Neonatal World Conference 2026

Abstract

Background

Advances in neonatal intensive care have significantly improved survival for preterm and medically complex infants. However, the transition from hospital to home remains one of the most vulnerable stages of the neonatal journey. Following discharge, care is often fragmented across multiple professionals and organisations, placing families at risk of inconsistent communication, delayed intervention, and reduced confidence in managing complex healthcare needs.

Neonatal outreach services are uniquely positioned to bridge this gap by coordinating care beyond discharge. We propose CONNECT—a collaborative model that creates collective intelligence by bringing together healthcare professionals, families and community services to deliver coordinated, family-centred care throughout the transition from hospital to home.

Aim

To describe the CONNECT model and explore how structured multidisciplinary collaboration strengthens continuity of care, improves communication, enhances parental confidence, and supports safer neonatal transitions from hospital to home.

Methods

This practice-based service development review is informed by experience within a UK Neonatal Outreach Service and supported by current evidence on family-integrated care, transitional care and multidisciplinary collaboration. The CONNECT model integrates neonatal outreach with neonatologists, paediatricians, health visitors, dietitians, speech and language therapists, physiotherapists, occupational therapists, pharmacists, family support workers and primary care professionals.

The model promotes coordinated discharge planning, structured communication, home visits, shared decision-making, parental education, and proactive multidisciplinary review to ensure timely identification and management of emerging clinical or social concerns.

Results

CONNECT strengthens continuity of care by transforming individual professional expertise into collective clinical intelligence centred around the infant and family. The model promotes earlier recognition of clinical concerns, coordinated decision-making, reduced fragmentation between hospital and community services, and enhanced parental confidence. By fostering collaboration across disciplines, families receive consistent support throughout the post-discharge period while remaining connected to specialist neonatal expertise.

Conclusion

Safe neonatal discharge is not achieved when an infant leaves hospital—it is achieved when coordinated support continues within the community.

CONNECT demonstrates how multidisciplinary collaboration can redesign the neonatal journey by creating collective intelligence around each infant and family. Rather than viewing discharge as the end of hospital care, CONNECT positions it as the beginning of an integrated continuum of care that strengthens safety, family empowerment, and long-term outcomes.