Guidance

Antenatal and newborn blood spot screening: KPI data submission

Updated 12 June 2025

Applies to England

Timescales

Q1 (1 April to 30 June)

Time for sense checking and return: 1 September to 30 September

Q2 (1 July to 30 September)

Time for sense checking and return: 1 December to 31 December

Q3 (1 October to 31 December)

Time for sense checking and return: 1 March to 31 March

Q4 (1 January to 31 March)

Time for sense checking and return: 1 June to 30 June

Key performance indicator (KPI) data is submitted one quarter in arrears, except the fetal anomaly screening KPI for ultrasound coverage (FA2) which is 2 quarters in arrears. Data collection must allow for sense checking, sign-off and submission by the deadline. Submissions received after the deadline will appear as a non-submission for that quarter.

Screening commissioners and the screening quality assurance service (SQAS) work with screening providers to review KPI data in accordance with locally agreed arrangements prior to submission. Local organisations can contact SQAS (england.annb-qa-admin@nhs.net)  for advice on data collection and submission.

Completing the KPI template

Updated templates are provided every quarter for the submission of KPI data from maternity service providers, child health information services (CHIS) and screening laboratories. The templates ask for the numerator, denominator and commentary for each KPI. The templates for coverage KPIs contain additional fields for:

• exclusion categories
• declines
• individuals to follow up (those eligible who were not screened and did not decline)

By entering the exclusion information, the eligible population (the denominator) is accurately identified so that the calculation of coverage is correct. The declines are not excluded as they are individuals who are eligible for screening, so they are in the denominator but not the numerator. We ask for them separately because they provide important intelligence about the screening pathway and help to identify the remaining individuals to be accounted for.

Screening providers and screening commissioners or SQAS will use ‘sense checking’ to make sure data is correct according to the national definitions.

Data submissions are reviewed by the national screening data and information team. Data that is not signed off, was not sense checked and does not meet the standard definition is not accepted. Where the data field is blank on the published data file this indicates that a submission:

• was not made
• was incomplete
• did not meet the definition or data quality issues were identified
• was withdrawn by the service.

Data sense checking

Generic

1. The template ‘submitted by’, ‘signed off by’ and ‘sense checking confirmed’ sections must be completed.
2. The correct name of ‘maternity service’ or ‘sub-ICB’ is selected from the drop-down list, particularly for organisations with multiple sites (make sure the correct site is selected).
3. All numerators are a subset of the denominators. This means there are no performance percentages that are over 100%.
4. Any zeros are appropriate and accurate.

Antenatal screening coverage KPIs for infectious diseases and sickle cell and thalassemia

1. Data is matched cohort (the numerator must be a subset of the denominator. i.e all pregnant women booked must be matched to their screening result or a documented decline).
2. Exclusions and inclusions are accurately applied.
3. Denominators are the same or, if different, the difference can be explained.
4. Additional commentary is provided where relevant. This usually only applies to women in the ‘left to follow up’ category.
5. Unaccounted women are followed up and the screening safety incident guidance is applied where appropriate.

Antenatal screening coverage of the fetal anomaly ultrasound (FA2)

1. Data is matched cohort (the numerator must be a subset of the denominator. i.e all pregnant women booked must be matched to their screening result or a documented decline).
2. Exclusions and inclusions are accurately applied, for example women presenting to service after 23 weeks are excluded.
3. Women who had 2 attempts to complete the 20-week screening scan and the scan is still incomplete should not be counted in the numerator (tested women); these women should appear in the left to follow up category.
4. Additional commentary is provided where relevant. This usually only applies to women in the ‘left to follow up’ category.
5. Unaccounted women are followed up and the screening safety incident guidance is applied where appropriate.

Antenatal screening coverage for T21/T18/T13 (FA3)

1. Data is matched cohort (the numerator must be a subset of the denominator. i.e all pregnant women booked must be matched to their screening result or a documented decline).
2. Exclusions and inclusions are accurately applied, for example women presenting to service ≥ 14⁺² weeks (crown rump lengths (CRL) >84.0mm) are excluded. Some women may book and are thought to be < 14⁺² weeks by last menstrual period (LMP) but when scanned they are found to be ≥ 14⁺² weeks; these women can be excluded if there were no delays in the usual process of booking the dating scan.
3. Additional commentary is provided where relevant. This usually only applies to women in the ‘left to follow up’ category.
4. Unaccounted women are followed up and the screening safety incident guidance is applied where appropriate.

Inadequate samples for T21, T18, T13 screening (FA4)

1. Data for this KPI is submitted by the screening laboratory. Maternity services must not submit data on this KPI.

Timely offer of prenatal diagnosis (PND) to women at risk of having an infant with sickle cell disease or thalassaemia (ST4 a and b)

1. If no cases state ‘no cases’ in the commentary and there should be zero in the numerator and zero in the denominator.

Newborn blood spot screening coverage (KPIs NB1 and NB4)

1. Data is matched cohort (the numerator must be a subset of the denominator. i.e all babies for whom the sub-Integrated Care Board (ICB) was responsible for must be matched to their result).
2. Additional commentary needs to account for all babies who do not have a recorded result at 17 days (NB1) or who do not have a recorded result at 21 calendar days of notifying the CHIS of movement in (NB4).
3. NB1 is based on only babies for whom the sub-ICB was responsible at birth and on the last day of the reporting period. Responsible sub-ICB refers to all babies registered with a GP within the sub-ICB. 
4. NB4 is based on the babies who have changed responsible sub-ICB or have moved in from another UK country or abroad, in the reporting period.  Responsible sub-ICB refers to all babies registered with a GP within the sub-ICB. 
5. For NB4, does the number of babies moving in correlate with what you know about the local population?
6. Unaccounted babies are followed up and the screening safety incident guidance is applied where appropriate.

Quality of the newborn blood spot sample (NB2)

1. The data submitted relates to the maternity service.
2. This indicator is calculated from a low numerator (the number of repeat or further samples requested) and a high denominator (number of first blood spot samples received by the laboratory in the reporting period), and therefore the percentage should be low not high.

Non-invasive prenatal testing (NIPT) experimental metrics

Antenatal screening coverage for NIPT (NIPT-S01)

1. Data is matched cohort.
2. Denominator is women with higher chance combined or quadruple results and includes twins.
3. Exclusions and inclusions are accurately applied, for example women with a higher chance combined or quadruple screening result who had bone marrow or organ transplant.
4. Numerator includes those who chose to have NIPT and have a result. A result includes lower chance, higher chance, and no result NIPT results.
5. Declines will include women in two separate data fields 1. those who chose no further testing and 2. those who chose to have PND following a higher chance combined or quad.
6. Additional commentary is provided where relevant. This usually only applies to women in the ‘left to follow up’ category.
7. Unaccounted women are followed up and the screening safety incident guidance is applied where appropriate.

Timeliness of information and support (NIPT-S04)

1. Denominator only includes those women with a higher chance or no result NIPT result (denominator for NIPT-S04 cannot be larger than the numerator of NIPT-S01). If there are no cases, there should be zero in the numerator and zero in the denominator.
2. Date of receipt of results is counted as day zero.
3. Days counted are working days.
4. Additional commentary is provided where relevant. This usually only applies to women in the ‘left to follow up’ category.

Timeliness of prenatal diagnosis (NIPT-S05)

1. Denominator only includes PND procedures completed where the indication is a higher chance or no result NIPT result (does not include women with higher chance combined or quad who chose to go straight to PND at that point) (denominator for NIPT-S05 cannot be larger than the denominator of NIPT-S04).
2. Date the woman attends the appointment to discuss the results is counted as day zero.
3. Days counted are working days.