3 newborn updates – Michelle Onslow

1. Public Health England is responsible for the NHS Screening Programmes
Quality Assurance (London)
Newborn Screening Updates
30.10.15
Angela Dietrich, Senior QA Advisor

2. Newborn Blood Spot Sampling
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Guidelines currently being updated. Should be available end of Nov 2015.
They will: -
 include information on all of the nine conditions currently screened for
 provide clarity on the type of transfusions that affect bloodspot samples
 contain useful scenarios that can be used for training purposes
 have more information on why bloodspot quality matters (see example below)
Compressed sample
(can be identified through staining of the glassine
envelope)
Significant risk of
false-negative result

3. Newborn Blood Spot Sampling
• Residual blood spot consultation – November 2015 to January 2016
• Residual blood spots are currently used for:
• molecular genetic diagnosis
• prenatal diagnosis for at risk relatives
• diagnosis of congenital infection
• research
• Consultation is to review the retention, storage, use and release of residual
blood spots and related information
• Expanded NBS screening review – will be completed Jan 2016
• Review of NBS card - 2016
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4. NBSFS – Exception Reports
Trusts should be receiving NBSFS reports weekly*
Regional teams now receive regular exception reports which include:
• a summary of those units with babies outstanding on their systems for more
than 17 days
• information on how often the failsafe is accessed**
We do not receive details of NHS numbers or any other PID***
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5. Newborn & Infant Physical Examination
Standards being revised - will be published with the NIPE Programme Handbook
in 2016. Proposed new standards: -
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6. NIPE Standard (cont.)
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7. Newborn & Infant Physical Examination
NIPE SMART
Implementation status for London – six London Trusts currently not participating*
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8. NIPE SMART IMPLEMENTATION
Some of the reasons given for not implementing NIPE SMART include: -
» screening team keen, neonatologist/NNU resistant
» not wanting to implement parallel systems which may require double (or
triple) entry
» already recording the data
It should be noted however that local systems will not meet the national service
specifications which require a robust national failsafe process.
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9. Pulse Oximetry
Pilots commenced February 2015
15 Trusts participating
Testing the impact of introducing Pulse
Oximetry – aim is to review the
feasible of its inclusion in the Newborn
& Infant Physical Examination
If rolled out nationally, pulse oximetry
fields will be added to NIPE SMART
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10. Newborn Hearing Screening Programme (NHSP)
 Programme standards under review
 Operational handbook being developed
Site / Border Changes
 Some Trusts are experiencing changes in how newborn hearing screening is
organised locally e.g. changes from community model to hospital model,
changes in service provider
 Largely influenced by funding / commissioning
 Presents a significant risk to this screening programme
Ensure concerns/issues related to these changes are discussed
formally at TSSGs and risks escalated appropriately
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11. Changes to local Hearing Screening Programmes
When changes are made/proposed QA and NHS England will
require assurance that: -
 local pathways have been reviewed and risk assessed
 where border changes have occurred, responsibility for screening is
clear
 planning includes the correct re- structuring of the NHSP IT system
(e-Screener Plus or eSP) so that babies are not missed or screening
delayed
 new hearing screening staff/providers of the service have
appropriate links with local internal governance structures
 local hearing screening guidelines are updated to reflect changes
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