Official Statistics

Antenatal screening standards: data report 1 April 2019 to 31 March 2020

Published 27 July 2021

Applies to England

In this report we use ‘screening year 2019 to 2020’ to refer to 1 April 2019 to 31 March 2020.

This is the third antenatal screening standards data report, covering 1 April 2019 to 31 March 2020. Antenatal screening is offered for 17 different conditions to approximately 700,000 pregnant women in England every year.

There are 3 NHS antenatal screening programmes. These are the:

• NHS Fetal Anomaly Screening Programme (FASP)
• NHS Infectious Diseases in Pregnancy Screening (IDPS) Programme
• NHS Sickle cell and thalassaemia (SCT) Screening Programme

Last year’s recommendations focused on achieving complete coverage submissions and meeting acceptable thresholds. Find out about progress against last year’s recommendations.

This year we focus on:

• non-submitting providers, including providers not submitting coverage data for FASP-S01 and FASP-S02, and providers where data was excluded as it did not meet the data definitions
• standards where providers are not yet meeting the minimum acceptable thresholds

We have aimed recommendations at NHS England and NHS Improvement (NHSEI) regional public health commissioning teams so they can work with their providers to address areas of improvement highlighted in this report.

The report is a testament to the hard work of everyone involved in the programmes. We would like to thank all those involved in collecting and collating the data, producing the report, and most of all those from the NHS who deliver the screening services.

We would like to acknowledge the important contributions of the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) and the Integrated Screening Outcomes Surveillance Service (ISOSS) in helping us to monitor and report on the outcomes for these screening programmes.

Further information

This report should be read in conjunction with the full standards datasets for 2019 to 2020 for the FASP, IDPS and SCT programmes.

Information about screening standards and service specifications are available for each programme.

For those standards that are also key performance indicators (KPIs), the annual data presented in this report is calculated by adding together all 4 quarters of KPI submissions. Screening services are only included where valid KPI submissions were made in all 4 quarters of 2019 to 2020.

Naming conventions for FASP are that:

• Down’s syndrome is referred to as trisomy 21 (T21)
• Edwards’ syndrome is referred to as trisomy 18 (T18)
• Patau’s syndrome is referred to as trisomy 13 (T13)

Please contact the screening helpdesk if you would like further information on screening data: phe.screeninghelpdesk@nhs.net

FASP summary

Coverage

Test	T21/T18/T13 (FASP-S01)	Fetal anomaly ultrasound (FASP-S02)
Coverage (%)	84.0	99.1

Test

Test	T21/T18/T13
Turnaround time (FASP-S05)	99.1
Completed laboratory request forms (FASP-S06)	98.1

Referral

Referral	Time to intervention
T21/T18/T13 (FASP-S07)	98.1
Fetal anomaly ultrasound, local referral (FASP-S08a)	75.4
Fetal anomaly ultrasound, tertiary referral (FASP-S08b)	91.1

Diagnosis or intervention

Test	%
QFPCR T21/T18/T13 results reported within 3 calendar days of sample receipt (FASP-S09a)	86.7
Karyotype T21/T18/T13 results reported within 14 calendar days of sample receipt (FASP-S09b)	76.8
QFPCR fetal anomaly ultrasound results reported within 3 calendar days of sample receipt (FASP-S09c)	77.2
Karyotype fetal anomaly ultrasound reported within 14 calendar days of sample receipt (FASP-S09d)	82.5

Test: performance

The standardised screen positive rate (SPR) for T21/T18/T13 was 2.8% (FASP-S03a).

In 2018 to 2019, the crude detection rate (DR) was 82.4% (95% confidence interval (CI) 80.2 to 84.6) for the T21 combined test, and 73.3% (95% CI 65.5 to 80.2) for the T21 quadruple test (FASP-S03b).

NCARDRS reported a detection rate of 77.2% for serious cardiac conditions on the fetal anomaly scan in screening year 2018 to 2019 (FASP-S04).

IDPS summary

Coverage

Condition	Coverage %
HIV (IDPS-S01)	99.8
Hepatitis B (IDPS-S02)	99.8
Syphilis (IDPS-S03)	99.8

Test: turnaround times

Condition	Results reported ≤ 8 working days of sample receipt %
HIV (IDPS-S04a)	99.3
Hepatitis B (IDPS-S04b)	99.2
Syphilis (IDPS-S04c)	99.2

Screen positive rates

Data shows that:

• 1.19 per 1,000 eligible pregnant women screened positive for HIV
• 3.77 per 1,000 eligible pregnant women screened positive for hepatitis B
• 1.50 per 1,000 eligible pregnant women screened positive for syphilis

Referral

Condition	Women with screen positive results attending a screening assessment ≤ 10 working days %
HIV (IDPS-S05a)	90.7
Hepatitis B (IDPS-S05b)	86.9
Syphilis (IDPS-S05c)	88.6

Diagnosis or intervention

85.3% of women with hepatitis B attended specialist assessment within 6 weeks (IDPS-S06).

Intervention or treatment

	%
Babies requiring hepatitis B vaccination receiving first dose ≤ 24 hours % (IDPS-S07a)	98.5
Babies requiring immunoglobulin receiving it ≤ 24 hours % (IDPS-S07b)	95.7

SCT summary

Coverage

99.7% of eligible pregnant women had SCT screening (SCT-S01).

Test

	%
Timeliness of screening: results available ≤ 10 weeks +0 days (SCT-S02)	59.6
Completion of family origin questionnaire (FOQ): antenatal samples for SCT testing received (SCT-S03)	98.0
Test turnaround time: ≤ 3 working days (SCT-S04)	94.9

Referral

Data shows that:

• 46.4% of women at risk of having an infant with sickle cell disease or thalassaemia were offered prenatal diagnosis (PND) ≤ 12 weeks +0 days (SCT-S05a)
• 62.4% of couples at risk of having an infant with sickle cell disease or thalassaemia offered PND ≤ 12 weeks +0 days (SCT-S05b)

Diagnosis or intervention

41.9% of PND tests performed ≤ 12 weeks +6 days (SCT-S06).

