BBC News: ‘Newborn hip checks ‘have failed to prevent late diagnosis’

News today [1] reports on new research showing that we still are still failing to reduce avoidable late diagnosis of developmental hip dysplasia. Screening for early detection of developmental hip dysplasia (DHD) is one of the core outcomes of the NHS Newborn & Infant Physical Examination Programme (NIPE) [2]. Early detection of this condition improves outcomes; missed diagnosis increases the likelihood that corrective surgery will be needed, and the risk of complications including long-term disability.

THE NEED FOR TRAINING

“There’s well-established evidence [3,4] that focused training to improve the quality of hip exam using the Barlow and Ortolani tests together with targeted ultrasound screening has been effective in reducing the prevalence of late presenting developmental hip dysplasia.” 

Professor Simon Mitchell 
Consultant Neonatologist St Mary’s Hospital, Manchester; Baby Lifeline Training Course Director, Examination of the Newborn

Baby Lifeline’s Mind the Gap report (2017/18) [5], showed national variation in provision of training on full physical examination of the newborn. Significantly, 20% of UK trusts reported that they did not provide any training on this topic for their maternity staff. We also showed variation in duration: with anything from 0-9 hours of mandatory training available to maternity staff, depending on which trust they worked at.

We believe that regular, standardised training is key to giving professionals the knowledge to perform newborn examinations to the highest standard possible and prevent missed opportunities to provide positive outcomes for at-risk babies.

WHAT ARE WE DOING TO HELP?

Our Examination of the Newborn course provides clinically based training which includes all four of the components set out as screening priorities by NIPE [2]. It seeks to maintain existing skills, inform and update practice, and also reflect the current relevant UK screening guidance. It provides an overview of common clinical problems presenting in infancy with an emphasis on the early recognition of infants at risk and their appropriate management.

This training is developed and delivered by experienced experts in the relevant specialties (i.e. ophthalmologists, orthopaedic surgeons, paediatric urologists, and neonatologists).

 The team behind the training:
Dr Abhimanu Lall
Consultant Neonatologist, King’s College Hospital, London

Mr R. Maximillian Cervellione
Consultant Paediatric Urologist, Royal Manchester Children’s Hospital

Mr Susmito Biswas
Consultant Opthalmologist,Royal Manchester Eye Hospital

Dr Emma Pascall
Cardiology Registrar, Evelina London Childrens Hospital

Professor Simon Mitchell
Consultant Neonatologist,St Mary’s Hospital, Manchester

Mr Om Lahoti
Consultant Adult and Paediatric Orthopaedic Surgeon,King’s College Hospital 

Mr Lee Smith
Clinical Fellow in Paediatric Surgery, Leicester Royal Infirmary 

 

Feedback from previous courses highlights its value to clinicians; 97% of our delegates reported that they intended to modify their practice following the course, and 96% of delegates rated the quality of training offered as ‘very good’ or ‘excellent.’

“Thank you, an absolutely brilliant study day – I have been performing NIPE for 13 years, but have still taken away thoughts of how I will alter my practice.”

“Fantastic teaching. Amazed by the content and knowledge of the lecturing.”

 “The most useful NIPE update I have attended since doing NIPE in 2003.”

 You can book or commission our Examination of the Newborn course by visiting our course page or contacting us directly at training@babylifeline.org.uk

 

 

References

[1] BBC News. (2019, March 29). Newborn hip checks ‘have failed to prevent late diagnosis.‘ BBC News. Retrieved 29th March 2019.

[2] Public Health England. (2016). Newborn and Infant Physical Examination Screening Programme Standards 2016/17

[3] Maxwell, S., Ruiz, A. and Cosgrove, A. (2002). Clinical screening for developmental dysplasia of the hip in Northern Ireland. BMJ, 324, 1031 – 1033.

[4] Chan, A., Cundy, P., Foster, B., Keane, R. and Byron-Scott, R. (1999). Late diagnosis of congenital dislocation of the hip and presence of a screening programme: South Australian population-based study. The Lancet, 354, 1514-1517.

[5] Ledger, S., Hindle, G. and Smith, T. (2018). Mind the Gap, An Investigation into Maternity Training for Frontline Professionals Across the UK (2017/18). Retrieved 29th March 2019.

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