Guidance: BCG vaccination and SCID screening: patient pathway

Eligible babies should be offered the BCG vaccine at 28 days or soon after.

Bacillus Calmette–Guérin vaccine (BCG) eligibility[footnote 1] identified at booking appointment and recorded in maternal notes.

Baby born in hospital in community or home birth.

Midwife, neonatal nurse or paediatrician assesses and records BCG eligibility on:

Offer BCG vaccination and obtain consent

Notify GP or health visitor (HV) via discharge summary or suitable local alternative, inform Childhood Information System (CHIS).

Discharge – follow local discharge policies.

Referral via local systems (includes mother’s medical history, checklist, translation needs).

Healthcare practitioner assesses eligibility or contraindications (CI) from referral or list.

Prior to clinic, provider checks SCID screening status of neonate (NBSFS/CHIS):

If SCID Screen not offered or SCID not suspected or SCID declined go to step 13.

If SCID Screen offered and result unavailable or repeat required – reschedule BCG appointment.

Provider checks with GP whether Immunology discharge letter received.

Record in PCHR red book, local database and inform GP, HV or CHIS.

Discharge – follow local discharge policies.

Record in PCHR red book, local database and inform GP, HV or CHIS.

Discharge – follow local discharge policies.

If not attended – reoffer appointment as per WNB policy.

Record in PCHR red book, local database and inform GP, HV or CHIS.

Discharge – follow local discharge policies.

BCG vaccination appointment: given or not given or declined.

Record in PCHR red book, local database and inform GP, HV or CHIS.

Discharge – follow local discharge policies.

NBSFS: Newborn Blood Spot Failsafe Solution

SCID: Severe Combined Immunodeficient Syndrome

NIPE S4N: National IT system for the Newborn and Physical Examination screening programme

PCHR: Personal Child Health Record aka ‘Red Book’