Coverage of neonatal screening: failure of coverage or failure of information system

OBJECTIVES—To evaluateneonatal screening coverage using data routinely collected on thelaboratory computer.
SUBJECTS—90 850births in 14 North East Thames community provider districts over a 21 month period.
METHODS—Birthsnotified to local child health computers are electronically copied tothe neonatal laboratory computer system, and incoming Guthrie cards arematched against these birth records before testing. The computerrecords for the study period were processed to estimate the coverage ofthe screening programme.
RESULTS—Out of anestimated 90 850 births notified to child health computers, all but746 (0.82%) appeared to have been screened or could be otherwiseaccounted for (0.14% in non-metropolitan districts, 0.39% in suburbandistricts, and 1.68% in inner city districts). A further 893 residentinfants had been tested, but could not be matched to the list ofnotified resident births. The calculated programme coverage alreadyexceeds the 99.5% National Audit Programme standard in 7/14 districts.Elsewhere it is not clear whether it is coverage or recording ofcoverage that is low.
CONCLUSION—Previousreports of low coverage may have been exaggerated. High coverage can beshown using routine information systems. Design of information systemsthat deliver accurate measures of coverage would be more useful thancomparison of inadequately measured coverage with a national standard.The new NHS number project will create an opportunity to achieve this.