What is the project about?

The effectiveness of the UK Newborn (Blood Spot) Screening Programme and the NHS Sickle Cell and Thalassaemia Screening Programme depends on the timely transfer of screening test status and results from the screening laboratory to the relevant Child Health department.

There is wide national variation in approach to this process, with many laboratories employing manual processes that are labour-intensive, error-prone and could result in unacceptable delay to the screening process. An improved process for the electronic transmission of status/results is urgently required.

Building on the development of national status codes for newborn blood spot results reporting, a message specification for transmitting such codes electronically over the NHS Spine has been written.

Prototyping work to be carried out/underway

A project is underway to trial the use of such electronic results, the outcome of which will be used to refine the message specification.

Benefits of the project

The following benefits are anticipated from the introduction of electronic messaging of results:

• Facilitates improved patient safety by enabling earlier identification of a delayed result or a missed case (which may have tangible benefits in terms of litigation costs)
• A reduction in the time delay in making screening results available, enabling organisations to meet screening programme standards i.e. result available by day 17
• Enables timely notification of sample receipt in the laboratory i.e. Status Code 01, to the responsible child health department without imposing an additional administrative burden on child health staff to track down missing results.
• Streamlining of the overall screening process and removal of the administrative overhead and costs associated with the labour intensive manual entry of results onto child health systems.
• In eliminating the need for the manual entry of results onto child health systems and the associated risk of error/delay, an improvement in data quality is anticipated thus enabling confidence in the automatic production of normal results to parent's letter.
• Improved data quality and ease of data capture will enable improved monitoring and performance management of the screening programme.
• Facilitates making the results available to other interested parties such as GPs and Health Visitors.

Project approach

The project has been formally constituted and a draft Project Initiation Document has been written but until it has been signed off by all parties, no firm dates are being made public. However, it is expected that the key milestones will be:

• Stage 1: Develop user interface prototypes: all parties collaborate on a short, intense piece of work to mock-up the screens relating to the functionality in the messaging specification.
• Stage 2: Develop a messaging test harness: vendors develop their messaging components and test them using a test harness rather than the Spine. A standard set of automated test scripts would be written to ensure compliance.
• Stage 3: Integrate to the Spine: vendors work with NHS CFH to connect to the Spine for the transmission and receipt of results messages. An appropriate Common Assurance Process is devised and followed.
• Stage 4: Pilot the solution: a period of pilot operation.

Assurance processes being applied

The development of user interface prototypes will help to ensure that from a user's perspective the specification will meet their needs.

The development of an example messages, a messaging harness and test scripts will help to ensure that any anomalies or discrepancies in the specification will be identified early in the project, and that the systems are generating fully compliant messages.

The NHS CFH Common Assurance Process group will assure that the lab systems pass all the relevant requirements specifications to ensure that they can be connected to the Spine.