Guidance

8. National IT system

Updated 10 October 2024

Applies to England

National IT system

The national IT system for the newborn hearing screening programme (NHSP) is SMaRT4Hearing (S4H). It replaced the previous version known as eSP.

The national IT system is configured to identify all babies that NHSP providers are responsible to screen. Each baby will be clearly assigned to a specific NHSP programme or site, so that responsibility can be assigned and unscreened babies identified.

The NHSP provider will be responsible for babies born both in their own and in other maternity units, if the baby is registered with a GP practice in their area. The local NHSP programme is responsible for screening completion and audiological referral for all babies who have not completed screening, or who have been referred from the screen, whether born locally or elsewhere. A summary of how the system works is provided below.

Information recorded on the system is available to each responsible provider in screening, audiology and aetiology teams. Child health record department teams can be granted read-only access and the ability to export screening results for their population. This access must be agreed by the local manager of the NHSP service. Further details are available from the national IT system helpdesk (see contact details in the ‘Support’ section below). Specified PHE Screening staff can access anonymised data in line with data protection regulations.

Confidential identifiers are used to meet data protection rules and enable communications to take place about specific records. The resource guides within the national IT system provide additional guidance for local programmes.

Functions

The national IT system enables management of babies through the screening and audiological assessment process and provides data for audit and service development.

It does this by:

• interfacing with the birth registration system to create a record for each baby
• enabling providers to manage babies through their patient journey (the entire process of screening and follow-up from birth onwards)
• identifying the population eligible for screening and providing failsafes to minimise missed babies and improve screening coverage
• by recording if timely diagnostic assessment is offered to the eligible population
• storing an ongoing record of screening results, which can be downloaded directly from screening equipment
• storing audiological follow-up assessment data where appropriate
• creating consistency of screening data across NHSP in England
• facilitating information sharing with other services such as audiology and aetiology
• enabling providers to generate patient proformas and letters
• enabling providers to record appointments offered, attended, cancelled or not attended
• enabling local and national reporting and audit

The system takes an electronic feed of new birth registrations and creates records for the appropriate provider. Records are managed within the system to ensure data protection and information governance rules are adhered to. Access to data is restricted appropriately.

This is a summary of how the system works:

1. After birth, the midwife or maternity completes the baby’s birth notification and an NHS number is automatically created via the patient demographic service (PDS).

2. This NHS number and some demographic data entered by the midwife are automatically uploaded from the PDS into the national screening store (NSS) database.

3. Records are created in the national IT system and assigned to the NHSP programme (creating site) based on the location of birth using the organisation (ORG) code assigned to each trust or the child health unit (CHU) code provided during the registration process.

4. The responsible site is determined by the registered GP practice. A share is created when the creating site is not the responsible site. If the GP details are changed subsequently the national IT system will automatically share the record with the responsible site if that differs.

5. Screening test results are uploaded to the national IT system from password-protected screening equipment via intermediate software. This helps assure the quality of data.

Demographic details

When the new birth is registered by the maternity or child health department through the PDS or birth notification application (BNA), a NHS number is generated. This number and some of the demographic information are automatically sent to the national IT system. System users can amend or update the demographic details. Please note this will not update the PDS record (the ‘spine’) but can update records on the NHS Newborn and Infant Physical Examination (NIPE) Screening Management and Reporting Tool (SMART) IT system.

The national IT system only receives one set of information from PDS on new, live births. It does not receive information on babies who are registered as stillbirth, or babies who move into England or any subsequent changes made on the spine record.

If demographic or data errors were made when the NHS number was generated, changes must be updated on the national IT system. This is because corrections made to maternity IT systems or PDS do not update the national IT system.

Updating the national IT system record when a baby has died

1. If newborn hearing screening has not been completed the record for the deceased baby must be updated without delay, minimising the risk of inappropriate contact being made with the family.

2. The screening team can update the record and, to avoid delay, this should normally be done by whichever user receives the information first.

3. All providers, such as maternity units and neonatal units, should notify the appropriate NHSP provider of the death so the record can be updated.

