A failure to meet demand for neo-natal services has prompted calls for greater performance management and changes to commissioning.

A Commons public accounts committee report found problems with neonatal units' financial and staff management, recruitment and training.

Units had to close to new admissions an average of once per week during 2006-07 and a third operated above the recommended occupancy rate.

The committee examined the impact of the government's organisation of neonatal services into 23 regional clinical networks, following a 2003 review.

It recommended that primary care trusts commission services on the basis of whether units had the right levels of suitable staff, and that strategic health authorities introduce formal performance management of the networks.

"In return for continued funding of networks, SHAs should agree a set of performance measures and review networks' performance against these objectives," said the report.

Phil Wilson, a Labour committee member, said: "PCTs need to improve their understanding of their changing demographics."

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