COVID-19: Information for screening providers
What health providers need to know about screening at different alert levels.
Antenatal and newborn screening programmes
- Antenatal and newborn screening programmes are considered high priority and will continue to operate across all COVID-19 alert levels, but with some changes as appropriate to ensure that health staff, women and babies are kept safe.
More details on different levels can be found in the downloads section (to the right of this text).
Breast screening and cervical screening
- At level 4, routine screening is paused for breast and cervical screening services, except for some required annual cervical screening.
- At levels 2 and 3, breast and cervical screening continue with safeguards.
- At alert level 1, breast and cervical screening return to normal.
For additional guidance for both breast and cervical screening at different alert levels, refer to the downloads section (to the right of this text).
- The National Bowel Screening Programme is continuing at all alert levels with safeguards in place to keep participants and staff safe. Participants can still expect to receive their invitation to take part in bowel screening. They can continue to return their completed screening test and this will be processed. If the test result is negative, the participant will get a letter. If it is positive, they will be contacted by phone.
- At Alert Level 4, bowel screening colonoscopies for those with a positive bowel screening test result are not performed. These resume at Alert Level 3 and continue to be performed at Alert Level 2. Alert levels may vary by region.
- If someone is experiencing possible symptoms of bowel cancer, such as a change in their normal bowel habit that continues for several weeks or blood in their bowel motion (poo), they are encouraged seek advice from their family doctor, who will take appropriate action which may include referral for urgent assessment and treatment.
Updates to the health sector will come through your contacts within the National Screening Unit.
The information below under individual programmes is reviewed and updated for the public as the situation develops.
Antenatal and newborn screening programmes (below)
Antenatal and newborn screening programmes are considered high priority and will continue to operate across all COVID-19 alert levels. However, there may be important changes in how the services are delivered at each alert level to minimise risks to staff and the public.
All services providers should abide by Ministry of Health guidelines regarding infection control.
Antenatal screening for Down syndome and other conditions
Antenatal care for pregnant women will continue to be provided across all Government alert levels, including antenatal screening for Down syndrome and other conditions.
All women, including those who identify as a probable / possible COVID-19 case should continue to receive maternity care.
Some changes to the radiology services provided to women for antenatal screening may be implemented at different Government alert levels to help limit the spread of COVID-19 in community settings and protect pregnant women and health staff. We encourage women or their LMC to contact radiology practices to check whether anatomy scanning services are available and any requirements they have in place for appointments. Changes implemented may include:
- Women who identify as a probable / possible COVID-19 case: Access to first trimester anatomy scans for women who identify as a probable / possible COVID-19 case may be limited as some practices are not equipped to manage these cases. Some radiology facilities do have correct protective PPE measures in place for staff and are able to provide essential maternity ultrasound services.
- Shorter scan times: Shorter scan times may be offered to allow more spacing between appointments. While essential scanning procedures will continue, social scanning, such as 3D imaging, may not be available in these shorter appointments.
- Scans can be stopped: Providers have the right to stop a scan if they are uncomfortable with a patient’s behaviour or undeclared symptoms, such as coughing.
- Some radiology practices are closed: Due to the restrictions on non-essential healthcare some radiology practices may close their offices or limit their opening hours.
- No support person present except in high risk situations: Women may be required to arrive and be scanned alone, except if they need a translator or their appointment is deemed to be high risk, for example where there is a suspected loss of pregnancy.
Remember, MSS2 is available to complete screening from 14 weeks if the nuchal scan is unavailable locally or the scan is unable to be completed.
Health providers should review the full guidance for ultrasound service providers available on the Ministry of Health COVID-19 website. This document should be read in conjunction with information available at www.health.govt.nz/covid-19.
Newborn metabolic screening programme
As an essential service, newborn metabolic screening will continue to be provided for babies under all alert levels. This includes babies where they or a family member identify as a probable / possible COVID-19 case.
- Collection of samples: Providers are to follow service guidelines for collection and use standard precautions during collection, and when handling the cards (PPE such as gloves, gown). Cards can be sent in the usual manner. If collecting from a baby or environment in which COVID-19 is suspected or confirmed, providers are to follow local DHB guidelines for patient management.
- Timing of sample collection: The optimal time for collection of a blood sample for newborn metabolic screening is 48 to 72 hours. However, where necessary and to fit with the schedule of visits, the laboratory will accept blood samples collected from 24 hours.
- Courier/mail deliveries as normal: Mail is an essential service that will operate as normal at all levels. However, some disruption to services may be experienced. Note that if a Post Shop is closed, providers can call the courier company for a pickup or to drop off samples at their local maternity facility. Please advise the laboratory of any issues regarding collection or delivery of samples as soon as you become aware of an issue.
- Results not received: Midwives and hospital staff are to ensure that test results are being received within 10 days of a child’s birth and if not, to check that the lab has the sample using the courier track number and call 0800 LABLINK to enquire about sample/result.
Newborn hearing screening
Newborn hearing screening is an important programme and will continue to be provided by DHBs where feasible across all Government alert levels and while demand can be met. DHBs will be prioritising screening babies born in hospital prior to discharge to maximise coverage and completion rates. Babies not screened prior to discharge, babies born at home or a birthing unit, or babies requiring a follow-up screen will need to be seen at an outpatient clinic. Priority will be given to babies who have commenced screening but who require a follow-up screen or older babies who have not yet commenced screening. The availability of outpatient appointments will vary at different Government alert levels and across DHBs.
- Contacting parents of unscreened babies: All DHBs have systems in place for identifying babies who have not been offered newborn hearing screening. Parents/guardians will be contacted by their DHB by phone or letter providing information about when they may expect an appointment and who to contact if they have any queries. Parents/guardians who have not been contacted by their DHB within two weeks of their baby’s birth, can contact their DHB screening team.
- Communication to parents awaiting audiology appointments: Availability of diagnostic audiology appointments will vary across alert levels. Parents/guardians waiting on an audiology appointment for the baby should have been contacted by the audiology department either with an appointment or providing an update on when they may expect to receive an appointment. The parents/guardians of babies of babies referred to audiology can contact their DHB screening team if they have any queries about their audiology appointment.
- Attendance at outpatient appointments: It is important that parents are encouraged to attend the outpatient appointment across all alert levels. Without screening or audiology testing it is difficult to detect hearing loss in babies until their speech and language development becomes delayed. Parents or guardians can discuss with the screening team options for supporting their attendance at an outpatient screening or audiology appointment if they think they may have difficulties attending.
- Advice for parents who are waiting for their diagnostic audiology appointment: The Well Child Tamariki Ora My Health Book includes suggestions for interacting with babies that can promote good listening and communication development in babies. Providers can advise parents to refer to this section while they await their audiology appointment.
All programme changes listed above will be reviewed regularly.
In the meantime, the NSU will publish advice for participants on the 'Time to Screen' website www.timetoscreen.nz
If you have any questions about the changes outlined above please email [email protected]