Capillary blood collection for neonatal screening tests should require a certificate of competence

Fourteen years ago, Patricia Townshend (1980) suggested that, "blood letting by heel prick should become a procedure that requires a certificate of competence". To date, her suggestion has not been adopted, as competency is not a requirement to undertake this procedure. However, over the years many institutions have introduced accreditation for similar skills, such as diabetic monitoring and venepuncture. As a consequence, I believe standards of patient care have improved immensely. No longer can we assume all midwives are using the same techniques for neonatal capillary blood collection. From my observations of varied practice, such as twisting the blade and making multiple punctures for the one screening test, coupled with the poor quality of blood spot specimens frequently received by the central screening laboratory, it could be suggested that the introduction of accreditation for this skill, is well justified.