, 27 families were discharged onto the new pathway.
One of the families to benefit from the project were parents Emily and Harry and their daughter Luna from Woodbury, Devon. Emily, who also appeared on BBC Spotlight on 4 August with clinical leads to speak about her positive experience of NOAH, said:
“After my home birth, I was told I would have to be transferred to hospital because there was meconium in my waters. I was devastated. Hospitals are a scary place for me, and all I wanted was to be at home.
“To be able to come home with antibiotics for Luna during my first few days as a mum made all the difference for us as a family. It meant we could be together, especially since my partner was on summer leave from the military. We had such a short time together, and I’m so grateful for that precious time as a family.
“The team genuinely wanted what was best for me and Luna, and did everything they could to make the transition to home much easier. I was shown how to administer the antibiotics, had follow-up calls, and felt reassured every step of the way. It wasn’t overwhelming, it was done so carefully. All you want is to be in your own space with familiar things, and the team was so understanding and supportive.
“Thank you for helping turn what could have been a negative experience into something empowering. This is all part of Luna’s journey, and I’m so proud to one day tell her that she was one of the first babies who made this possible for families in the future.”
A joint approach
The project is a collaboration between Health Innovation South West, Royal Devon, the NIHR Applied Research Collaborative South West Peninsula (PenARC) and the South West Neonatal Network. Our organisations are now working together to support wider adoption and evaluation of the approach across other Trusts in the region.
Rebecca Whitting, Executive Director of Implementation, Health Innovation South West said:
“This initiative is a powerful example of how we’re helping new ideas in health and care reach more of our rural and coastal communities, making a real difference to the people of the South West. It has been incredibly rewarding to bring our expertise to this project, helping to drive wider adoption of the NOAH pathway across the region for the benefit of even more families. I look forward to continued collaboration with the Royal Devon and NIHR PenARC.”
Carolyn Mills, Chief Nursing Officer for the Royal Devon, said:
“We are pleased that this exciting initiative is already making a significant difference for families across our communities. In rural areas like Devon, where many families face long journeys to reach neonatal services, this initiative is bringing vital care closer to home.
Being a key partner in this project allows us to further strengthen our relationship with leading organisations across the South West like NIHR PenARC and Health Innovation South West.”
Professor Stuart Logan, Director NIHR ARC South West Peninsular, said:
“These changes mean large numbers of newborn babies spending less time in hospital, which is great for families and reduces the pressure on neonatal units. It is a fantastic example of brilliant clinicians producing and using evidence which can improve the lives of newborn babies. I’m delighted that Health Innovation South West and NIHR PenARC have been able to help with this work and will now work with the team to spread this change across the country.”
Health Innovation South West has supported Royal Devon to produce a suite of resources for clinicians to be able to implement NOAH in other trusts, and conducted an initial evaluation into the findings of the pilot. Our focus now is working with our partners to spread the project more widely whilst undertaking an implementation evaluation across sites to assess the impact of the pathway in different settings and provide additional learning about the model.
You can find out more about our partners below and read the BBC News article here.
NIHR ARC South West Peninsular
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