Collaboration achieving results for Newborn Metabolic Screening Programme

The purpose of the NMSP is to identify babies with metabolic disorders as early as possible to enable early treatment. A blood sample is taken from a baby’s heel at or as soon as possible after 48 hours of age and screened for over 20 metabolic disorders.

Dr Webster says each year about 45 newborns are found to have one of the metabolic disorders screened for. Early treatment can improve their health and prevent severe disability and even death.

The National Screening Unit (NSU) has responsibility for the funding, monitoring and strategic direction of the programme run at LabPLUS, the Auckland District Health Board laboratory at Auckland City Hospital.

Dr Webster says over the last few years, the NSU, LabPLUS, district health boards and other stakeholders have worked together to develop new policy and governance arrangements for the programme to determine how it is performing and to address areas that needed improvement.

“These arrangements set out how we do things, such as how results will be notified and what the blood spots will be used for. They also give structure to the programme’s changes, such as the introduction of new tests.

“Monitoring of the programme ensures ongoing quality and an evidence base for service development. Action taken following unsatisfactory results improves screening performance, and reporting has improved awareness of the programme and engagement with the country’s maternity health professionals.”

She says interagency collaboration has brought about practical solutions to other issues the programme faced.

“For example, the blood sample is very time critical, both in terms of when it is taken and in getting the blood spot cards to the laboratory for testing. Severe forms of some disorders can be fatal within seven to ten days, and blood samples can be compromised if they take too long to reach the laboratory.”

Stamped, addressed envelopes, paid for by NSU, now help ensure samples are sent to the laboratory as soon as they are dry.

All maternity carers have been provided with high quality, retractable lancets to use for the heel prick. “This has seen continued improvement in the number of samples received by LabPLUS within the ideal four days, and in blood spot sample quality.

“There’s been a 0.6 percent improvement. That may not sound much, but it represents hundreds of babies a year who don’t need a second sample taken, which is a major plus for babies and their families and for maternity carers.

“We’ve also developed more online education courses for maternity carers and new resources for them, such as parent DVDs and pamphlets. I think we’re doing really well, and better than many countries, in terms of maternity professionals being better resourced and educated about newborn metabolic screening.”