Clinical practice and health management
Findings from several BPSU studies have gone on to influence changes in national service provision, informed the development of national published guidelines, and changes to the UK Child Screening and Surveillance Programme.
Biliary Atresia
Evidence from the BPSU survey concluded that patient outcome was improved significantly where surgeons were experienced in performing the Kasai operation. This led to a change in the national service provision of the procedure with the concentration of biliary atresia surgery and management in three national centres. The resultant development of improved guidelines also informed the concentration of services in other European countries eg. Scandinavia and France. Fifteen years later, outcomes for those receiving the operation are still being monitored and the overall survival rate has improved from 82% to 94%.
Sudden unexpected postnatal collapse
At the start of this study there was uncertainty of the extent of sudden severe postnatal collapse. Findings indicated that many neonatal units had experienced this problem without any clear guidelines on investigation, management and legal matters.
Findings from this study have informed the development of national published guidelines and were also incorporated into the international ‘UNICEF Baby Friendly Hospital’ guidelines. The evidence from the study has been presented nationally and internationally. There have been requests from multiple centres throughout the UK and across the rest of world for further information and for permission to use published materials and in-house resources to help educate staff and improve patient safety.
Severe visual impairment and blindness/congenital cataracts
The BPSU has been working in collaboration with the British Ophthalmology Surveillance Unit to survey rare eye conditions in children. Such joint epidemiological research into childhood visual impairment and blindness has transformed our understanding of the population characteristics and burden, outcomes and impact of childhood visual impairment and blindness in the UK. This has resulted in amendments to the UK Child Screening and Surveillance Programme, the management of specific conditions, and the assessment and planning of services.
Hyperbilirubinaemia
The study led to the development of a National Institute of Clinical Effectiveness (NICE) guideline for investigation and management of neonatal jaundice and was quoted by the Chief Medical Officer in their 2004 report. The guidelines referenced the BPSU study as an evidence update for the 2010 guidelines.
As recommended by the Jaundice Guideline Development group, the NSC decided not to recommend screening for kernicterus.