Test: results

	%
Women receiving PND results: ≤ 5 working days of PND test (SCT-S07)	80.3
Newborn screen positive results to parents: ≤ 28 days of age (SCT-S08)	77.5

Intervention or treatment

85.1% newborn infants with a positive screening result were seen at a paediatric clinic or discharged for insignificant results ≤ 90 days of age (SCT-S09).

Coverage

This section covers standards FASP-S01, FASP-S02, IDPS-S01, IDPS-S02, IDPS-S03 and SCT-S01. See the 2 recommendations relating to coverage.

We measure coverage of the screening programmes to provide assurance that screening is offered to the eligible population. Low coverage should be investigated as it may indicate:

• eligible women are not being offered screening
• those offered screening are not accepting the test
• the test is not completed for those accepting screening

Figure 1: Antenatal screening, coverage standards, performance against thresholds, screening year 2019 to 2020, England

Standard	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
FASP-S02	132	2	0	9	143
IDPS-S01	142	0	0	1	143
IDPS-S02	142	0	0	1	143
IDPS-S03	141	0	0	2	143
SCT-S01	140	2	0	1	143

FASP-S01 is not shown in figure 1 as there are no performance thresholds set for this standard.

Performance thresholds for FASP-S02 are:

• acceptable: ≥ 90.0%
• achievable: ≥ 95.0%

Performance thresholds for IDPS-S01, IDPS-S02, IDPS-S03 and SCT-S01 are:

• acceptable: ≥ 95.0%
• achievable: ≥ 99.0%

Figure 2: FASP-S01: Coverage: T21/T18/T13 screening, completeness, screening year 2019 to 2020, by region

Region	Number of accepted returns	No return/data excluded	Total
London	26	0	26
Midlands and East	37	3	40
North	31	10	41
South	33	3	36

There is no intention to publish this standard by individual maternity service. Thresholds are not set for this standard, performance between providers should not be compared. FASP supports informed choice for women.

Table 1: FASP-S02: Coverage: 18⁺⁰ to 20⁺⁶ week screening scan, performance, screening year 2017 to 2018 to screening year 2019 to 2020, by region

2017 to 2018

Regional summary	Numerator	Denominator	Performance (%)
London	102,455	103,942	98.6
Midlands and East	136,323	137,666	99.0
North	79,518	80,510	98.8
South	114,350	115,179	99.3
England	432,646	437,297	98.9

2018 to 2019

Regional summary	Numerator	Denominator	Performance (%)
London	115,653	116,804	99.0
Midlands and East	151,532	153,194	98.9
North	116,378	117,475	99.1
South	136,327	137,219	99.3
England	519,890	524,692	99.1

2019 to 2020

Regional summary	Numerator	Denominator	Performance (%)
London	112,888	114,150	98.9
Midlands and East	161,398	162,944	99.1
North	136,712	137,936	99.1
South	126,778	127,676	99.3
England	537,776	542,706	99.1

Figure 3: FASP-S02: Coverage: 18⁺⁰ to 20⁺⁶ week screening scan, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	25	0	0	1	26
Midlands and East	38	1	0	1	40
North	35	1	0	5	41
South	34	0	0	2	36

Performance thresholds are:

• acceptable: ≥ 90.0%
• achievable: ≥ 95.0%

Table 2: IDPS-S01: Coverage: HIV, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	142,823	143,054	99.8
Midlands and East	191,045	191,516	99.8
North	175,574	176,091	99.7
South	151,806	152,224	99.7
England	661,248	662,885	99.8

Figure 4: IDPS-S01: Coverage: HIV, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	26	0	0	0	26
Midlands and East	40	0	0	0	40
North	40	0	0	1	41
South	36	0	0	0	36

Performance thresholds are:

• acceptable: ≥ 95.0%
• achievable: ≥ 99.0%

Table 3: IDPS-S02: Coverage: hepatitis B, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	142,834	143,060	99.8
Midlands and East	191,047	191,519	99.8
North	175,581	176,086	99.7
South	151,819	152,221	99.7
England	661,281	662,886	99.8

Figure 5: IDPS-S02: Coverage: hepatitis B, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	26	0	0	0	26
Midlands and East	40	0	0	0	40
North	40	0	0	1	41
South	36	0	0	0	36

Table 4: IDPS-S03: Coverage: syphilis, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	135,516	135,701	99.9
Midlands and East	191,046	191,515	99.8
North	175,579	176,083	99.7
South	151,821	152,224	99.7
England	653,962	655,523	99.8

Figure 6: IDPS-S03: Coverage: syphilis, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	25	0	0	1	26
Midlands and East	40	0	0	0	40
North	40	0	0	1	41
South	36	0	0	0	36

Table 5: SCT-S01: Coverage: antenatal screening, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	142,541	142,806	99.8
Midlands and East	190,859	191,410	99.7
North	175,456	176,030	99.7
South	151,782	152,372	99.6
England	660,638	662,618	99.7

Figure 7: SCT-S01: Coverage: antenatal screening, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	26	0	0	0	26
Midlands and East	40	0	0	0	40
North	39	1	0	1	41
South	35	1	0	0	36

Performance thresholds are:

• acceptable: ≥ 95.0%
• achievable: ≥ 99.0%

We continue to see year on year improvement in data completeness for the coverage standards.

