Child-Parent Screening Service (CPSS)
What is the Child-Parent Screening Service?
The Child-Parent Screening Service (CPSS) is a service development programme, with an associated evaluation, which aims to identify children and their families with familial hypercholesterolaemia (FH) in order to support the NHS Long Term Plan ambition to increase the identification of FH to 25% by 2024.
This pilot is based upon a previous MRC-funded research project where child-parent screening was carried out in 10,000 children at 92 UK General Practices. For every 1000 children screened, 8 persons (4 children and 4 parents) were identified as having positive results for FH, meaning they were at high risk for cardiovascular disease. Parents were initiated on statins immediately and children later (at about 10 years of age). Both adopted healthy lifestyle measures including a diet low in saturated fat and the avoidance of smoking.
What does the programme involve?
In this evaluation programme, testing sites have been set up in partnership with 7 AHSNs and the aim is to screen 30,000 children over 24 months with a view to a national roll out across the whole AHSN Network over the subsequent 12 months. The first child was screened in October 2021.
Sites who sign up for the programme are provided with a point of care analyser to measure the child’s cholesterol along with relevant training. Consumables are also funded by the programme and there is a nominal payment to the practice per child screened.
The map shows the geographical spread of the sites taking part in the CPSS as of Nov ’21. (Note that some sites that are close together appear as one pin on the map)
What does screening involve?
The CPSS procedure takes place as follows:
- A child between the age of 1-2 years, who is due their routine immunisation, is identified and a letter is sent to the child’s parents/carers outlining the CPSS.
- When parents arrive at the surgery, they are informed of the programme again and verbal consent is gained by the lead nurse.
- Following the heel prick test, the blood sample is analysed and if the child’s cholesterol is elevated, the remaining blood sample is sent to a genomics laboratory for further genetic testing. The genetic testing aims to identify the faulty gene linked with FH. If the test is positive, the child will be offered dietary advice as early as possible, then treatment according to local pathways. The local FH Cascade team will be alerted, because for every child with FH one parent will have the faulty gene. Adults with a positive test for FH will receive statins immediately.
Learn more about the heel prick test and screening in this podcast with GP, Dr Sue Kemsley.