Research and analysis

Antenatal and newborn screening KPI data: Q4 summary factsheets (1 January to 31 March 2022)

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 to this, some providers were justifiably not able 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 key performance indicator (KPI) data tables published each quarter.

1. Fetal anomaly screening

1.1 KPI FA2: coverage: fetal anomaly ultrasound

National performance of FA2 (see standard FASP-SO2) in Q3 2021 to 2022 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 2018.

All screening services that submitted data (137 out of 142) met the acceptable threshold of 90%, with 135 meeting the achievable threshold of 95% and 34 of them reporting performance of 100%.

Activity for Q3 is presented by Public Health England (PHE) regions (valid at the time of data collection). Coverage ranged from 99.0% in the South to 99.4% in the Midlands and East, and the North.

Quarter 3 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 October to 31 December 2021 130,590 131,592 99.2% 96.5%
Region  Performance %
London  99.1%
Midlands and East 99.4%
North 99.4%
South 99.0%
England 99.2%

1.2 KPI FA3

There is no intention to publish FA3 (see standard FASP-S01) by individual maternity service. We are reviewing the data with the aim of publishing it nationally in the future.

In Q4 138 out of 142 screening services submitted data.

1.3 KPI FA4: combined samples

FA4 (see standard FASP-SO6) 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 Q4 2021 to 2022, national performance of FA4 for inadequate combined samples was 4.1%. FA4 is a KPI where a lower performance is better.

All 22 fetal anomaly screening programme (FASP) laboratories submitted data, for a total of 141 maternity services.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 4,575 112,735 4.1% 100%
Region Performance %
East of England  4.0%
London 3.1%
Midlands 3.4%
North East and Yorkshire 5.6%
North West 5.6%
South East 4.7%
South West 2.3%
England 4.1%

1.4 KPI FA4: quadruple samples

FA4 (see standard FASP-SO6) 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 Q4 2021 to 2022, national performance of FA4 for inadequate quadruple samples was 7.3%. FA4 is a KPI where a lower performance is better.

All 22 FASP laboratories submitted data, for a total of 141 maternity services.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 1,103 15,033 7.3% 100%
Region Performance %
East of England  6.3%
London 3.4%
Midlands 6.5%
North East and Yorkshire 10.5%
North West 8.2%
South East 8.3%
South West 12.6%
England 7.3%

2. Infectious diseases in pregnancy screening

2.1 KPI ID1: HIV coverage

National performance of ID1 (see standard IDPS-S01) in Q4 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.

Out of all screening services that submitted data (141 out of 142) 139 met the achievable threshold of 99%, and 31 of them reported performance of 100%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 165,952 166,317 99.8% 99.3%
Region Performance %
East of England  99.8%
London 99.9%
Midlands 99.7%
North East and Yorkshire 99.8%
North West 99.8%
South East 99.7%
South West 99.6%
England 99.8%

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

National performance of ID2 (see standard IDPS-S06) in Q4 was 83.2%. The trend graph below shows that England ID2 performance has remained above the acceptable threshold of 70% since 1 April 2018.

All 142 screening services submitted data, including 62 services that reported zero women. Of the remaining 80 services, 64 met the acceptable threshold. ID2 is a small number KPI, therefore the data should be interpreted with caution.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 134 161 83.2% 100%
Region Performance %
East of England  92.0%
London 92.3%
Midlands 50.0%
North East and Yorkshire 90.9%
North West 84.4%
South East 87.0%
South West 100.0%
England 83.2%

2.3 KPI ID3: coverage: hepatitis B

National performance of ID3 (see standard IDPS-S02) in Q4 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.

Out of all screening services that submitted data (141 out of 142) 139 met the achievable threshold of 99%, and 32 reported performance of 100%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 165,962 166,321 99.8% 99.3%
Region  Performance %
East of England  99.8%
London 99.9%
Midlands 99.8%
North East and Yorkshire 99.8%
North West 99.8%
South East 99.7%
South West 99.7%
England 99.8%

2.4 KPI ID4: coverage: syphilis

National performance of ID4 (see standard IDPS-S03) in Q4 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.

Out of all screening services that submitted data (141 out of 142) 138 met the achievable threshold of 99%, and 32 reported performance of 100%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 165,952 166,315 99.8% 99.3%
Region  Performance %
East of England  99.8%
London 99.9%
Midlands 99.7%
North East and Yorkshire 99.8%
North West 99.8%
South East 99.7%
South West 99.7%
England 99.8%

3. Sickle cell and thalassaemia screening

3.1 KPI ST1: coverage: antenatal screening

National performance of ST1 (see standard SCT-S01) in Q4 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 142) met the acceptable threshold of 95%. 135 screening services reached the achievable threshold of 99%, and 31 reported performance of 100%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 165,828 166,264 99.7% 99.3%
Region Performance %
East of England  99.6%
London 99.9%
Midlands 99.7%
North East and Yorkshire 99.8%
North West 99.8%
South East 99.7%
South West 99.5%
England 99.7%

3.2 KPI ST2: test: timeliness of antenatal screening

National performance of ST2 (see standard SCT-S02) in Q4 was 55.5%, 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.

