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Hip health matters

2 March 2009


STEPS press release

PCTs fall short on baby hip examinations

National charity STEPS has revealed an alarming number of Primary Care Trusts (PCTs) in England have no formal policy in place for infant hip examinations.

The charity provides support and information for all lower limb conditions in children and young adults. On 24 February, during Baby Hip Health Awareness Week, STEPS supporter Dave Anderson MP will table a cross-party Early Day Motion in the Commons to urge government action to overcome shortcomings.

Research carried out by STEPS asked Acute Trusts and PCTs in England to submit existing guidelines and formal policy on baby hip checks. Of those who responded*, it was revealed 57 per cent of PCTs and 10 per cent of Acute Trusts have no formal policy in place, despite a national screening policy being introduced in the UK in 1969

The aim of the screening programme is to identify and treat infants with a hip abnormality at an early stage, with a post-birth hospital check and again at six to eight weeks.

Up to 2000 children a year are diagnosed with development dysplasia of the hip (DDH) which requires treatment involving splints and plaster body casts. Late diagnosis can lead to complex surgery and lifelong problems, often impacting on psychological development.

STEPS also conducted a survey of parents with children affected by lower limb conditions. While many praised the care received during treatment for DDH, the majority of parents felt they weren’t informed about the condition and it wasn’t clearly explained to them.

Theresa Quinn from Haywards Heath in West Sussex has a daughter, Harriet, who was diagnosed with DDH aged 10 months:

“A health visitor came to check on Harriet, who was developing very quickly and gave us no cause for concern. She noticed, on further examination, when Harriet put both legs together lying down, her right leg appeared to be half a centimetre shorter.

“When she suggested we should visit our GP it sent me into a blind panic – I felt like I’d failed my daughter in not finding it sooner.  My GP didn’t even touch Harriet during the check and was extremely dismissive.

“After months of waiting and chasing the GP for diagnosis, Harriet was admitted for treatment in hospital and had her second spica cast on 11 December. We will be going back to hospital again this month to review her case. It really is a waiting game and an emotional rollercoaster. We can’t fault the care Harriet has received in hospital but I can’t believe there is such a lack of information out there for parents.”

Radio presenter, Sara Cox, is getting behind the cause and was personally affected by DDH as a young child: “I obviously can't remember the trips to hospital, the corrective cast I had to wear or my parents telling my siblings I was a special baby. I’m sure my parents would have been grateful for an organisation like STEPS.

"I think it’s really important families have information to hand and a good support network to help them through what can be a very emotional experience. Organisations like STEPS are invaluable and offer advice, a friendly ear and access to people in the same situation who understand exactly what you’re going through.”

Dave Anderson, MP for Blaydon, said: "I am very proud to support the important work of the STEPS charity and to highlight it in Parliament. I am impressed by their work in showing that the national screening programme needs to be backed by proper procedures and policies which can then prevent needless suffering as well as spending. I hope that the Minister will meet STEPS to see how current shortcomings in the screening programme can be overcome."

Sue Banton, founder and director of STEPS, added: “Our research highlights a staggering gap in health policy which, if correctly followed, could detect lower limb conditions at an early age and save both parents and children from years of pain and emotional distress.

“It’s frightening so many PCTs are refusing to take responsibility for checking babies’ hips, leaving it to GPs and creating massive inconsistency in procedure.”

Andreas Roposch, orthopaedic surgeon and epidemiologist at Great Ormond Street Hospital, said: "The failure to diagnose hip dysplasia in a timely manner is very disconcerting to families with children affected but screening is a complex issue with mixed results world-wide. Suffice it to say that the hips should be checked in all newborns in routine examinations performed by well-trained health professionals, especially in those with known risk factors. Specialist referral is essential in any uncertain cases, and treatment should be commenced early on if needed"

Contact information:

GOSH-ICH Press Office: 020 7239 3125
Email: Coxs@gosh.nhs.uk
For genuine and urgent out of hours call speak to switchboard on 020 7405 9200

Notes to editors

*STEPS contacted 155 Acute Trusts, of which 110 responded. 121 PCTs from across the UK responded from the 148 who were approached.

STEPS is the only UK charity which provides support and information for all lower limb conditions in children and young adults.

Early Day Motion

That this House warmly welcomes Baby Hip Health Awareness Week from 23-28th February organised by the STEPS charit,y which provides support and information for lower limb conditions in children and young adults; notes that the aim of the national screening policy is to identify and treat infants with a hip abnormality at an early stage,

with a post-birth hospital check and at six to eight weeks because late diagnosis can lead to complex surgery and lifelong problems, often impacting on psychological development; further notes that up to 2000 children a year are diagnosed with development dysplasia of the hip (DDH) which requires treatment involving splints and plaster body casts; is concerned, therefore a STEPS survey of Acute Trusts and of PCTs showed a staggering gap in health policy which, if correctly followed, could detect DDH at an early age and prevent years of pain and emotional distress; is disappointed that many Primary Care Trusts refuse to take responsibility for checking babies' hips, leaving it to GPs and creating massive inconsistency in procedure; further welcomes

the STEPS survey of parents with children affected by lower limb conditions which shows that while many praised the care received during treatment for DDH, the majority felt they weren't informed about the condition which wasn't clearly explained to them; and urges the Government to meet STEPS to investigate how these shortcomings can be overcome.


Great Ormond Street Hospital for Children NHS Trust is the country’s leading centre for treating sick children, with the widest range of specialists under one roof.

With the UCL Institute of Child Health, we are the largest centre for paediatric research outside the US and play a key role in training children’s health specialists for the future.

Our charity needs to raise £50 million every year to help rebuild and refurbish Great Ormond Street Hospital, buy vital equipment and fund pioneering research. With your help we provide world class care to our very ill children and their families.