Public Health England is responsible for quality assuring the NHS newborn screening programmes. An update was provided on changes to the newborn blood spot and hearing screening guidelines and standards, as well as the implementation of new screening technologies like pulse oximetry screening and the NIPE SMART system for standardized newborn physical examinations. Trusts are encouraged to discuss any concerns about changes to local screening programs to ensure babies continue receiving complete and timely screening.

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
2 Newborn Screening Update - 30.10.15
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
3 Newborn Screening Update - 30.10.15

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***
4 Newborn Screening Update - 30.10.15

5. Newborn & Infant Physical Examination
Standards being revised - will be published with the NIPE Programme Handbook
in 2016. Proposed new standards: -
5 Newborn Screening Update - 30.10.15

6. NIPE Standard (cont.)
6 Newborn Screening Update - 30.10.15

7. Newborn & Infant Physical Examination
NIPE SMART
Implementation status for London – six London Trusts currently not participating*
7 Newborn Screening Update - 30.10.15

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.
8 Newborn Screening Update - 30.10.15

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
9 Newborn Screening Update - 30.10.15

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
10 Newborn Screening Update - 30.10.15

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
11 Newborn Screening Update - 30.10.15