Of those submitting data:

• no provider was below the acceptable threshold for any of the coverage standards
• the number of providers meeting the achievable thresholds increased compared to last year (screening year 2018 to 2019) with the most notable improvements in the Midlands and East, and the North
• all regions and England met the achievable threshold for all coverage indicators

Completeness of data for FASP-S01 across England increased from 70.5% in screening year 2018 to 2019 to 88.8% in screening year 2019 to 2020, with improvements seen in all regions.

There are 16 providers (3 in Midlands and East, 10 in the North and 3 in the South) that did not submit complete data. Of these, 4 submitted no data and 12 submitted for some quarters but not all.

Whilst performance for FASP-S02 over the last 2 years has remained stable at 99.1%, data completeness has improved from 89.0% in screening year 2018 to 2019 to 93.7% in screening year 2019 to 2020. With more providers submitting data this shows that nationally the number of women eligible for the scan and those receiving the scan has increased by nearly 18,000.

The number of non-submitting providers has decreased from 16 to 9 in the last year. Of the 9 providers who did not submit complete data, 8 submitted for some quarters but not all (1 in London, 1 in Midlands and East, 4 in the North and 2 in the South), and 1 provider in the North submitted no data.

Performance of IDPS-S01, IDPS-S02 and IDPS-S03 has improved from 99.7% to 99.8% over the last year.

One provider in the North submitted for some quarters but not all for IDPS-S01, IDPS-S02, IDPS-S03 and SCT-S01, and the same applies to 1 provider in London for IDPS-S03.

All regions met the achievable threshold for IDPS-S01, IDPS-S02, IDPS-S03 and SCT-S01.

Test

This section covers standards FASP-S03a, FASP-S03b, FASP-S04, FASP-S05, FASP-S06, IDPS-S04, SCT-S02, SCT-S03, SCT-S04, SCT-S07 and SCT-S08. See the 10 recommendations relating to test.

Timely analysis of the screening sample is important in making sure women have their results or enter clinical services without delay.

Figure 8: FASP-S03a: Test: screen positive rate T21/T18/T13 screening, screening year 2013 to 2014 to screening year 2019 to 2020, England

Line graph showing an increase from 2.20% in screening year 2015 to 2016 to 3.10% in screening year 2018 to 2019. There was a decrease from screening year 2018 to 2019 to screening year 2019 to 2020 to 2.80%.

The reference maternal age distribution changed, resulting in an increase in the screen positive rate. The reference range for this standard was revised in April 2018 from 2.3% to 2.8%.

Table 6: FASP-S03b: Test: Detection rates (%): T21, T13 and T18 by year, estimated delivery date (EDD) screening year 2015 to 2016 to screening year 2018 to 2019, England

Detection rate (95% confidence interval (CI))	2015 to 2016	2016 to 2017	2017 to 2018	2018 to 2019
T21 combined test	81.9% (77.6-85.5)	82.1% (78.8-85.1)	81.5% (79.0-83.7)	82.4% (80.2-84.6)†
T21 quadruple test	61.7% (47.4-74.2)	66.3% (56.0-75.3)	71.9% (63.7-78.8)	73.3% (65.5-80.2)†
T18 and T13 combined test	-	-	81.1% (77.5-84.3)	80.2% (75.8-84.6)†

† Maternal age adjusted detection rate.

Public Health England (PHE) launched the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) in 2015. NCARDRS records people with congenital anomalies and rare diseases in England and is best placed to collect data on detection rates. This is vital for the ongoing monitoring and evaluation of the screening programme.

Maternal age adjusted targets for Down’s syndrome screening were met for the quadruple test but not for the combined test.

Figure 9: FASP-S04: Test: 18⁺⁰ to 20⁺⁶ week screening scan. Detection rates with and without early detections (%) for serious cardiac conditions, EDD in screening year 2018 to 2019, by region

All regions and England had a detection rate over 75% for serious cardiac conditions, which is higher than the acceptable threshold of 50.0%.

Data from 97% of NHS maternity providers, for 5,521 babies with an expected date of delivery (EDD) between 1 April 2018 and 31 March 2019, shows detection rates were significantly above the threshold for all cardiac conditions across England, with and without the inclusion of detections prior to 18⁺⁰ weeks gestation.

Table 7: FASP-S05: Test: turnaround time T21/T18/T13 screening, performance for England, screening year 2015 to 2016 to screening year 2019 to 2020

Performance	2015 to 2016	2016 to 2017	2017 to 2018	2018 to 2019	2019 to 2020
England	97.9%	98.1%	97.9%	99.3%	99.1%

Figure 10: FASP-S05: Test: turnaround time T21/T18/T13 screening, performance by laboratory, screening year 2019 to 2020

Two screening laboratories (1 in London and 1 in the Midlands and East) did not submit data for the second year in a row.

One laboratory in the Midlands and East did not meet the acceptable threshold.

The overall performance for England was 99.1%, meeting the achievable threshold.

Table 8: FASP-S06: Test: completion of laboratory request forms T21/T18/T13 screening, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	102,707	103,638	99.1
Midlands and East	139,816	142,500	98.1
North	108,123	110,676	97.7
South	121,859	124,608	97.8
England	472,505	481,422	98.1

Figure 11: FASP-S06: Test: completion of laboratory request forms T21/T18/T13 screening, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	0	24	1	1	26
Midlands and East	0	35	5	0	40
North	0	37	3	1	41
South	0	28	8	0	36

Performance thresholds are:

• acceptable: ≥ 97.0%
• achievable: 100.0%

Figure 12: FASP-S06: Test: completion of laboratory request forms T21/T18/T13 screening, performance trends, screening year 2014 to 2015 to screening year 2019 to 2020, England

Line chart showing a steady increase from screening years 2014 to 2015 and 2018 to 2019. The percentage of completed laboratory request forms was below the acceptable threshold of 97.0% in screening years 2014 to 2015 (96.6%) and 2015 to 2016 (96.8%). The overall performance in England was above the acceptable threshold since screening year 2016 to 2017 (97.4%) and is now at 98.1% for screening year 2019 to 2020 which is similar to screening year 2018 to 2019.

