What do you do, Elsa?

Elsa is Evelina London’s antenatal and newborn screening coordinator

Colourful question marks drawn by a child

July 2023

What is your career history to date?

I was born in Spain and first qualified as a nurse in 2006 but then moved to the UK to become a midwife in 2009. What I didn’t know at that time, is that I was going to love working in midwifery in this country so much that I would make the decision to stay permanently.

I’ve been working at Guy’s and St Thomas NHS Foundation Trust since 2011, as a rotational midwife in the hospital birth centre, postnatal ward, antenatal ward, and high dependency unit and also as a midwife sonographer.

In 2017, I became the Guy’s and St Thomas’ first antenatal and newborn screening co-ordinator, and I have led and coordinated several local and international screening projects. I am the screening team and aquanatal services team leader as well as a Speak up Advocate.

What is your role and what does it entail?

I coordinate six national screening programmes within the Trust to ensure there are robust antenatal and newborn pathways to ensure available screening tests have been offered to all pregnant women and birthing people and their babies in a timely manner. These screening programmes are:

fetal anomaly
sickle cell and thalassaemia
infectious diseases
newborn blood spot
newborn and infant physical examination
newborn hearing screening

These screening programmes have been designed to reduce inequalities across the country and each of them has standards that all maternity units must achieve.

I monitor and help improve the programmes by analysing key performance indicators and implementing ways to make them more successful.

There is never a dull day in my job. I can be writing a document, investigating an incident, setting up failsafes, analysing data, performing audits or monitoring national platforms. I could also be having multiple and very different conversations with laboratories, team leaders, external clinical groups, commissioners and others. I work closely with NHS England and the Screening Quality Assurance Service (SQAS) team to review, maintain and improve those quality standards.

The beauty of my job is that there is always something that we can do to improve the care we offer to our patients. Every little thing counts even though it is not always visible. I really love how varied my job is!

How did you get into this specialism?

I remember seeing an email advertising for a sonographer in the Trust during one of my night shifts on the antenatal ward, and found it interesting because it was an unusual job to see!

I went to speak to one of the sonographers. They were passionate about their role and convinced me to become one.

Having an ultrasound specialty, makes midwifery even more rewarding as you are able to see with your eyes and with your hands too! I realised how important is to have a strong pathway to standardise care. A few years later, the opportunity for my current role came up, which has allowed me to expand my skills and knowledge across all national screening programmes.

What training did you have to do for your current role?

I didn’t have to do any specific training to become an antenatal and newborn screening coordinator.

What was important was having the passion and a great understanding of the importance of screening. To do this role, you need to be able to organise and prioritise your job in a fast-paced environment and have a strategic and analytical mind to prevent risks for pregnant women and birthing people and their newborns.

How does the antenatal and newborn screening team work?

While we are a small team of 4 in a busy Trust we somehow manage to get everything done. The screening team communicates daily with various teams across Evelina London, and we monitor each pathway every day throughout failsafes and standard operating procedures. We also ensure that positive, abnormal or high chance results are delivered to the right team and in a timely manner. We provide support and guidance to midwives, health visitors and specialists teams when needed.

Why is antenatal screening during pregnancy important?

All pregnant women and birthing people and their babies should have access to screening regardless of their low or high-risk family or medical background. Screening is a way of identifying a health condition in healthy people. Some conditions can be passed onto the baby and identifying them early, helps parents to make an informed choice during their pregnancy. Fortunately, people under our care have the opportunity to decide what they want for them and their future baby and we are able to support them with the best resources to make sometimes very difficult and life changing decisions.

What does newborn screening involve and why is it important?

Newborns are offered a physical examination to screen for abnormalities in their eyes, heart, hips and testes (if a boy) and this should be done within 72h after birth unless clinically not indicated.

Before a baby is discharged home, a hearing screening will check the baby’s hearing.

On day 5 of life, the midwife will take a blood spot sample from the baby’s heel to screen for 9 rare but serious health conditions.

Why is early diagnosis important?

Identifying a health condition as early as possible, can save lives. This means that babies can have access to further diagnostic testing or early treatment to improve their health, prevent them from severe disability or even death.

What do you and your team do to address families’ concerns about screening?

Parents can access information about all the screening tests we offer in the NHS via an app, NHS website, leaflets and posters displayed in the antenatal clinic and community hubs.

They can contact the screening team if they wish to discuss a test further or a personal situation to help them make an informed choice. Pregnancy is a very delicate moment in a woman or birthing person’s life and it is very common to have lots of questions regarding options in pregnancy. The screening team works to provide them with the best possible care and most up to date information.

What do you love about your job?

I love everything about my role! I believe I have the best job that a midwife could have. Having to think and do so many interesting things on a daily basis, keeps me going and motivated to do my job.

I get to work and talk to people with very different backgrounds. Knowing what they do, how they work and what challenges they have, and working with them to find the best way to solve a problem, is just amazing. I love being able to provide expert screening advice to colleagues and parents and be able to offer an equal service to all women, birthing people and their babies regardless of where they are born, live or their ethnic background.

What is your proudest moment?

Personally speaking, my proudest moment is when I had my own son at St Thomas’. I had built up so many memories and done so many long shifts in those delivery rooms. Now I was there, on the other side, being looked after by my amazing colleagues. I won’t forget this!

Professionally speaking, my proudest moment is when the London quality assurance screening team recognised the job I’ve done at Guy’s and St Thomas’ and invited me to collaborate with their team. This is how I became a professional clinical advisor allowing me to support other Trusts and screening coordinators to improve their screening pathways. Many years on, I still enjoy working with them.