Pregnancy and neonates: hip screening

  • NICE indicator
  • IND77
  • Published:
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Indicator

The proportion of babies with a screen positive newborn hip result who attend for ultrasound scan of the hips within the designated timescale.

Indicator type

Network / system level indicator.

The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.

To find out how to use indicators and how we develop them, see our NICE indicator process guide.

Rationale

Approximately 1 or 2 in 1,000 babies have hip problems that may require surgery and 3 to 5 per 1,000 may require a Pavlik harness. Undetected unstable hip(s) with delayed treatment may result in the need for complex surgery and, or long-term complications such as impaired mobility and pain, osteoarthritis of the hip and back. Early diagnosis and intervention should improve health outcomes and reduce the need for surgical intervention. This indicator will help to ensure that babies at risk have an early hip ultrasound to minimise the risk of long-term complications. A screen positive hip result is an abnormal clinical hip examination (with or without risk factors) and, or presence of NIPE hip risk factors.

Specification

Numerator: The number of babies in the denominator who attend for ultrasound scan of the hips who are between:

  • 4 and 6 weeks of age for babies born over 34 weeks and zero days (34+0) gestation

  • 38+0 and 40+0 weeks corrected age for babies born under 34+0 weeks gestation.

Denominator: The number of babies born in the reporting period who have a screen positive newborn hip result, defined as those with:

  • suspected dislocated or dislocatable hip(s) at clinical examination, or

  • those with 1 or more national hip risk factors (see NIPE clinical handbook for list of risk factors).

Calculation: Numerator/denominator*100

Exclusions: Babies who:

  • die before the ultrasound appointment date

  • are found to have 'clicky hips'.

Data source: NHS newborn and infant physical examination (NIPE) screening programme.

Minimum population: The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

ISBN: 978-1-4731-5567-1