Two providers did not submit data on this standard. Seventeen providers submitting data did not meet the acceptable threshold, an improvement from screening year 2018 to 2019 when 27 of the providers submitting data did not meet the acceptable threshold. Only one provider submitting data met the achievable threshold. NHS FASP has reviewed and introduced a new standard, FASP-S06 (KPI FA4) for data submissions starting April 2020.

Table 9: IDPS-S04: Test: turnaround times for HIV, hepatitis B, and syphilis, performance, screening year 2019 to 2020, by region

IDPS-S04a: HIV

Region	Numerator	Denominator	Performance (%)
London	122,028	122,277	99.8
Midlands and East	189,225	190,290	99.4
North	160,702	162,676	98.8
South	157,781	159,097	99.2
England	629,736	634,340	99.3

IDPS-S04b: hepatitis B

Region	Numerator	Denominator	Performance (%)
London	123,057	123,303	99.8
Midlands and East	189,386	190,332	99.5
North	160,743	163,125	98.5
South	157,778	159,144	99.1
England	630,964	635,904	99.2

IDPS-S04c: syphilis

Region	Numerator	Denominator	Performance (%)
London	121,163	121,435	99.8
Midlands and East	189,011	190,263	99.3
North	160,717	162,786	98.7
South	157,704	159,162	99.1
England	628,595	633,646	99.2

Figure 13: IDPS-S04: Test: turnaround times for HIV, hepatitis B, and syphilis, performance against thresholds, screening year 2019 to 2020, by region

Region and Standard	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London IDPS-S04a	24	0	0	2	26
London IDPS-S04b	24	0	0	2	26
London IDPS-S04c	23	0	1	2	26
Midlands and East IDPS-S04a	38	1	0	1	40
Midlands and East IDPS-S04b	38	1	0	1	40
Midlands and East IDPS-S04c	38	1	0	1	40
North IDPS-S04a	37	0	1	3	41
North IDPS-S04b	36	0	2	3	41
North IDPS-S04c	37	0	1	3	41
South IDPS-S04a	32	3	1	0	36
South IDPS-S04b	32	3	1	0	36
South IDPS-S04c	32	3	1	0	36

Performance thresholds are:

• acceptable: ≥ 95.0%
• achievable: ≥ 97.0%

The number of non-submitting providers has decreased again this year compared to screening year 2018 to 2019, from 13 to 6.

Two providers (1 in Midlands and East and 1 in the North) did not submit data. The 1 non-submitting provider in the North reported that they were unable to submit data due to the IT system used in the laboratory.

Data was excluded for 4 providers where it was incomplete or inaccurate, in some instances due to IT limitations.

Three laboratories did not meet the acceptable threshold for at least one part of IDPS-S04.

The achievable threshold was met for England for all 3 parts of IDPS-S04.

Figure 14: SCT-S02: Test: timeliness of antenatal screening, performance trends, screening year 2014 to 2015 to screening year 2019 to 2020, England

A line graph showing the overall England performance at 51.2% in screening year 2014 to 2015, which is above the acceptable threshold of 50%, increasing to 59.6% in screening year 2019 to 2020.

Performance thresholds are:

• acceptable: ≥ 50.0%
• achievable: ≥ 75.0%

Due to inconsistencies in the way that SCT-S02 is reported, we do not recommend that this standard is used to compare performance between maternity services. A regional comparison of performance against thresholds is therefore not presented in this report. However, the trend of England performance for the last 6 years is shown above.

Table 10: SCT-S03: Test: completion of family origin questionnaire (FOQ), performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	116,292	117,844	98.7
Midlands and East	187,523	191,948	97.7
North	176,926	181,082	97.7
South	141,824	144,598	98.1
England	622,565	635,472	98.0

Figure 15: SCT-S03: Test: completion of family origin questionnaire (FOQ), performance against thresholds, screening year 2019 to 2020, by region

Region	Performance over achievable	Performance between acceptable and achievable	Performance less than acceptable	No return/data excluded	Total
London	14	6	2	4	26
Midlands and East	14	21	4	1	40
North	12	27	2	0	41
South	15	18	1	2	36

Performance thresholds are:

• acceptable: ≥ 95.0%
• achievable: ≥ 99.0%

Seven providers, compared to 8 last year, did not submit data despite this being a long-standing indicator; these were all providers that submitted data for some quarters but not all.

Of those providers submitting data in screening year 2019 to 2020, 9 did not meet the acceptable threshold. Five of these also did not meet the acceptable threshold in 2018 to 2019.

Of those that submitted data, 40.4% (55 out of 136) met the achievable threshold, but no region nor England met this threshold.

Table 11: SCT-S04: Test: turnaround time (antenatal screening), performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	132,870	135,962	97.7
Midlands and East	171,229	176912	96.8
North	146,311	156,206	93.7
South	91,370	101,585	89.9
England	541,780	570,665	94.9

Figure 16: SCT-S04: Test: turnaround time (antenatal screening), performance against thresholds, screening year 2019 to 2020.

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	Data excluded	No return	Total
London	13	0	1	1	0	15
Midlands and East	26	1	3	2	2	34
North	21	5	5	4	3	38
South	14	3	4	6	3	30

Performance thresholds are:

• acceptable: ≥ 90.0%
• achievable: ≥ 95.0%

Eight laboratories (2 in the Midlands and East, 3 in the North and 3 in the South) did not submit data. The number of non-submitting laboratory providers decreased by half from the previous screening year (2018 to 2019).

