Title : Are screen-positive babies being seen within the NICE 2-week target? A single centre retrospective audit at Queen Alexandra Hospital, Portsmouth, UK
Abstract:
Aims: Newborn eye screening is a non-invasive and vital tool for detecting serious ocular conditions such as congenital cataracts, retinoblastoma, congenital glaucoma. Eye development is complex, and can be affected by genetic, infective and environmental factors. Prompt identification and referral is essential to prevent irreversible visual impairment. NICE guidelines recommend babies with screen-positive results from the Newborn and Infant Physical Examination (NIPE) should be urgently referred and seen by an Ophthalmologist within two weeks.
This audit evaluates whether screen-positive infants at Queen Alexandra Hospital (QAH) were reviewed by the Ophthalmology department within the recommended 2-week period.
Method: A retrospective audit was conducted of screen-positive cases referred between November 2019 and November 2024 at QAH. Forty-seven patients were identified to be screen positive. Data was collected on referral and appointment dates, time to first ophthalmology consultation, and outcomes.
Results: Of the 47 screen positive patients identified, 14 were not seen within the two-week target. Three were seen within 15 days, while ten waited over 20 days, the delays ranged from 15 to 59 days. Eleven delays originated from Neonatal department referrals, and six occurred during the COVID-19 pandemic. Three delays were due to missed initial appointments. One appointment was delayed by 59 days due to an initial mis-referral to the orthoptists, which was returned to the GP before being correctly redirected to the Ophthalmology team. All patients were ultimately discharged following their consultations.
Conclusion: A significant proportion of screen-positive babies were not assessed within the recommended NICE timeframe. Contributing factors included pandemic-related service disruptions, missed appointments and delayed referrals from the Neonatal department. One case was significantly delayed due to a misdirected referral pathway. These findings highlight the importance of improved interdepartmental coordination and targeted education for both staff and parents, to ensure timely assessment and optimal visual outcomes for at risk babies.
