The Newborn and Infant Physical Examination Cymru (NIPEC)

The Welsh Government has recently published Newborn and Infant Physical Examination Cymru (NIPEC) Guidelines and Standards for Wales. The Guidelines aim to standardise practice and improve the quality of the NIPEC examination, contributing to the health and wellbeing of babies and infants through early detection of congenital abnormalities of the eyes, hips, heart and (in males) testes. The Guidelines have been developed in collaboration with experts from across Wales based on research evidence and best practice. The guidelines will be reviewed periodically and updated in accordance with any new or emerging evidence.

The newborn and infant physical examination is offered to all babies in Wales. The main aims of the examination are to:

Identify and refer all children born with congenital abnormalities of the eyes, heart, hips and (in males) testes, where these are detectable, within 72 hours of birth.
To further identify those abnormalities that may become detectable by 6 weeks of age, at the physical infant examination.
Reduce morbidity and mortality.

The NIPEC examination must be completed by a trained practitioner who is competent to undertake all elements of the newborn screening examination and who has undergone relevant training. This can be a midwife, nurse, health visitor, doctor, or physician associate.

Health Education and Improvement Wales has developed resources to support NIPEC practitioners with their continuing professional development (CPD) with an aim of standardising the approach across Wales, they can be found here The Newborn and Infant Physical Examination Cymru (NIPEC) – HEIW (nhs.wales).

Go to Newborn and Infant Physical Examination Cymru (NIPEC) Guidelines and Standards for Wales

New report – Calling Time on child poverty: how Wales can do better

This week, the Equality and Social Justice Committee of the Senedd has published the report of its inquiry into child poverty – Calling Time on child poverty: how Wales can do better. The inquiry was prompted by the high levels of child poverty in Wales and concerns about the Welsh Government’s draft strategy to eradicate it.

The report provides stark data and challenge, asking:

“Across the United Kingdom 4.2 million children under 18 live in poverty… Why do we tolerate that when we are part of the 6th richest economy in the world?”

The latest figures show 28% of all children in Wales are living in relative income poverty. That is 8 children in a class of 30. Most child health outcomes are socially driven, with the poorest children consistently and disproportionately disadvantaged compared to their more affluent peers. The Committee’s report recommends a root and branch review of the Welsh Government’s approach as it finalises its new child poverty strategy.

At the iHV, we support the Senedd’s Equality and Social Justice Committee call for a dedicated Minister for Babies, Children and Young People to be appointed to provide a more coherent response to the scourge of child poverty.

Under the current Welsh Government arrangements, the Minister for Social Justice has responsibility for tackling child poverty, while the Deputy Minister for Social Services and the Deputy Minister for Mental Health and Wellbeing lead on children’s well-being issues, and the Minister for Education retains responsibility for their educational attainment.

The Committee is calling for one Minister to be accountable for the wellbeing and happiness of babies, children and young people. This role should incorporate overall responsibility for tackling child poverty and implementing children’s rights with other key areas such as childcare, education and supporting families.

The report is also recommending that the Welsh Government set ambitious and realistic interim and longer-term targets for reducing child poverty, learning from the approaches taken in other countries such as Scotland, Norway and New Zealand.

Jenny Rathbone, MS Chair of the Equality and Social Justice Committee, said:

“Our central message is that the Welsh Government needs to follow the evidence and prioritise those policies which make the maximum contribution to tackling child poverty. This may involve difficult decisions and trade-offs. But it must embed children’s rights in policy and in practice.

“The Government needs to overcome its aversion to setting targets. The evidence from Scotland and New Zealand is clear: targets work. Alongside other measures and milestones, they set the direction of travel, and keep track of progress.

“Finally, appointing a Minister for Babies, Children and Young People would send the clearest signal that Wales is serious about giving every child the best start in life.”

Read the full report here

Ending physical punishment in Wales

21 March 2022 is a historic moment for children and their rights in Wales. From this day on, physically punishing children will be illegal in Wales.

Michelle Moseley, Education and lifelong learning adviser, RCN Wales, provides an overview of the latest change in children law in Wales.

head and shoulders of smiling woman wearing glasses

Michelle Moseley, Education and lifelong learning adviser, RCN Wales

The law change to end physical punishment of children is something that I have been passionate about raising for years. The new law is named the ‘Children (Abolition of Defence of Reasonable Punishment) (Wales) Act 2020. With a background in children’s nursing, health visiting and as a previous lead nurse in safeguarding, the rights of children and young people have always been at the heart of my practice. I continue to champion children’s rights both professionally and personally. I became involved in the change of law process in 2019, as an RCN Wales Nurse of Year alumni. My Nurse of the Year award was in ‘Safeguarding’, and I was approached to attend the National Assembly of Wales Children and Young People’s committee to provide evidence on behalf of RCN Wales members. I have therefore followed and been involved in this change of law journey since then, being part of the strategic implementation group as well as the training, operations, guidance, and diversion task and finish group. There has been a multi-professional approach to the development of clear processes in relation to this change in law involving all essential agencies. This has promoted partnership working and has been structured in a way that the voice of each partner agency has been ‘recognised and heard.’ I have been able to employ the principle of health visiting to “Influence policies affecting health” in its fullest form, by influencing policy and legislation that directly affects the health and wellbeing of babies, children and young people.

Children come into this world as blank canvases so to speak, and their early experiences shape their future behaviour and interaction with the world around them. Professionals are now aware of the impact of adverse childhood experiences on babies, children and young people, as well the importance of taking trauma-informed approaches to practice. This is particularly relevant to those healthcare practitioners working with parents and families in the early years – for example, midwives, health visitors, school nurses, children and young people nurses. Although the law change is of course applicable to all, as we know, safeguarding is ‘everybody’s responsibility’. Physical punishment is already illegal in many areas, for example: schools, children’s homes, local authority foster care homes and childcare settings. Any form of physical punishment can cause trauma – a ‘tap’, ‘a smack’, ‘a hit’, a punch’ or ‘a shake’. The physical punishment of children is often seen as a loss of control of the adult who is caring for them. Is it reasonable to hit someone? Should children have different rights to the adults around them? So, by removing the defence of reasonable punishment as justification, this ensures that the children and young people of Wales are protected in the same way as the adult population.

The disciplining of children is about setting the right example, understanding how and why certain behaviours occur, and showing children how to cope with their emotions and manage difficult situations. Parenting is complex. There will be times when parents need to walk away from situations and take a very deep breath (whilst maintaining the safety of the child of course). Parenting will successfully continue without physical chastisement and support is available for parents and carers, especially from the health visiting service as they are essential in delivering intervention in the early years. Children deserve the best possible start in life and the Welsh Government recognises the importance of the rights of the child and their ongoing protection from any type of abuse.

Therefore, from 21 March 2022, physically punishing children will be illegal in Wales. This is underpinned by the UN Convention on the rights of the child which states that children have the right to be protected from all types of violence (Article 19) as well as have equal protection within the law. The new legislation will make the interpretation of it clearer, not only for professionals but for parents, carers, and the public. There will be a clear boundary defining what ‘reasonable punishment’ is, as this is often a grey area. The law will apply to any adult who is responsible for a child, as well as visitors to Wales, and the removal of the defence of reasonable punishment will be applicable to criminal and civil law.

Further information about the change in law can be found on the Welsh Government website.

There is information for parents and a factsheet for healthcare professionals.