Research and analysis

Antenatal and newborn screening KPI data: Q1 summary factsheets (1 April to 30 June 2021)

Updated 23 March 2023

Applies to England

Please be aware that this data covers the time period through the COVID-19 pandemic. Provider performance should therefore be interpreted with caution.

In addition, some providers were justifiably unable to make timely data returns or validate their data in this period. We recommend looking at the historical trend data of services before the COVID-19 pandemic to help interpret the data.

This report should be read in conjunction with the full KPI data tables published each quarter.

1. Fetal anomaly screening

1.1 KPI FA2: coverage – fetal anomaly ultrasound

National performance of FA2 in Q4 2020 to 2021 was 99.2%, the same as the previous quarter. FA2 is collected 6 months (2 quarters) in arrears. The trend graph below shows that England FA2 performance has remained above the achievable threshold of 95% since 1 April 2017.

All screening services that submitted data (138 out of 143) met the acceptable threshold of 90%, with 135 meeting the achievable threshold of 95% and 26 of them reporting performance of 100%.

Quarter 4 performance

Reporting period 1 January to 31 March 2021
Numerator 146,165
Denominator 147,338
Performance 99.2%
Completeness of data 96.5%
Region Performance %
London 99.3%
Midlands and East 99.2%
North 99.3%
South 99.0%
England 99.2%

1.2 KPI FA3

There is no intention to publish FA3 by individual maternity service. England performance is published in the annual dataset.

In Q4, 139 out of 143 screening services submitted data.

1.3 KPI FA4: combined samples

FA4 was introduced in 2020 to 2021. New KPIs are not published in the first year of data collection. This time is used to improve the data quality and completeness, by revising the definition, adding clarity and/or setting thresholds as required.

In Q1 2021 to 2022, national performance of FA4 for inadequate combined samples was 3.4%. FA4 is a KPI where a lower performance is better.

Of the 143 screening services, combined sample data was reported for 140 of them through data returns from 20 of the 22 FASP laboratories.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 3,684
Denominator 109,513
Performance 3.4%
Completeness of data 90.9%
Region Performance %
London 1.7%
Midlands and East 3.8%
North 4.7%
South 2.9%
England 3.4%

1.4 KPI FA4: quadruple samples

FA4 was introduced in 2020 to 2021. New KPIs are not published in the first year of data collection. This time is used to improve the data quality and completeness, by revising the definition, adding clarity and/or setting thresholds as required.

In Q1 2021 to 2022, national performance of FA4 for inadequate quadruple samples was 6.7%. FA4 is a KPI where a lower performance is better.

Of the 143 maternity services, data was reported for 142 of them through data returns from 20 of the 22 FASP laboratories.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 908
Denominator 13,549
Performance 6.7%
Completeness of data 90.9%
Region Performance %
London 3.0%
Midlands and East 7.5%
North 6.8%
South 8.3%
England 6.7%

2. Infectious diseases in pregnancy screening

2.1 KPI ID1: HIV coverage

National performance of ID1 in Q1 was 99.8%, remaining at the highest ever level recorded for this KPI. The trend graph below shows that England ID1 performance has remained above the achievable threshold of 99% since 1 April 2018.

All screening services that submitted data (141 out of 143) met the acceptable threshold of 95%. 139 screening services reached the achievable threshold of 99%, and 30 of them reported performance of 100%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 158,758
Denominator 159,128
Performance 99.8%
Completeness of data 98.6%
Region Performance %
London 99.9%
Midlands and East 99.7%
North 99.7%
South 99.8%
England 99.8%

2.2 KPI ID2: diagnosis/intervention – timely assessment of women with hepatitis B

National performance of ID2 in Q1 was 85.4%. The trend graph below shows that England ID2 performance has remained above the acceptable threshold of 70% since 1 April 2018.

All 143 screening services submitted data, including 61 services that reported zero women. Of the remaining 82 services, 65 met the acceptable threshold. ID2 is a small number KPI, so the data should be interpreted with caution.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 175
Denominator 205
Performance 85.4%
Completeness of data 100%
Region Performance %
London 88.1%
Midlands and East 78.5%
North 89.6%
South 87.9%
England 85.4%

2.3 KPI ID3: coverage – hepatitis B

National performance of ID3 in Q1 was 99.8%, the same as the previous quarter. The trend graph below shows that England ID3 performance has remained above the achievable threshold of 99% since 1 April 2018.