4. Updating the national IT system does not replace other forms of communication relating to a deceased baby.

5. Local processes should be followed as usual.

6. If newborn hearing screening is complete, the record should be updated to ‘deceased’ status when a baby dies.

Access

Users must log into the system via the secure N3 network. User access is managed by the local manager of the NHSP provider. They should instruct the IT system helpdesk to set up logins, passwords, roles and permissions. The user details will be included in the NHSP contacts database in the national IT system. See the ‘Support’ section below for the helpdesk contact details.

Data and paperwork storage

Electronic upload of screening results means data is stored on the national IT system and is not required to be stored locally. Data that is not stored electronically on the national IT system should be stored securely so it can be retrieved for later ascertained hearing loss investigations.

Previous versions of the screening equipment software should be kept. This will enable data retrieval for all screening results, whether stored on the national IT system or locally. This should be for each type of screening equipment that is or has been used by the local programme.

Printed proformas assist hospital screening services by providing the baby’s information in a pre-defined template. These should be stored or disposed of according to local information governance rules.

Non-availability of national IT system or birth notifications

If a programme is unable to access the system, current system performance information will be displayed within the national IT system customer portal latest news or major incidents sections on the home page.

If no performance issues are displayed, the NHSP programme should first contact their IT department to find out if it is a local issue. If there are no local issues, users should inform the national IT system helpdesk (contact details in the ‘Support’ section below). In the unlikely event of the system not being available for a significant period of time, a back-up system (hosted in a different location) is automatically available.

Operational procedure: no national IT system available – hospital model

Programmes should:

• print blank proformas
• handwrite a proforma for each baby using the birth register in maternity
• use any other available information such as bed lists to make sure a baby is not missed
• make sure neonatal intensive care unit (NICU) admissions are included
• ensure home births are included
• screen as usual
• upload data into the intermediate software where it can remain until the national IT system becomes available again
• ensure that any data that has been transferred to the intermediate software is stored on a secure server, or should store the laptops or PCs and proformas in a secure location
• make sure that data remaining on the equipment is securely stored
• inform neighbouring programmes about transfers and share babies if the problem lasts for more than 48 hours
• transfer all data stored on the intermediate software when the national IT system becomes available again
• ensure transfers and shares are actioned when the national IT system becomes available again

Operational procedure: no NHSP national IT system available – community model

Programmes should:

• screen as usual
• inform all screening staff that screening data will be removed from the screening equipment upon upload but will remain on the intermediate software until the national IT system is working again
• ensure results are stored on a secure server or ensure that the PC or laptop containing the intermediate software is stored securely until the national IT system is working again
• inform neighbouring programmes about transfers and share babies if the problem lasts for more than 48 hours
• transfer all data stored on the intermediate software when the national IT system becomes available again
• ensure transfers and shares are actioned when the national IT system becomes available again

NHSP national IT system available but birth notifications failed – hospital and community programmes

If no new birth records are appearing in the national IT system check with the maternity department for local IT problems.

If the problem is not local, contact the national IT system and report the problem without delay.

While the problem is being rectified, programmes should:

• screen as usual
• manually create a record on the national IT system for each baby taking care to record details accurately
• liaise with NIPE colleagues to ensure both the NHSP and NIPE IT systems have accurate data recorded
• use any other available information such as bed lists to ensure a baby is not missed
• make sure admissions to NICU are included
• make sure home births are included
• merge records as appropriate when the birth feed is resumed
• be extra vigilant in making sure no babies are missed
• inform neighbouring programmes about transfers and share babies if the problem lasts for more than 48 hours

Support

The national IT system helpdesk should be the first port of call for any query, change request or issue.

National hearing screening IT helpdesk

Email S4H.helpdesk@nhs.net

Phone 0845 0130183

For users of the S4H IT system. The helpdesk is open from 7am to 7pm, 365 days a year.

The customer portal will show the current system performance within the latest news or major incidents sections on the home page. This should be viewed before contacting the helpdesk for assistance.