Rate for June 2018 for Newborn Blood Spot Screening - Manchester Laboratory The avoidable repeat rate for samples received during June 2018 is displayed by Trust in Figure 1 and by current hospital (for in-patients) in Figure 2. The raw data is provided in Tables 2 and 3. The avoidable repeat rate is calculated by dividing the total number of avoidable repeats by the number of babies tested (i.e. first samples). Please note that the Trust of the sample taker data is incomplete as 137 samples (first samples and repeats) received in June had no Trust code (3%). Please write the Trust code for your maternity unit/ neonatal unit in the PCT field on the blood spot card to improve the accuracy of the figures. A list of trust codes is provided in Table 1. Alternatively maternity units could stamp cards with the code prior to issuing to midwives/neonatal units, depending on local arrangements. It would also be helpful if health visitors could write HV in the PCT field, so that we can provide data specific to health visitors. Table 1 Code RXL RMC RXR RXN RW3/R0A RM2/R0A RW6 RVY RWJ RMP RTX RRF Trust Name BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST BOLTON NHS FOUNDATION TRUST EAST LANCASHIRE HOSPITALS NHS TRUST LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST MANCHESTER UNIVERSITY NHS FOUNDATION TRUST ST. MARY S & RMCH MANCHESTER UNIVERSITY NHS FOUNDATION TRUST - WYTHENSHAWE PENNINE ACUTE HOSPITALS NHS TRUST SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST STOCKPORT NHS FOUNDATION TRUST TAMESIDE HOSPITAL NHS FOUNDATION TRUST UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST 1
Figure 1 - repeats by Trust 2
Figure 2 - repeats by current hospital (in-patients) The following hospitals were excluded from the chart: Ormskirk (2/3 samples were avoidable repeats; 67%), Wigan (10/29 samples; 35%) and RMCH (2/2; 100%). Furness was excluded from the graph as there were no avoidable repeats (0/3 samples). 3
Table 2 repeats by Trust for June 2018 Trust Number of first samples received/ babies tested Too soon after transfusion (<72 hours)* Too young ( 4 days) Damaged in transit Compressed/ damaged Expired card Incorrect application of blood Insufficient quantity >14 days in transit No NHS number Contaminated (discrepant IRT) Blackpool Teaching Hospitals NHS FT 223 0 0 0 0 0 1 1 0 0 0 0 0 2 0.9% Bolton NHS FT 462 1 0 0 0 0 1 10 0 0 2 0 0 13 2.8% East Lancashire Hospitals NHS Trust 488 5 2 0 1 0 2 10 0 1 0 2 0 18 3.7% Lancashire Teaching Hospitals NHS FT 335 0 2 0 0 0 3 3 0 1 0 0 0 9 2.7% MFT - St. Mary's Hospital (& RMCH) 391 2 0 0 0 0 4 4 0 0 0 2 0 10 2.6% MFT - Wythenshawe 317 1 0 0 0 0 5 1 0 0 1 1 0 8 2.5% Not Stated 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% Health Visitor 32 0 0 0 0 0 0 2 0 0 0 0 0 2 6.3% Pennine Acute Hospitals NHS Trust 754 3 0 0 0 0 6 4 0 2 0 5 0 17 2.3% Southport & Ormskirk Hospital NHS Trust 40 0 2 0 0 0 0 1 0 0 0 1 0 4 10.0% Stockport NHS FT 251 0 0 0 1 0 5 5 0 1 0 0 0 12 4.8% Tameside And Glossop Integrated Care NHS FT 244 0 0 0 0 0 2 2 0 0 0 1 0 5 2.0% University Hospitals of Morecambe Bay NHS FT 220 0 2 0 1 0 1 2 0 1 1 0 0 8 3.6% Wrightington, Wigan and Leigh NHS FT 232 0 0 0 0 0 3 7 0 2 0 1 0 13 5.6% Grand Total 4123 12 8 0 3 0 33 52 0 8 4 13 0 121 2.9% Missing sample date DOB missing Number of Rate *Not included in calculation of avoidable repeats 4
Table 3 repeats by current hospital (in-patients) for June 2018 * Current Hospital Number of first samples received/ babies tested Too soon after Too young ( 4 Damaged in transfusion (<72 days) transit hours)* Compressed/ Damaged Expired card Incorrect application of blood Insufficient quantity >14 days in transit No NHS number Contaminated (discrepant IRT) Missing Dates DOB Missing Number of Rate Blackpool Victoria Hospital 26 0 0 0 0 0 0 1 0 0 0 0 0 1 3.8% Burnley General Hospital 53 5 2 0 1 0 0 6 0 1 0 1 0 11 20.8% Furness General Hospital 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% North Manchester General Hospital 21 0 0 0 0 0 1 0 0 0 0 0 0 1 4.8% Not in hospital 3639 0 4 0 1 0 15 32 0 5 3 9 0 69 1.9% Ormskirk & District General 3 0 2 0 0 0 0 0 0 0 0 0 0 2 66.7% Royal Albert Edward Infirmary 29 0 0 0 0 0 2 5 0 2 0 1 0 10 34.5% Royal Bolton Hospital 48 1 0 0 0 0 1 3 0 0 1 0 0 5 10.4% Royal Lancaster Infirmary 15 0 0 0 1 0 0 0 0 0 0 0 0 1 6.7% Royal Manchester Childrens Hospital 2 0 0 0 0 0 0 2 0 0 0 0 0 2 100.0% Royal Oldham Hospital 47 3 0 0 0 0 1 1 0 0 0 1 0 3 6.4% Royal Preston Hospital 38 0 0 0 0 0 1 0 0 0 0 0 0 1 2.6% St Mary's Hospital, Manchester 117 2 0 0 0 0 4 2 0 0 0 1 0 7 6.0% Stepping Hill Hospital 28 0 0 0 0 0 4 0 0 0 0 0 0 4 14.3% Tameside General Hospital 18 0 0 0 0 0 1 0 0 0 0 0 0 1 5.6% Wythenshawe 36 1 0 0 0 0 3 0 0 0 0 0 0 3 8.3% Grand Total 4123 12 8 0 3 0 33 52 0 8 4 13 0 121 2.9% *Not included in calculation of avoidable repeats 5
Tips to help avoid rejection of samples: Collect sample on day 5 (date of birth is day 0) Check the expiry date on the card Wash the baby s heel with water to reduce the risk of a contaminated IRT result Ensure that blood spots are the size of the guide circles on the card Allow the blood to drop onto the card rather than touching the filter paper to the baby s heel Some brands of lancet device are more effective than others Extra blood spots, in addition to the 4 indicated by the guide circles, can be collected elsewhere on the card the test at the same visit if the spots are too small or have not soaked through to the back of the card Make sure there is a valid NHS number on the card Conclusion The avoidable repeat rate for June was 2.9%. The rate has increased slightly compared to last month (2.8%). Insufficient and multi-spotted (incorrect application) samples accounted for 70% of avoidable repeats. Two trusts met Standard 6: Blackpool and Tameside. 6