140 out of 142 screening services submitted data for this KPI for Q4.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 92,897 167,249 55.5% 98.6%
Region  Performance %
East of England  59.0%
London 51.8%
Midlands 47.3%
North East and Yorkshire 69.2%
North West 50.7%
South East 55.4%
South West 61.6%
England 55.5%

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

National performance of ST3 (see standard SCT-S03) in Q4 was 97.8%, the same as the previous quarter. The trend graph below shows that England ST3 performance has remained above the acceptable threshold of 95% since 1 April 2018.

Of the 141 (out of 142) screening services who submitted data, 122 met the acceptable threshold of 95% and 61 reached the achievable threshold of 99%, including 27 who reported performance of 100%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 166,013 169,802 97.8% 99.3%
Region  Performance %
East of England  98.1%
London 99.5%
Midlands 97.3%
North East and Yorkshire 97.8%
North West 96.4%
South East 96.7%
South West 98.2%
England 97.8%

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 (see standard SCT-S05) in Q4 was 44.5%, lower than the previous 5 quarters. 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 142 screening services submitted data, including 61 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 (NHSE) are reviewing this KPI with the aim of improving data quality.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 194 436 44.5% 100%
Region  Performance %
East of England  46.4%
London 48.4%
Midlands 30.0%
North East and Yorkshire 52.9%
North West 47.6%
South East 37.5%
South West 12.5%
England 44.5%

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 (see standard STC-S05) in Q4 was 64.7%, 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 142 screening services submitted data, including 50 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. NHSE are reviewing this KPI with the aim of improving data quality.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 194 300 64.7% 100%
Region  Performance %
East of England  91.3%
London 72.4%
Midlands 42.3%
North East and Yorkshire 64.7%
North West 68.6%
South East 51.2%
South West 80.0%
England 64.7%

4. Newborn blood spot screening

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

National performance of NB1 (see standard NBS-S01a) in Q4 was 97.0%, slightly lower than the previous quarter. 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 Q3, all 106 CCGs submitted data for NB1, and 90 met the acceptable threshold of 95%.

30 CCGs reached the achievable threshold of 99%, and 4 of them reported performance of 100%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 131,140 135,179 97.0% 100%
Region  Performance %
East of England  99.6%
London 94.8%
Midlands 98.0%
North East and Yorkshire 97.3%
North West 96.8%
South East 96.5%
South West 96.9%
England 97.0%

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

National performance of NB2 (see standard NBS-S06) in Q4 was 2.1%, lower than 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 142 screening services submitted data, 82 met the acceptable threshold and 38 met the achievable threshold of 1%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 2,905 141,679 2.1% 100%
Region  Performance %
East of England  1.1%
London 1.8%
Midlands 1.7%
North East and Yorkshire 2.5%
North West 2.1%
South East 2.7%
South West 2.9%
England 2.1%

4.3 KPI NB4: coverage of movers in

National performance of NB4 (see standard NBS-S01b) in Q4 was 81.6%, the second lowest ever level recorded for this KPI after Q3. 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 Q2, all 106 CCGs submitted data for NB4, and 18 met the acceptable threshold of 95%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 10,151 12,443 81.6% 100%
Region  Performance %
East of England  87.3%
London 72.4%
Midlands 80.8%
North East and Yorkshire 87.5%
North West 83.9%
South East 86.6%
South West 79.6%
England 81.6%

5. Newborn hearing screening

5.1 KPI NH1: coverage

National performance of NH1 (see standard NHSP-S01) in Q4 was 98.1%, slightly higher than the previous quarter. The trend graph below shows that England NH1 performance has met the acceptable threshold of 98% since Q3 2020 to 2021.

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 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 136,837 139,506 98.1% 100%
Region  Performance %
East of England  98.6%
London 98.5%
Midlands 98.5%
North East and Yorkshire 97.9%
North West 96.0%
South East 98.7%
South West 98.0%
England 98.1%

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

National performance of NH2 (see standard NHSP-S05) in Q4 was 89.1%, higher than the previous quarter but below 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.

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

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 2,841 3,190 89.1% 100%
Region  Performance %
East of England  88.4%
London 90.4%
Midlands 89.3%
North East and Yorkshire 87.0%
North West 86.5%
South East 94.1%
South West 91.5%
England 89.1%

6. Newborn and infant physical examination screening

6.1 KPI NP1: coverage

National performance of NP1 (see standard NIPE-S01) in Q4 was 96.5%, slightly higher than the previous quarter. The trend graph below shows that England NP1 performance has remained above the acceptable threshold of 95% since 1 April 2018.

Out of 129 screening services, 114 met the acceptable threshold, and 44 services met the achievable threshold of 97.5%.

Quarter 4 performance

Reporting period Numerator Denominator Performance % Completeness of data %
1 January to 31 March 2022 133,862 138,653 96.5% 100%
Region  Performance %
East of England  97.2%
London 96.4%
Midlands 96.8%
North East and Yorkshire 96.3%
North West 95.8%
South East 96.2%
South West 97.8%
England 96.5%

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

NP3 (see standard NIPE-S03) 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, NHSE will review the data with the aim of publishing it from the following year.