1. Antenatal screening updates

Antenatal Screening Updates

Alison Fiddler QA Advisor Public Health England leads the NHS Screening Programmes

FASP

Implementation of 3 vessel trachea view

• Two regional workshops with practical training have

been completed for the screening support sonographers

from each Trust across London

• Roll out and implementation to be completed within 16

weeks of attending the workshop

2 Antenatal Screening Updates LCO & HoM Forum – 1 July 2016

FASP

T18/13 screening has been implemented in the majority of laboratories

and maternity units. Some issues in a few laboratories using

Viewpoint are still to be resolved

Quad testing for twins has been implemented in all second trimester

screening laboratories

FA2 KPI coverage for 18 – 20+6 scan

This will be included in the 2016/17 KPI schedule – a practical tips and

guidance document will be released shortly


FASP: elearning

The 18-20+6 elearning resource has been fully revised and

relaunched: 6 units aimed at midwives and

sonographers

CEMT21 is currently being updated: due end of 2016 - to

include T18/13 and Quad test for twins & NIPT module

to be inserted on implementation


FASP: NIPT

Scoping of NIPT implementation

Awaiting ministerial decision

Planning groups are in development around:

• Laboratory issues

• Procurement

• Education and information

• Data reporting and monitoring

• NIPT ethical issues online survey: deadline 25th July


IDPS – data collection 2016/17

Streamlining and reducing duplication

Collate matched cohort data and ensure consistency

Data submitted annually 30 June: Fiscal year April – March

Data will include:

• NAISM previously submitted quarterly

• 5 of the 7 standards (2 standards are reported quarterly

as KPI’s)

In the longer term: data may be available from the

maternity and children’s dataset via HSCIC


IDPS KPI changes 2016/17:

• ID1: Threshold change

Acceptable raised from >90% to >95%

Achievable raised from >95% to >99%

• ID2 Definition change:

Inclusion criteria: All newly positive or high infectivity

• 2017/18: Plans to incorporate standard 2 and 3 into quarterly KPI

reporting (HepB and Syphilis coverage). 2016/17 pilot planned

• Reoffer of IDS screening is now by 20/40


IDPS: New leaflets available


“What does my positive

screening result mean?”

Leaflets available for download:

• HIV

• HepB

• Syphilis

• Available in English and 12

other languages

https://www.gov.uk/government/collections/infectious

-diseases-in-pregnancy-screening-clinical-guidance

https://www.gov.uk/government/collections/infectious-diseases-in-pregnancy-screening-clinical-guidance














IDPS

New resources planned:

• eLearning resources – a higher knowledge version

• Counselling resource tool

• Posters and specialised guidance for Delivery Suites


Update e- FOQ

Sunquest have been commissioned to design an Electronic Family

Origin Questionnaire to be incorporated into their blood test

requesting system ICE.

Testing at a pilot site (Wexham Park): issues at the midwife end

have been fixed.

There have been several challenges with the lab side of the process

which have been undergoing fixing and testing.

Roll out expected to start in July

4 Trusts in London use Sunquest


SCT documents


SCT programme handbook 2011

Handbook for laboratories 2012

Updated documents due end of

2016

Annual data report 2014/15 • Data report for 2014/15 was published on

24th March

• Available on gov.uk at

• https://www.gov.uk/government/publications/

sickle-cell-and-thalassaemia-screening-data-

trends-and-performance-analysis


https://www.gov.uk/government/publications/sickle-cell-and-thalassaemia-screening-data-trends-and-performance-analysis






















ST2 – Improving timeliness of screening

and PND

Aims of SCT antenatal screening are to offer reproductive choice to

women/couples at risk of having an affected child

To maximise choice the aim and the national standard is that prenatal

diagnosis is performed by: 12+6

Acceptable standard: 50%

Achievable standard: 75%

A working group was formed with members from the SCT advisory group

Reasons for why women are tested late were explored


ST2: Why are women tested late? Contracts, financial incentives

PND data: incomplete, sensitive data

Ease of access to maternity care

Lack of awareness of the screening programme

Cultural issues

No fast track for at risk couples

Complex pathway

HCP’s/hospital staff: roles, responsibilities, awareness, knowledge base

Multitude of IT and systems issues


Early testing: KPI ST2


61.3

56.0

37.4

60.1

53.1

58.1

56.8

48.6

40.7

60.7

51.2

0

10

20

30

40

50

60

70

80

90

100

EastMidlands

East ofEngland

London North East North West SouthCentral

South East South West WestMidlands

Yorkshire &The Humber

England

%

Excludes 16 trusts that did not provide data for all four quarters.

Pregnancy outcomes: early testing and

offer of informed choice (2008-15)


75.1 67.7 57.3 0

10

20

30

40

50

60

70

80

90

100

<12+6 weeks 13+0 - 14+6 weeks ≥15+0 wks

%

Gestation

Proportion of affected results where parents opted to terminate, grouped by gestation at PND for known pregnancy outcomes, 2008-15: England

*Excludes cases where the gestation at PND was unknown, and cases where the pregnancy outcome was unknown.

ST2 – Improving timeliness of screening

and PND

SCS and UKTS collaboration awarded the contract

for public engagement

Working with 2 of the lowest performing Trusts:

One in London and one in West Midlands


ST2 project Key messages on early testing have been added to:

• NHS choices

• BMJ e-learning


Thank you


1. Antenatal screening updates

Healthcare

Transcript of 1. Antenatal screening updates