Some data submissions were excluded (13 laboratories) as the data did not meet the definition of the standard as they:

• reported in calendar days instead of working days (2 laboratories)
• did not have systems that allowed this data to be provided (5 laboratories)
• could not separate the referred work from the in-house work (2 laboratories)
• only reported samples tested by high performance liquid chromatography (HPLC) (1 laboratory)
• reported turnaround times that were not based on annual samples (2 laboratories)

In addition, data was excluded for data quality reasons (1 laboratory).

Table 12: SCT-S04: Test: turnaround time (antenatal screening), performance trends, screening year 2017 to 2018 to screening year 2019 to 2020

Region	2017 to 2018	2018 to 2019	2019 to 2020
London	90.6	98.5	97.7
Midlands and East	93.4	94.0	96.8
North	95.8	95.3	93.7
South	94.6	96.5	89.9
England	93.9	95.8	94.9

London and Midlands and East have improved their performance between screening year 2017 to 2018 and screening year 2019 to 2020. England performance was above the achievable threshold in screening year 2018 to 2019.

Just under 95% of tests were turned around in 3 working days; a slight reduction from 95.8% in screening year 2018 to 2019. Of those laboratories submitting data, 13 did not meet the acceptable threshold. Overall, all regions met the acceptable threshold apart from the South. London and Midlands and East met the achievable threshold, but this was not met for England overall.

Figure 17: SCT-S04: Test: turnaround time (antenatal screening), performance trends, screening year 2017 to 2018 to screening year 2019 to 2020

Table 13: SCT-S07: Test: timely reporting of prenatal diagnosis (PND) results to parents, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	167	186	89.8
Midlands and East	63	105	60.0
North	63	74	85.1
South	33	41	80.5
England	326	406	80.3

Figure 18: SCT-S07: Test: timely reporting of PND results to parents, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No cases identified	No return / data excluded	Total
London	17	3	5	1	0	26
Midlands and East	8	2	15	15	0	40
North	12	0	7	21	1	41
South	10	0	6	20	0	36

Performance thresholds are:

• acceptable: ≥ 70.0%
• achievable: ≥ 90.0%

This is a small number standard and it should be noted that all regions had providers with no cases in 2019 to 2020. One provider in the North did not submit data.

All regions had providers that did not meet the acceptable threshold. Midlands and East did not meet the acceptable threshold but shows continued improvement since screening year 2017 to 2018. No region met the achievable threshold.

Table 14: SCT-S07: Test: timely reporting of PND results to parents, performance, screening year 2017 to 2018 to screening year 2019 to 2020, by region

2017 to 2018

Region	Number of no returns	Numerator	Denominator	Performance (%)
London	2	173	214	80.8
Midlands and East	5	24	53	45.3
North	10	35	40	87.5
South	1	52	61	85.2
England	18	284	368	77.2

2018 to 2019

Region	Number of no returns	Numerator	Denominator	Performance (%)
London	0	183	205	89.3
Midlands and East	0	27	55	49.1
North	0	37	40	92.5
South	0	22	30	73.3
England	0	269	330	81.5

2019 to 2020

Region	Number of no returns	Numerator	Denominator	Performance (%)
London	0	167	186	89.8
Midlands and East	0	63	105	60.0
North	1	63	74	85.1
South	0	33	41	80.5
England	1	326	406	80.3

Table 15: SCT-S08: Test: reporting newborn screen positive results to parents, performance, screening year 2019 to 2020, England

Numerator	Denominator	Performance (%)	Exclusions from the denominator due to missing data
165	213	77.5	46

There were 46 infants with missing data on when the screen positive result was given to the parents. This is more than in screening year 2018 to 2019, where there were 37 infants with missing data, but similar to screening year 2017 to 2018, where there were 47 infants with missing data.

Figure 19: SCT-S08: Test: reporting newborn screen positive results to parents, screening year 2019 to 2020, England

Measure	Where parents received newborn screen positive results ≤ 28 days of age	Where parents received newborn screen positive results > 28 days of age	With newborn screen positive result where age parents received result is missing	Total
Number of infants	165	48	46	259

Performance thresholds are:

• acceptable: ≥ 90.0%
• achievable: ≥ 95.0%

We identified data quality issues with the submitted data, therefore only England level data is shown. This must be interpreted with caution as it may not be reflective of true performance. We also do not have enough information on 46 infants to determine performance for this standard.

NHS SCT has worked with newborn blood spot labs and their clinical networks to roll out the newborn outcomes (NBO) system which will be fully implemented by March 2021. This will improve data quality, particularly for the missing data.

Referral

This section covers FASP-S07, FASP-S08, IDPS-S05, and SCT-S05. See the 3 recommendations relating to referral.

These standards give us assurance that women with higher chance/screen positive results have a timely opportunity to discuss their results and further options with an appropriately trained health professional.

Table 16: FASP-S07: Referral: time to intervention T21/T18/T13 screening, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	3,264	3,356	97.3
Midlands and East	3,916	3,995	98.0
North	3,323	3,357	99.0
South	3,536	3,607	98.0
England	14,039	14,315	98.1

Figure 20: FASP-S07: Referral: time to intervention T21/T18/T13 screening, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No return/data excluded	Total
London	15	3	8	0	26
Midlands and East	25	8	7	0	40
North	29	4	7	0	41
South	23	4	9	0	36

Performance thresholds are:

• acceptable: ≥ 97.0%
• achievable: ≥ 99.0%

Bridgewater Community Healthcare NHS Foundation Trust is not included in this standard as it is a community maternity service.

All providers submitted data. All regions met the acceptable threshold, but all had providers that did not meet the acceptable threshold. Of those submitting data, 31 providers did not meet the acceptable threshold. Of these, 9 providers did not meet the acceptable threshold for the last 3 years.