All screening services that submitted data (141 out of 143) met the acceptable threshold of 95%. 139 screening services reached the achievable threshold of 99%, and 31 of them reported performance of 100%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 158,767
Denominator 159,125
Performance 99.8%
Completeness of data 98.6%
Region Performance %
London 99.9%
Midlands and East 99.7%
North 99.7%
South 99.8%
England 99.8%

2.4 KPI ID4: coverage – syphilis

National performance of ID4 in Q1 was 99.8%, the same as the previous quarter. The trend graph below shows that England ID4 performance has remained above the achievable threshold of 99% since 1 April 2018.

All screening services that submitted data (141 out of 143) met the acceptable threshold of 95%. 139 screening services reached the achievable threshold of 99%, and 31 of them reported performance of 100%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 158,757
Denominator 159,118
Performance 99.8%
Completeness of data 98.6%
Region Performance %
London 99.9%
Midlands and East 99.7%
North 99.7%
South 99.8%
England 99.8%

3. Sickle cell and thalassaemia screening

3.1 KPI ST1: coverage – antenatal screening

National performance of ST1 in Q1 was 99.7%. The trend graph below shows that England ST1 performance has remained above the achievable threshold of 99% since 1 April 2018.

All screening services that submitted data (141 out of 143) met the acceptable threshold of 95%. 136 screening services reached the achievable threshold of 99%, and 30 of them reported performance of 100%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 158,688
Denominator 159,099
Performance 99.7%
Completeness of data 98.6%
Region Performance %
London 99.9%
Midlands and East 99.7%
North 99.7%
South 99.7%
England 99.7%

3.2 KPI ST2: test – timeliness of antenatal screening

National performance of ST2 in Q1 was 59.2%, lower than the previous quarter. The trend graph below shows that England ST2 performance dropped below the acceptable threshold of 50% for Q1 and Q2 of 2020 to 2021 but has been back above the acceptable threshold in every quarter since then.

Data suggests that while services were maintained, performance was affected for this KPI during COVID-19 in 2020. This is not unexpected as technical guidance in place at the time stated that services could offer screening later than 10 weeks.

141 out of 143 screening services submitted data for this KPI for Q1.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 96,220
Denominator 162,625
Performance 59.2%
Completeness of data 98.6%
Region Performance %
London 59.2%
Midlands and East 57.0%
North 62.5%
South 58.1%
England 59.2%

3.3 KPI ST3: test – completion of family origin questionnaire (FOQ)

National performance of ST3 in Q1 was 97.9%, slightly lower than the previous quarter. The trend graph below shows that England ST3 performance has remained above the acceptable threshold of 95% since 1 April 2018.

All 143 screening services submitted data, and 128 met the acceptable threshold of 95%. 68 screening services reached the achievable threshold of 99%, and 21 of them reported performance of 100%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 161,866
Denominator 165,347
Performance 97.9%
Completeness of data 100%
Region Performance %
London 99.4%
Midlands and East 98.1 %
North 97.1%
South 97.2%
England 97.9%

3.4 KPI ST4a: referral – timely offer of prenatal diagnosis (PND) to women at risk of having an infant with sickle cell disease or thalassaemia

National performance of ST4a in Q1 was 57.5%, the highest ever level recorded for this KPI. The trend graph below shows England ST4a performance since the KPI was first published in Q1 2019 to 2020. Thresholds have not yet been set for this KPI.

All 143 screening services submitted data, including 69 services that reported zero women at risk.

We have identified quality issues with the submitted data. Therefore we recommend that regional performance is not compared. NHS England and NHS Improvement are reviewing this KPI with the aim of improving data quality.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 226
Denominator 393
Performance 57.5%
Completeness of data 100%
Region Performance %
London 57.0%
Midlands and East 49.6%
North 76.1%
South 63.6%
England 57.5%

3.5 KPI ST4b: referral – timely offer of prenatal diagnosis (PND) to couples at risk of having an infant with sickle cell disease or thalassaemia

National performance of ST4b in Q1 was 69.3%, slightly lower than the previous quarter. The trend graph below shows England ST4b performance since the KPI was first published in Q1 2019 to 2020. Thresholds have not yet been set for this KPI.

All 143 screening services submitted data, including 58 services that reported zero couples at risk.

We have identified quality issues with the submitted data. Therefore we recommend that regional performance is not compared. NHS England and NHS Improvement are reviewing this KPI with the aim of improving data quality.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 169
Denominator 244
Performance 69.3%
Completeness of data 100%
Region Performance %
London 72.6%
Midlands and East 52.5%
North 81.4%
South 72.0%
England 69.3%

4. Newborn blood spot screening

4.1 KPI NB1: coverage of clinical commissioning group (CCG) responsibility at birth

National performance of NB1 in Q1 was 97.9%, higher than the previous 4 quarters. The trend graph below shows that England NB1 performance has remained above the acceptable threshold of 95% since 1 April 2018.

