Newborn Metabolic Screening Programme Monitoring Update

A heel prick is carried out at 48 hours after birth, or as soon as possible after this. Almost all babies in New Zealand are screened, and early detection can prevent severe disability and death.  Approximately 45 babies a year are identified with one of the conditions through screening. 

Quarterly monitoring reports are produced for the NMSP. The reports monitor a number of indicators including the timing of sample taking, the time taken for samples to reach the laboratory and the time taken for results reporting.

The monitoring reports are showing a consistent trend of improvement across all district health boards (DHBs). This shows a commitment from health practitioners to improving the quality of this screening and they are to be commended.

The programme’s priorities for 2013/14 are to further improve the timeliness of blood spot sample taking and transit time to the laboratory. 

To continue to collect high-quality data, the NMSP relies on health practitioners filling in the blood spot card completely. This includes completing the sections for the date and time of birth and the date and time of sample collection.

Other national data for annual and biannual monitoring indicators shows:

• the timeliness of reporting positive results by disorder was 100 percent for those results where it was likely the condition was present and there is clinical urgency about the commencement of treatment
• collection and receipt of second samples remains an area for improvement, as overall only 42.3 percent of second samples were received within 10 days. Second samples are requested by the laboratory from health practitioners when samples are unsatisfactory (not enough blood, too much blood or taken before 48 hours) or there are minor elevations of screened metabolites.

National data in the table below for the five quarterly monitoring indicators shows:

• the timeliness of sample taking (between 48 and 72 hours of birth) has improved significantly from 2011 (41 percent to 72 percent). There is still room for improvement with this indicator as approximately 24 percent of samples were taken after 72 hours during 2012
• since the provision of postage-paid envelopes and lancets to health practitioners in late 2010, there has been:
  • continued improvement in the number of samples being received by the laboratory within four days of collection 
  • on-going improvement in blood spot sample quality, which is meeting the target of 99 percent.

Ethnicity and deprivation data is also monitored for timing of sample taking. There are some differences, as per the Percentage of samples taken at 48-72 hours graph, for Māori, Pacific and Other populations (top of page), and for those with higher levels of deprivation (NZDep 8 – 10).

The NSU is working with DHBs to continue to make quality improvements for all indicators. 

Monitoring reports and further information can be found here.

Monitoring indicators and targets are being reviewed later this year, so if you have any feedback or questions please contact Diane Casey, NMSP Programme Leader by email: [email protected]