Only the North region met the achievable threshold.

Performance has increased from 97.0% in screening year 2018 to 2019 to 98.1% in screening year 2019 to 2020.

National audits were conducted on screening standards IDPS-S05 and FASP-S07 to understand why acceptable thresholds set for these specific screening standards are not met. The aim is to find out, if possible, if standards are not being met because of service issues such as capacity or design or because of possible health inequity issues. This data is now being analysed.

Table 17: FASP-S08a: Referral: time to intervention 18⁺⁰ to 20⁺⁶ fetal anomaly ultrasound, local referral, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	896	987	90.8
Midlands and East	1,845	2,714	68.0
North	1,344	1,851	72.6
South	730	835	87.4
England	4,815	6,387	75.4

Figure 21: FASP-S08a: Referral: time to intervention 18⁺⁰ to 20⁺⁶ fetal anomaly ultrasound), local referral, performance against threshold, screening year 2019 to 2020, by region

Region	Performance ≥ acceptable	Performance < acceptable	No cases identified	No return/data excluded	Total
London	11	11	2	2	26
Midlands and East	11	22	6	1	40
North	12	19	7	2	40
South	17	13	6	0	36

Performance threshold:

• acceptable: ≥ 97.0%

Bridgewater Community Healthcare NHS Foundation Trust is not included in this standard as it is a community maternity service.

Table 18: FASP-S08b: Referral: time to intervention 18⁺⁰ to 20⁺⁶ fetal anomaly ultrasound, tertiary referral, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	343	359	95.5
Midlands and East	1,050	1,153	91.1
North	1,008	1,159	87.0
South	824	870	94.7
England	3,225	3,576	91.1

Figure 22: FASP-S08b: Referral: time to intervention 18⁺⁰ to 20⁺⁶ fetal anomaly ultrasound, tertiary referral, performance against threshold, screening year 2019 to 2020, by region

Region	Performance ≥ acceptable	Performance < acceptable	No cases identified	No return/data excluded	Total
London	9	8	6	3	26
Midlands and East	11	19	8	2	40
North	13	18	6	3	40
South	19	9	8	0	36

Performance threshold:

• acceptable: ≥ 97.0%

Bridgewater Community Healthcare NHS Foundation Trust is not included in this standard as it is a community maternity service.

The number of providers submitting data is improving. In screening year 2018 to 2019, there were 10 non-submitting providers and 5 in screening year 2019 to 2020 for FASP-S08a. For FASP-S08b, there were 12 non-submitting providers in screening year 2018 to 2019 and 8 non-submitting providers in screening year 2019 to 2020.

The acceptable threshold was not met for 45.5% of providers for FASP-S08a and 37.7% of providers for FASP-S08b in England. No region met the acceptable threshold for either FASP-S08a or FASP-S08b.

Work is ongoing to look at ways to improve FASP-S08 as part of the FASP major standards review.

Table 19: IDPS-S05: Referral: timely assessment of screen positive and known positive women, performance, screening year 2019 to 2020, by region

IDPS-S05a: HIV

Region	Numerator	Denominator	Performance (%)
London	245	269	91.1
Midlands and East	209	233	89.7
North	159	169	94.1
South	97	112	86.6
England	710	783	90.7

IDPS-S05b: hepatitis B

Region	Numerator	Denominator	Performance (%)
London	858	995	86.2
Midlands and East	570	662	86.1
North	430	473	90.9
South	299	352	84.9
England	2,157	2,482	86.9

IDPS-S05c: syphilis

Region	Numerator	Denominator	Performance (%)
London	241	278	86.7
Midlands and East	285	320	89.1
North	265	282	94.0
South	94	119	79.0
England	885	999	88.6

Figure 23: IDPS-S05: Referral: timely assessment of screen positive and known positive women, performance against thresholds, screening year 2019 to 2020, by region

Region and Standard	Performance ≥ achievable	Performance > acceptable and < achievable	Performance < acceptable	No cases identified	No return / data excluded	Total
London IDPS-S05a	14	0	11	1	0	26
London IDPS-S05b	9	0	17	0	0	26
London IDPS-S05c	13	0	13	0	0	26
Midlands and East IDPS-S05a	28	0	9	3	0	40
Midlands and East IDPS-S05b	21	1	18	0	0	40
Midlands and East IDPS-S05c	21	0	18	1	0	40
North IDPS-S05a	22	0	9	8	1	40
North IDPS-S05b	22	0	16	1	1	40
North IDPS-S05c	27	0	10	2	1	40
South IDPS-S05a	20	0	9	7	0	36
South IDPS-S05b	16	0	20	0	0	36
South IDPS-S05c	19	0	12	5	0	36

Performance thresholds are:

• acceptable: ≥ 97.0%
• achievable: ≥ 99.0%

Bridgewater Community Healthcare NHS Foundation Trust is not included in this standard as it is a community maternity service.

One provider in the North did not submit data.

The performance for the assessment of women who screen positive for HIV is better than for the assessment of women who screen positive for hepatitis B and syphilis. This likely reflects long established pathways for HIV.

No region met the acceptable threshold for IDPS-S05a, IDPS-S05b or IDPS-S05c for 4 years in a row.

Figure 24: IDPS-S05: Referral: timely assessment of screen positive and known positive women, performance trends for England, screening year 2016 to 2017 to screening year 2019 to 2020

Line graph showing that performance for IDPS-S05 for women who screen positive for HIV is better than women who screen positive for hepatitis B and syphilis. In screening year 2019 to 2020, performance for all 3 infections is more similar.

