Introduction

NHS England is committed to ensuring everyone using maternity and neonatal services receive high quality care throughout their perinatal journey. An important part of that care is the delivery of the newborn and infant physical examination (NIPE) screening programme, which is integral to identifying health issues early and effectively to help reduce morbidity and mortality alongside other screening programmes. This is achieved as part of the holistic assessment of the newborn.

To best achieve this, the programme stipulates that the NIPE newborn screening examination must be completed by a “…trained practitioner who is competent to undertake all elements of the newborn screening examination and who has undergone relevant training and a locally agreed competency assessment by a practising NIPE examiner. This can be a midwife, nurse or health visitor who has successfully completed a university accredited ‘examination of the newborn’ programme of study or a doctor…”, or who has completed a midwifery education programme under the Nursing and Midwifery Council Standards (2019).

Purpose

This guidance seeks to clarify the NIPE screening programme requirements, to ensure only trained and competent individuals who meet the requirements of the NHS England NIPE clinical guidance (section 12) undertake examination of the newborn (including NIPE newborn screening for eyes, heart, hips and testes).

The information is presented through six possible scenarios to help providers assure themselves that midwives within their current workforce have the required level of training to be deemed as a NIPE trained practitioner:

Scenarios

1. Midwives joining the NMC register completing programmes approved on the Standards of proficiency for midwives (2019):

• All students successfully completing and exiting a programme approved against the 2019 NMC Education Standards should have completed both theory and practice requirements of the systematic physical examination of the newborn.
• In England, this would meet NIPE screening programme requirements and assuming both theory and practice has been included in the training these midwives are, therefore, able to carry out NIPE newborn screening examinations as newly qualified midwives (NIPE trained). 

2. Pre-registration midwifery programmes (Approved against the NMC Standards of proficiency for midwives (2009):

• There will still be some third year, and potentially second year student midwives on education programmes approved against the 2009 Standards. Some of these students may have:
  • not completed any examination of the newborn training (including NIPE screening)
  • completed theory only
  • completed full (theory and practice) elements (NIPE trained).

This will depend on the curriculum at their approved education institution and can be ascertained by a discussion with the individual midwife and liaising with the relevant lead midwife for education. These colleagues therefore may not be considered NIPE trained.

3. Internationally educated midwives:

• Internationally educated midwives (IEMs) undertake a systematic physical examination of the newborn (SEN) NMC OSCE as part of their test of competence (ToC). While the OSCE has some principles and elements of a newborn NIPE examination via the simulated assessment, the OSCE standards and marking criteria are for SEN.
• This means that successful SEN OSCE completion would not constitute examination of the newborn and NIPE university accredited training or assessment and therefore would not meet the NIPE screening programme training requirements.

4. Return to Practice (RTP) midwives through a RTP programme or completion of the ToC:

• Where a midwife is returning to practice through a university RTP programme the midwife will have achieved both theory and practice elements of the examination of the newborn and NIPE screening training and would meet the NIPE screening programme requirements upon successful completion of the programme.
• Those returners completing the ToC route may have previously undertaken NIPE newborn screening university accredited training and undertook examination of the newborn and NIPE screening prior to leaving the NMC register.
  • In line with the NIPE screening programme requirements these individuals could recommence examination, but trusts/employers would need to ensure that there are local processes in place to assess their competence (ideally using the NIPE screening annual learning framework and peer review assessment tools).
• Those returners completing the ToC route that have not previously completed NIPE newborn screening accredited training will need to complete a university accredited programme to complete NIPE examinations.

5. All midwives completing the ToC without previous examination of the newborn training (including NIPE screening):

• Completion of a ToC does not equate to NIPE accreditation. All midwives who complete the ToC will have achieved some of the theory or practice elements of the NIPE screening programme requirements, but not all.
  • You will need to consider this with the local HEI along with the support they need while in employment to fully achieve the NIPE screening programme requirements to safely carry out formal examination of the newborn examinations (including NIPE screening).

Registrants who do not fall into one of the categories in the scenarios above should refer to the guidance provided in the NIPE Handbook: Newborn and infant physical examination (NIPE) screening programme handbook.

Further support

Please consider this guidance when identifying and determining whether your colleagues are considered trained practitioners for the NHS NIPE screening programme. To help provide clarity around the training requirements, we ask that you proactively share this information within your systems and midwifery workforce.

Should you have any further queries, do not hesitate to contact us via england.screeninghelpdesk@nhs.net and england.nursingworkforce@nhs.net.

Publication reference: PRN00610