On April 1 2021, 38 CCGs merged creating 9 new ones, resulting in a total of 106 CCGs in England. In Q1, 100 out of 106 CCGs submitted data for NB1, and 96 met the acceptable threshold of 95%.

37 CCGs reached the achievable threshold of 99%, and 5 of them reported performance of 100%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 133,386
Denominator 136,187
Performance 97.9%
Completeness of data 94.3%
Region Performance %
London 96.7%
Midlands and East 99.2%
North 97.4%
South 97.9%
England 97.9%

4.2 KPI NB2: test – quality of the blood spot sample

National performance of NB2 in Q1 was 2.3%, the same as the previous quarter. The trend graph below shows that England NB2 performance is above the acceptable threshold of 2%. NB2 is a KPI where a lower performance is better.

Due to COVID-19, during the Q1 (April to June 2020) time period newborn screening laboratories were instructed to relax blood spot acceptance criteria on samples that would normally have been rejected and to accept day 4 samples. Together these factors are likely to explain the reduced ‘avoidable repeat’ rate observed during Q1 2020 to 2021.

All 143 screening services submitted data, 60 met the acceptable threshold and 20 met the achievable threshold of 1%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 3,420
Denominator 147,475
Performance 2.3%
Completeness of data 100%
Region Performance %
London 2.2%
Midlands and East 1.4%
North 3.0%
South 2.8%
England 2.3%

4.3 KPI NB4: coverage of movers in

National performance of NB4 in Q1 was 87.4%, slightly lower than the previous quarter. The trend graph below shows that England NB4 performance has remained below the acceptable threshold of 95% since 1 April 2018.

On April 1 2021, 38 CCGs merged creating 9 new ones, resulting in a total of 106 CCGs in England. In Q1, 100 out of 106 CCGs submitted data for NB4, and 27 met the acceptable threshold of 95%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 10,299
Denominator 11,785
Performance 87.4%
Completeness of data 94.3%
Region Performance %
London 82.0%
Midlands and East 89.0%
North 90.6%
South 89.6%
England 87.4%

5. Newborn hearing screening

5.1 KPI NH1: coverage

National performance of NH1 in Q1 was 98.7%, slightly higher than the previous quarter. The trend graph below shows that England NH1 performance has met the acceptable threshold of 98% for the second time since Q4 2019 to 2020.

During the COVID-19 pandemic in 2020 NHSP encouraged services to continue screening where safe to do so in line with national standards and the NHSP technical guidance. However, in some areas screening was delayed due to COVID-19 and we have seen lower coverage as a result. This particularly affected community services where health visitors suspended home visits.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 143,736
Denominator 145,592
Performance 98.7%
Completeness of data 100%
Region Performance %
London 98.8%
Midlands and East 99.0%
North 98.4%
South 98.7%
England 98.7%

5.2 KPI NH2: diagnosis/intervention – time from screening outcome to attendance at an audiological assessment appointment

National performance of NH2 in Q1 was 90.0%, lower than the previous quarter but still meeting the acceptable threshold of 90%. The trend graph below shows that England NH2 performance dropped significantly in Q4 2019 to 2020 and Q1 2020 to 2021, however since then it has risen again to above the acceptable threshold.

During the COVID-19 pandemic in line with NHSE guidance, many audiology departments closed. This resulted in a delay in the assessment of babies referred from the screen in most services.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 2,878
Denominator 3,197
Performance 90.0%
Completeness of data 100%
Region Performance %
London 91.4%
Midlands and East 90.4%
North 86.9%
South 94.9%
England 90.0%

6. Newborn and infant physical examination screening

6.1 KPI NP1: coverage

National performance of NP1 in Q1 was 96.9%, slightly lower than the previous 3 quarters. The trend graph below shows that England NP1 performance has remained above the acceptable threshold of 95% since 1 April 2018.

Out of 131 screening services, 116 met the acceptable threshold. 56 services met the achievable threshold of 97.5%.

Quarter 1 performance

Reporting period 1 April to 30 June 2021
Numerator 141,673
Denominator 146,217
Performance 96.9%
Completeness of data 100%
Region Performance %
London 96.8%
Midlands and East 97.3%
North 96.4%
South 97.1%
England 96.9%

6.2 KPI NP3: diagnosis/intervention – timeliness of ultrasound scan of the hips for developmental dysplasia

NP3 was introduced in 2021 to 2022. New KPIs are not published in the first year of data collection. This time is used to improve the data quality and completeness, by revising the definition, adding clarity and/or setting thresholds as required. After this time, NHSEI will review the data with the aim of publishing it from the following year.