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The New-born and Infant Physical Examination Programme Cymru (NIPEC) Survey

Hello, I am Rachel Hayward a Consultant Neonatologist in the University Hospital of Wales. I am currently involved in an exciting new project, initiated by the Welsh Government, related to newborn screening examinations conducted on babies and infants in Wales. These examinations are routinely conducted within 72 hours of birth and again at 6-8 weeks of life. They are carried out by a wide range of health professionals, such as paediatricians, midwives, advanced nurse practitioners, GPs and health visitors in various clinical settings within primary, secondary and tertiary care.

The purpose of a newborn screening examination is to identify babies more likely to have conditions that would benefit from further investigation and management. This comprises taking a detailed history of the pregnancy and completing an overall physical examination and more specific examinations to screen for eye problems, congenital heart defects, developmental dysplasia of the hip and undescended testicles. Most examinations report findings of a healthy baby. However, in cases where a problem is identified, the prompt recognition of such an abnormality should ensure the provision of early interventions which may improve the health of the baby and prevent or reduce disability.

Currently, there is no set training programme for newborn screening examinations. Each health profession has a different training regime, governed by local departmental protocols and its own professional standards. This variation in practice is further amplified by the disparity between each Health Board and the referral pathways they have in place for babies for whom an abnormality has been detected.

The New-born and Infant Physical Examination Programme Cymru (NIPEC) Project Board was set up in 2019 by the Welsh Government to develop a consistent approach for all health professionals undertaking newborn examinations within 72 hours of birth or between 6-8 weeks of age. The aims of the programme are to reduce variation in practice through the development of an All Wales newborn and physical infant examination programme with a single set of service standards to be implemented throughout Wales. This will include a robust education and training programme; standardised referral pathways for diagnostic investigation, assessment and treatment; performance indicators; defined outcome measures and long-term monitoring of such measures.

The Education and Training workstream of the NIPEC Board are distributing a survey that will provide the first baseline data for Wales on the number of practitioners and the skill mix of those involved in conducting newborn and infant physical examinations. The NIPEC Project Board, in conjunction with Health Education and Improvement Wales, will use the data to develop a standardised training programme (including set competencies, assessments and revalidation requirements) to support all health professionals conducting newborn and infant physical examinations within Wales in primary, secondary and tertiary healthcare settings.

The survey is open to all medical staff (neonatal and paediatric doctors), nursing staff, midwifery (hospital and community based) staff, Advanced Neonatal Nurse Practitioners (ANNPs), GPs and Health Visitors who currently undertake newborn and infant physical examinations in Wales. The results will play a key part in establishing a programme to provide equitable health care for all babies in Wales and provide early interventions to improve outcomes and reduce disability.

Take the survey: