Newborn blood spot screening: programme overview
Source: gov.uk (2025-09-26)

This overview is aimed at professionals working in the NHS newborn blood spot (NBS) screening programme.

Public information about NBS screening is available on NHS.UK (https://www.nhs.uk/conditions/pregnancy-and-baby/newborn-blood-spot-test/).

The NHS recommends NBS screening because it can improve health and prevent severe disability or even death. However, screening is always a choice (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/2-screening-pathway#informed-choice) and parents can decline it for their baby if they wish.

NHS England produces information about patient confidentiality in population screening programmes (https://www.gov.uk/government/publications/patient-confidentiality-in-nhs-population-screening-programmes).

It is committed to reducing inequalities and variation in participation (https://www.gov.uk/government/collections/nhs-population-screening-access-for-all) to help make sure everyone has fair and equal access to screening services.

Target population

All babies up to but not including their first birthday are eligible (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/2-screening-pathway#eligibility) for NBS screening for the 10 conditions listed below. This excludes testing for one of the conditions, cystic fibrosis (CF), (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#cystic-fibrosis) which is unreliable after 8 weeks of age.

Babies who are new to the country or are yet to have a blood spot test (https://www.gov.uk/government/publications/movers-in-screening-babies-with-no-available-records) are eligible for testing up to a year old.

Conditions screened for

The NBS screening programme enables early identification, referral and treatment of babies with 10 rare but serious conditions. (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions) These are:
- sickle cell disease (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#sickle-cell-disease) (SCD)
- cystic fibrosis (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#cystic-fibrosis) (CF)
- congenital hypothyroidism (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#congenital-hypothyroidism) (CHT)
- phenylketonuria (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (PKU)
- medium-chain acyl-CoA dehydrogenase deficiency (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (MCADD)
- maple syrup urine disease (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (MSUD)
- isovaleric acidaemia (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (IVA)
- glutaric aciduria type 1 (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (GA1)
- homocystinuria (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (HCU)
- hereditary tyrosinaemia type 1 (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (HT1)
The last 7 conditions are inherited metabolic diseases (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) (IMDs).

Health professionals should ask parents if there is a family history (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/5-family-history) of the 10 NBS conditions during pregnancy. If there is, then the health team should create a care plan which could involve an additional early blood spot sample. (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/5-family-history#when-to-take-the-sample)

It is the health professional’s responsibility to explain and offer parents screening for their baby. The health professional should give the Screening tests for you and your baby (https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby-description-in-brief) leaflet to parents. The leaflet is available in 13 languages and there are easy guides (https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby-easy-guides) which explain the screening tests in more straightforward language, with pictures.

Parents are asked for verbal consent for NBS screening. They can decline (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/2-screening-pathway#declined-screening) for SCD, CF and CHT individually but they can only decline the 7 IMDs (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/7-conditions#inherited-metabolic-diseases) as a group.

Screening tests

A health professional will usually take a blood spot sample on day 5 (day of birth is day 0) from a child’s heel and send the sample for testing.

There are guidelines (https://www.gov.uk/government/publications/newborn-blood-spot-screening-sampling-guidelines) which health professionals need to follow to take a good quality sample.

Samples should be sent to the screening laboratory for analysis the same day they are taken. Parents receive the results (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/3-results-and-records) within 6 weeks.

Using the NBS fail safe solution (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/2-screening-pathway#newborn-blood-spot-failsafe-solution) (an IT system which identifies babies born in England who have missed screening) helps prevent mistakes being made, for example, babies being missed from screening, NBS samples not reaching screening laboratories or samples getting delayed in transit.

The code of practice (https://www.gov.uk/government/publications/newborn-blood-spot-screening-code-of-practice-for-the-retention-and-storage-of-residual-spots) explains the retention, storage and potential uses of residual NBS samples. (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/2-screening-pathway#residual-blood-spots) See the NBS programme handbook for information about ordering blood spot cards. (https://www.gov.uk/government/publications/health-professional-handbook-newborn-blood-spot-screening/2-screening-pathway#ordering-blood-spot-cards)

Evidence base

NBS screening is one of 11 NHS national population screening (https://www.gov.uk/guidance/nhs-population-screening-explained) programmes available in England.

