Newborn blood spot (NBS) screening programme: care pathway
Updated 3 February 2021
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This flowchart (illustration and text description below) describes the care pathway for newborn blood spot screening.
1. Check antenatal history
If there is a family history for any of the conditions, note the condition in the comments box on the newborn blood spot (NBS) card and carry out additional early NBS screening tests as required.
Provide information and offer screening test. Go to question 2.
2. Is consent given?
Yes: Take sample and send to laboratory. The routine NBS sample should be taken on day 5 (day of birth is counted as day 0). Laboratory processes and checks card. Go to question 3.
No: Send card with completed demographics to laboratory. Inform GP, health visitor (HV) and child health information services (CHIS) that screening has been declined. End of pathway.
3. Is the quality sufficient?
Yes: Laboratory tests the sample and records the results. Go to question 4.
No: Request a repeat sample. Go to question 2.
4. Is the baby screen negative for all conditions?
Yes: CHIS sends results letter to parents. HV makes sure that parents have received the results by 6 weeks and that these have been recorded in the personal child health record (PCHR). End of pathway.
No: Go to question 5.
5. Is the baby screen positive for any condition?
Yes: Laboratory refers baby to clinical specialist team. End of pathway.
No (borderline, inconclusive, or carrier results): Take action in line with condition-specific pathways. End of pathway.