Figure 25: IDPS-S05: Referral: timely assessment of screen positive and known positive women, performance trends for England, screening year 2016 to 2017 to screening year 2019 to 2020, by region

Line graphs showing the regional trend lines for each part of standard IDPS-S05 separately.

Looking at trend data for HIV (IDPS-S05a) from screening year 2016 to 2017, it would appear that performance in London is on a downward trend.

Performance overall is improving year on year for hepatitis B (IDPS-S05b) and syphilis (IDPS-S05c).

National audits were conducted on screening standards IDPS-S05 and FASP-S07 to understand why acceptable thresholds set for these specific screening standards are not met. The aim is to find out, if possible, if standards are not being met because of service issues such as capacity or design or because of possible health inequity issues. This data is now being analysed.

Table 20: SCT-S05: Referral: timely offer of PND to women (a) or couples (b) at risk of having an infant with sickle cell disease or thalassaemia, performance, screening year 2019 to 2020, by region

SCT-S05a: The proportion of women at risk offered PND by 12 weeks + 0 days gestation

Region	Numerator	Denominator	Performance (%)
London	395	929	42.5
Midlands and East	291	584	49.8
North	104	203	51.2
South	76	151	50.3
England	866	1,867	46.4

SCT-S05b: The proportion of couples at risk offered PND by 12 weeks + 0 days gestation

Region	Numerator	Denominator	Performance (%)
London	220	360	61.1
Midlands and East	157	265	59.2
North	126	177	71.2
South	79	131	60.3
England	582	933	62.4

Figure 26: SCT-S05: Referral: timely offer of PND to women (a) or couples (b) at risk of having an infant with sickle cell disease or thalassaemia, data completeness, screening year 2019 to 2020, by region

Region	Data included	No cases identified	One or more return missing	Total
London SCT-S05a	22	1	3	26
London SCT-S05b	23	0	3	26
Midlands and East SCT-S05a	31	9	0	40
Midlands and East SCT-S05b	33	7	0	40
North SCT-S05a	22	19	0	41
North SCT-S05b	25	16	0	41
South SCT-S05a	24	12	0	36
South SCT-S05b	25	11	0	36

This standard was collected for the first time in 2017 to 2018, and performance thresholds have not yet been set. The above figure presents the data completeness for this standard.

We have identified data quality issues with the submitted data for SCT-S05 and recommend you do not compare regional or individual maternity service performance. PHE Screening are reviewing this KPI with the aim of improving data quality.

There were 3 providers that submitted data for some quarters but not all, one of which was due to the impact of COVID-19.

Diagnosis or intervention

This section covers FASP-S09, IDPS-S06, and SCT-S06. See the 3 recommendations relating to diagnosis or intervention.

These standards provide assurance that women with screen positive results, higher chance results or known to have a condition, who wish to have a diagnostic procedure or intervention, have these in a timely manner.

Table 21: FASP-S09: Diagnosis or intervention: diagnostic tests fetal anomaly screening, performance, screening year 2015 to 2016 to screening year 2019 to 2020, England

Standard	2015 to 2016	2016 to 2017	2017 to 2018	2018 to 2019	2019 to 2020
9a – QFPCR† testing for higher chance T21/T18/T13	97.1	89.8	90.1	87.7	86.7
9b – Karyotype testing for higher chance T21/T18/T13	82.1	82.7	81.0	86.0	76.8
9c – QFPCR† testing for fetal anomaly ultrasound	91.3	84.0	84.2	83.9	77.2
9d – Karyotype testing for fetal anomaly ultrasound	82.2	86.2	86.8	87.9	82.5
Number of submissions	15/18	16/18	15/18	15/18	13/18

†QFPCR is Quantitative Fluorescence-Polymerase Chain Reaction

Figure 27: FASP-S09: Diagnosis or intervention: diagnostic tests fetal anomaly screening, screening year 2019 to 2020, England

Standard	Performance ≥ acceptable	Performance < acceptable	No cases identified	No return/data excluded	Total
FASP-S09a	6	6	1	5	18
FASP-S09b	0	13	0	5	18
FASP-S09c	5	7	1	5	18
FASP-S09d	4	8	1	5	18

Performance threshold:

• acceptable: ≥ 90.0%

The Association of Clinical Genomic Science (ACGS) collects this data on behalf of NHS FASP. Standards FASP-S09a and FASP-S09b measure the turnaround times for results from either QFPCR or karyotype following a higher chance screening result for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome.

An increasing number of diagnostic laboratories report that they are more likely to perform micro-array than karyotype following an unexpected finding at the 18 to 20 weeks screening scan. It should be noted that the current NHS FASP standards and service specification recommends karyotype.

There were 5 genomic laboratories that did not submit data.

Completeness and performance for each part of FASP-S09 has worsened over the last year.

Table 22: IDPS-S06: Diagnosis or intervention: timely assessment of women with hepatitis B, performance, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)
London	220	260	84.6
Midlands and East	254	301	84.4
North	166	187	88.8
South	116	138	84.1
England	756	886	85.3

Figure 28: IDPS-S06: Diagnosis or intervention: timely assessment of women with hepatitis B, performance against thresholds, screening year 2019 to 2020, by region

Region	Performance ≥ achievable	Performance ≥ achievable and < acceptable	Performance < acceptable	No cases identified	No return/data excluded	Total
London	11	9	5	0	1	26
Midlands and East	25	9	6	0	0	40
North	19	7	8	7	0	41
South	20	5	9	2	0	36

Performance thresholds are:

• acceptable: ≥ 70.0%
• achievable: ≥ 90.0%

Figure 29: IDPS-S06: Diagnosis or intervention: timely assessment of women with hepatitis B, performance trends, screening year 2014 to 2015 to screening year 2019 to 2020, England

†Since 2016 to 2017, IDPS-S06 counts only women with hepatitis B who are either newly diagnosed or known positive with high infectivity markers detected in the current pregnancy.

