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The NIPE Screening Management and Reporting Tool (SMaRT 4 NIPE) (S4N) IT system aims to identify babies with congenital conditions of the eyes, heart, hips or testes. Initial checks are undertaken within 72 hours of birth as part of the ‘head‐to‐toe’ – the ‘newborn’ part of the physical examination. The purpose of the examination is to identify babies likely to have conditions that may need further monitoring, investigation or treatment. However, as some conditions can develop later, the examination is repeated at 6–8 weeks of age ‐ the ‘infant’ part of the physical examination.

S4N provides a field containing the six national risk factors mapped to the UK NSC Antenatal and Newborn Screening Programme. The NIPE standards stipulate that ‘family history’ should be confined to a first‐degree relative (PHE 2018a). Additional local risk factors, e.g. BCG vaccination requirement, maternal GBS infection, sibling with jaundice at birth, can be added to the local risk factor menu for each individual maternity unit. Table 1.5 outlines the NIPE Programme national risk factors (PHE 2018a) and an example of additional local risk factors.

The system provides data collection for audit purposes and the provision of key performance indicator (KPI) data against the NIPE National Standards screening elements for quality assurance purposes and local performance monitoring. More importantly, S4N provides a failsafe system and a consistent means of capturing data and tracking newborn babies throughout the screening pathway to ensure that no babies miss out on this detailed physical examination. Provision of a failsafe process for examinations not offered or missed, as well to track children through the health care system, makes it possible to ensure that any required follow‐up is timely and in line with national guidance. The safety net for additional screening remains with the examiner at the time of the newborn examination to determine any further element of risk with the clinical assessment.

Use of the NIPE Screening Management and Reporting Tool (S4N) IT system is mandatory (PHE 2018a), provided for use for the NHS by PHE (NIPE Screening Programme). It is regularly updated to make sure it meets the needs of NIPE practitioners across England. S4N is an IT solution for the recording of all elements the newborn NIPE for all babies born in or residing in England. When the Birth Notification is submitted and an NHS number generated, S4N is automatically populated with newborn baby data records, and it operates via the secure N3 network.

TABLE 1.5 Summary of defined and national risk factors.

NIPE Programme national risk factors	Additional defined risk factors
Antenatal diagnosis of a cardiac abnormality	Maternal GBS positive status in current pregnancy/risk of early onset neonatal infection
Antenatal diagnosis of a trisomy	Meconium stained liquor present in labour
First‐degree relative with DDH or hip problem in infancy or childhood	Risk of haemolytic disease in the newborn
Breech presentation at birth or after 36 weeks’ gestation	Sibling with neonatal jaundice requiring phototherapy
First‐degree relative with a cardiac abnormality	Neonatal BCG vaccine required
First‐degree relative with a childhood eye condition

There is a national requirement for the NIPE practitioner to enter screening and post‐referral outcome information for the four screening elements of the examination – eyes, heart, hips and testes – to improve programme reporting and assure a safe and effective screening pathway. This also allows local NIPE services to review coverage data and to audit and provide oversight/management of referral outcomes.

All NIPE practitioners should be familiar with and use S4N to record all newborn NIPE screening activity (currently not available to record the 6–8 week examination). Always ensure that data is entered in a contemporaneous way and direct any queries to the Trust NIPE Lead.

More information is available at https://phescreening.blog.gov.uk/2019/07/17/smart‐4‐nipe‐s4n‐is‐up‐and‐running/.