Screening pathway. The NHSP pathway consists of the following: Identify eligible population • all eligible babies, born or resident in England, should be offered a newborn hearing screen before 3 months corrected age for prematurity (see section 3.14 for details of exclusion criteria). It is expected that all reasonable efforts will be made to ensure that babies have their screen completed before they move area from the one in which they were born • the eligible population of ‘new births’ or ‘new registrations’ is identified through a birth notification into the NHSP national IT system or notification to the screening team by the local child health records department (CHRD) • the local maternity services, or in exceptional cases the CHRD, is responsible for entering high quality, timely data into the NHS number registration system (Patient Demographic System) to enable electronic identification of babies eligible for screening within the national IT system. This should be completed as soon as possible after birth and ideally prior to any newborn screening being performed (i.e. NIPE/NHSP/NBS) • where a NHS number has not been generated for any reason the provider should have systems in place to identify these eligible babies and undertake screening without delay • a mechanism should be in place to identify babies who move into the area under three months of age who have not been screened. The local screening programme must be informed of these babies by child health/health visitor/primary care
Screening pathway. A full description of the screening pathway is given below, along with a diagram of the pathway. Providers must be familiar with the screening pathway and the timeframes in which to refer women (figure 1). The fetal anomaly screening pathway consists of the following: • identify population - the eligible population is identified through maternity services. For fetal anomaly screening the eligible population are women less than or equal to 23+0 weeks of pregnancy confirmed by ultrasound scan • inform - during the ‘first contact’ or ‘booking visit’ with the midwife, verbal and written information should be given about the fetal anomaly scan (using NHS Screening programmes booklet ‘Screening Tests for You and Your Baby’) to enable women to make a personal informed choice. • offer - the offer of screening and subsequent acceptance or decline must should be documented in the patient held record/maternity notes (paper or electronic) • test - the fetal anomaly ultrasound scan should be performed between 18+0 to 20+6 weeks gestation. Where the image quality of the first scan is compromised a single further scan should be offered by 23+0 weeks gestation • the fetal anomaly ultrasound scan should be performed to comply with the requirements of the anatomical base menu and fetal cardiac protocol which are detailed in the programme handbook. • a local failsafe protocol must be in place to ensure that all women who accept fetal anomaly screening complete the testing pathway Management of results: No anomaly suspected: all women should be notified of their scan findings at the time of the screen. The results should be documented in the patient held record/maternity notes (paper or electronic). Anomaly suspected: the woman is informed at the time of the scan and the sonographer/ midwife/clinician and woman discuss the options available