The UK National Screening Committee (https://www.gov.uk/government/groups/uk-national-screening-committee-uk-nsc) (UK NSC) makes recommendations (https://www.gov.uk/guidance/evidence-and-recommendations-nhs-population-screening#recommendations-for-screening) to ministers in the 4 UK countries on all aspects of population screening. It makes sure screening provides more benefits than harms, at a reasonable cost to the NHS.

Recommendations are based on internationally recognised criteria (https://www.gov.uk/government/publications/evidence-review-criteria-national-screening-programmes) and a rigorous evidence review process. (https://www.gov.uk/government/publications/uk-nsc-evidence-review-process)

There is a separate UK NSC recommendation (https://legacyscreening.phe.org.uk/screening-recommendations.php) for each of the 10 NBS conditions.

Data and intelligence

NHS England publishes reports setting out annual data collected from the NBS screening programme (https://www.gov.uk/government/publications/newborn-blood-spot-screening-data-collection-and-performance-analysis-report).

Key performance indicator (KPI) data reports (https://www.gov.uk/government/collections/nhs-population-screening-programmes-kpi-reports) are available for all 11 national screening programmes.

Requests for screening data and research

All requests for NBS screening data need to be approved by the NHS antenatal and newborn screening programmes research advisory committee. (https://www.gov.uk/guidance/nhs-population-screening-data-requests-and-research#application-process)

There are terms of reference for NHS population screening programme research advisory committees. (https://www.gov.uk/government/publications/nhs-population-screening-research-and-data-requests-terms-of-reference)

Commissioning

NHS England publishes the NBS screening pathway requirements specification (https://www.gov.uk/government/publications/newborn-blood-spot-screening-pathway-requirements-specification), which provides an overview of NBS screening by describing what should happen at each stage of the end-to-end pathway. Providers and commissioners should use this to ensure high quality and consistent screening services.

Quality assurance

The role of the screening quality assurance service (https://www.gov.uk/guidance/nhs-population-screening-quality-assurance) is to:
- assess the quality of local screening programmes
- monitor compliance with standards
- support services with improving quality
- undertake regional level quality assurance (QA) visits (https://www.gov.uk/government/publications/nhs-population-screening-regional-quality-assurance-teams-in-england)
The programme specific operating model (https://www.gov.uk/government/publications/antenatal-and-newborn-screening-quality-assurance-procedures) for quality assurance of the antenatal and newborn screening programmes should be read in conjunction with the operating model for PHE screening QA service: 2015/16 to 2017/18 (https://www.gov.uk/government/publications/screening-quality-assurance-service-operating-model) and the NBS programme standards. (https://www.gov.uk/government/publications/standards-for-nhs-newborn-blood-spot-screening)

Workforce – education and training

Education and training resources (https://www.gov.uk/guidance/newborn-blood-spot-screening-education-and-training) are available for healthcare professionals working in NBS screening.

There are general resources (https://www.gov.uk/guidance/nhs-population-screening-education-and-training) to support screening professionals during their initial training and continuing professional development.

Keep up to date

Keep up to date with what is new in the programme, including the latest guidance and good practice.

You can register to get updates (https://www.gov.uk/health-and-social-care/population-screening-programmes-newborn-blood-spot) on the NHS newborn blood spot screening programme direct to your inbox. Follow the instructions to get emails about the pages you are interested in.

Contact the screening team

NHS England screening Wellington House 133-155 Waterloo Road London SE1 8UG

Read our leaflet on screening tests for you and your baby and find out how to request alternative formats (https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby) on GOV.UK.

We cannot help with media enquiries or access screening results.