It's difficult to imagine an operation as delicate and sensitive as transporting a tiny baby, whose life is already hanging in the balance. But, when vital surgery is needed, there's no other choice.
A year ago this month a specialist transport service was set up by a team at the Royal Victoria Infirmary in Newcastle. It's equipped with specialist medicine and life support - on a minute scale - to make sure the life-saving moves are as safe as possible.
640 babies have been transported in the first 12 months.
Maxwell was born 12 weeks prematurely, weighing two and a half pounds.
Now he's six weeks old and his condition has deteriorated. Doctors at North Tees Hospital are concerned he needs surgery, for that he must go to the RVI.
But just as the ambulance is about to leave Maxwell is struggling to breathe. His heart rate drops, the transport team have to act immediately.
It's a balance of risk and benefit, so if the end point is that you can't give the care at the place where the baby is you have to move the baby.
An ambulance is carrying Maxwell but the trolley and staff are part of the Northern Neo Natal Transport Team.
Absolutely everything that we can do on ward 35 we can do in the back of an ambulance, the kit is all on the trolley and the ambulance service just get us from A to B.
The service has transported more than 600 babies in its first year between the 11 hospitals in the North East and Cumbria which look after new born babies.
Maxwell arrives at the RVI to be assessed by surgeons. Moving babies to the right hospital for the care they need can mean they are a long way from their parents' home.
Indie was born by emergency caesarean at 31 weeks. Her mum Laura has been at the RVI a month, leaving her other children an hour away in Northumberland.
Worrying about two lots of children, in two different places and trying to sort of split yourself in two and not being able to.
Dad, Colin, is left at home juggling normal life with hospital visits.
The costs were just mounting up, parking and fuel costs. One Friday night it took us over 2 hours to get in. I mean the kids have had doctors appointments this week, parents evenings things like that, so you don't really get chance to think Oh Christ I've got a baby in hospital.
Indie is doing well and is transferred to Cramlington much nearer her family home.
Maxwell has also been transfered again. He recovered without surgery and is back at North Tees, alongside his twin brother Myles.
Hopefully the next journey the boys make will be home with their parents.
The transport team remain on standby, 24 hours a day, with the incubator ready for when the next call comes in.
The charity, Tiny Lives, assists families whose sick and premature babies are being treated at the RVI's neo-natal unit. We spoke to its head, Kelly Blakeney, to find out more about its work:
Watch Julia Barthram's full report: