Maternity services: Great Ormond Street Hospital

There are around 600,000 live births a year and, with parental consent, each baby is tested for a range of serious conditions such as phenylketonuria (PKU), congenital hypothyroidism (CHT), sickle cell disorders and cystic fibrosis.

The tests are carried out on bloodspots taken from the baby's heel which go onto cards that are then sent to screening laboratories.

Delay in treatment for PKU and CHT can result in permanent mental retardation, so speed is crucial in dispatching these cards.

An audit in 2000 revealed that across south London screening laboratories were receiving just 63.1 per cent of cards within four working days of the sample being taken - the national standard set by the UK Newborn Screening Programme.

In an attempt to improve this, the London newborn bloodspot screening laboratory group introduced a pre-addressed and pre-paid envelope. The initiative was funded by Bexley Care trust, which commissions newborn screening services in London and the Home Counties.

On the back of the envelope are instructions to midwives about the importance of timely dispatch. All midwifery managers were trained in using the envelopes in January 2005.

Audit showed significant improvement in the three labs using the system. They received 81.9 per cent of cards in four working days, and showed a significant reduction in the number of samples with extreme delays of more than 10 days.

The scheme may be introduced nationally. Continued funding has now been taken up by primary care trusts and newborn screening labs.

Ying Foo is director of newborn screening and director of chemical pathology at Great Ormond Street Hospital

fooy@gosh.nhs.uk