Updated guidance released on newborn and infant physical examination (NIPE)

The newborn and infant physical examination (NIPE) screening programme guidance has been updated with a new standard which is due to come into force from 1 April 2021.

An outline of the changes to the NIPE standards is below with links to further reading.

NIPE-S01 (KPI NP1): newborn physical examination screening coverage has no change to eligibility, but new guidance has been published to clarify ‘too young for NIPE screening’ and ‘too ill for NIPE screening’ as reasons for not meeting this standard.

NIPE-S03: diagnosis/intervention - timeliness of ultrasound scans of the hips for developmental dysplasia

Babies with screen positive results on newborn examination should attend for ultrasound scan of the hips between:

• 4 to 6 weeks of age for babies born at 34 weeks and zero days (34⁺⁰) or later gestation, 38⁺⁰ to 40⁺⁰ weeks corrected age for babies born earlier than 34⁺⁰ weeks gestation.

An outcome decision should be made of either:

● 'discharge from the hip screening pathway after review of normal hip ultrasound scan results
● attendance for clinical assessment by orthopaedic specialist'

This change should enable babies to be scanned at a more appropriate stage of hip development and reduce the number of ‘immature’ hip diagnoses made when the requirement was for all babies with suspected or confirmed dislocated hips to have had an ultrasound scan by 2 weeks of age and babies with hip risk factors scanned by 6 week of age.

NIPE-S04: diagnosis/intervention - timeliness of hip clinical assessment or discharge

Babies who attend an 'ultrasound scan of the hips after screen positive referral should have an outcome decision made by:

• 6 weeks of age for babies born 34⁺⁰ gestation', and 40⁺⁰ weeks corrected age for babies born earlier than 34⁺⁰ weeks gestation.

NIPE-S03 and NIPE-S04: hip pathway changes

'The screen positive pathway will apply to babies with either:

● suspected dislocated or dislocatable hip(s) at clinical examination
● the presence of one or more national hip risk factors

The timescales will be the same for a referral for an ultrasound scan and orthopaedic review, if required.'

For Public Health England’s (PHE) summary, please visit the PHE blog. Please visit gov.uk for further information on the NIPE guidance.