Line graph showing that performance for IDPS-S06 in England improved from screening year 2014 to 2015 to screening year 2017 to 2018 but has plateaued between screening year 2017 to 2018 and screening year 2019 to 2020.

Figure 30: IDPS-S06: Diagnosis or intervention: timely assessment of women with hepatitis B, performance trends, screening year 2014 to 2015 to screening year 2019 to 2020, by region

†Since 2016 to 2017, IDPS-S06 counts only women with hepatitis B who are either newly diagnosed or known positive with high infectivity markers.

Line graph showing that regional performance has become more similar since screening year 2017 to 2018. London was below the acceptable threshold until screening year 2016 to 2017. Performance for all regions was between the acceptable threshold and achievable threshold from screening year 2016 to 2017 to screening year 2019 to 2020.

IDPS-S06 is a small number standard, therefore the data should be interpreted with caution.

There was 1 provider that submitted data for some quarters but not all.

Of those submitting data, the number of providers not meeting the acceptable threshold has increased from 24 in screening year 2018 to 2019 to 28 in screening year 2019 to 2020.

Performance in London and the North has improved since 2016 to 2017. Overall, in screening year 2019 to 2020, 130 women who were newly diagnosed with hepatitis B or known to have hepatitis B with high infectivity markers were not seen within the target timeframe.

The number of providers submitting data that met the achievable threshold has increased from 72 in screening year 2018 to 2019 to 75 in screening year 2019 to 2020.

Table 23: SCT-S06: Diagnosis or intervention: timeliness of PND, screening year 2019 to 2020, by region

Region	Numerator	Denominator	Performance (%)	Exclusions from the denominator due to missing data
London	72	178	40.4	1
Midlands and East	33	75	44.0	2
North	20	60	33.3	1
South	21	37	56.8	0
Unknown	3	6	50.0	0
England	149	356	41.9	4

The numerator relates to PND fetal samples that are taken less than or equal to 12 weeks + 6 days gestation. Region is based on the maternity booking service or hospital where the PND sample was taken if booking hospital information was unavailable.

Figure 31: SCT-S06: Diagnosis or intervention: timeliness of PND, screening year 2019 to 2020, England

Measure	Performed ≤ 12 weeks + 6 days gestation	Performed > 12 weeks + 6 days gestation	Where gestation at PND test is unknown	Total
Number of PND tests	149	207	4	360

This standard was collected at the national level for the first time in 2017 to 2018. We are not able to report this standard by maternity service at the time of publishing and have improved data collection processes to enable us to do this in future.

Intervention or treatment

This section relates to standards IDPS-S07 and SCT-S09. See the 3 recommendations related to Intervention or treatment.

These standards provide assurance that babies who require treatment receive it in a timely manner.

Table 24: IDPS-S07: Intervention or treatment: timely neonatal hepatitis B vaccination and immunoglobulin, performance, screening year 2019 to 2020, by region

IDPS-S07a: vaccination

Region	Numerator	Denominator	Performance (%)
London	790	797	99.1
Midlands and East	567	576	98.4
North	398	407	97.8
South	280	285	98.2
England	2,035	2,065	98.5

IDPS-S07b: immunoglobulin

Region	Numerator	Denominator	Performance (%)
London	83	86	96.5
Midlands and East	53	57	93.0
North	41	42	97.6
South	25	26	96.2
England	202	211	95.7

Figure 32: IDPS-S07: Intervention or treatment: timely neonatal hepatitis B vaccination (a) and immunoglobulin (b), performance against thresholds, screening year 2019 to 2020, by region

Region and Standard	Performance ≥ achievable	Performance ≥ acceptable and < achievable	Performance < acceptable	No cases identified	No return / data excluded	Total
London IDPS-S07a	20	2	4	0	0	26
London IDPS-S07b	19	0	3	4	0	26
Midlands and East IDPS-S07a	32	1	6	0	1	40
Midlands and East IDPS-S07b	23	0	4	12	1	40
North IDPS-S07a	29	1	6	3	2	41
North IDPS-S07b	17	0	1	22	1	41
South IDPS-S07a	30	0	5	1	0	36
South IDPS-S07b	15	0	1	20	0	36

Performance thresholds are:

• acceptable: ≥ 97.0%
• achievable: ≥ 99.0%

Bridgewater Community Healthcare NHS Foundation Trust is not included as they are a community service.

One provider in the North did not submit data for IDPS-S07a.

One provider in the Midlands and East was excluded from IDPS-S07a and IDPS-S07b as they submitted data for women instead of babies.

There were 21 providers that did not meet the acceptable threshold for IDPS-S07a and 9 providers that did not meet the acceptable threshold for IDPS-S07b.

All regions met the acceptable threshold for IDPS-S07a. London was the only region that met the achievable threshold for IDPS-S07a. The North were the only region that met the acceptable threshold for IDPS-S07b. England overall met the acceptable threshold for IDPS-S07a but did not meet the acceptable threshold for IDPS-S07b.

Figure 33: IDPS-S07: Intervention or treatment: timely neonatal hepatitis B vaccination (a) and immunoglobulin (b), performance, screening year 2016 to 2017 to screening year 2019 to 2020, England

Bridgewater Community Healthcare NHS Foundation Trust is not included as they are a community service.

Table 25: SCT-S09: Intervention or treatment: timely follow-up, diagnosis and treatment of newborn infants with a positive screening result, performance, screening year 2019 to 2020, by region

Region†	Numerator	Denominator	Performance (%)	Exclusions from the denominator due to missing data
London	85	99	85.9	26
Midlands and East	35	45	77.8	13
North	25	30	83.3	5
South	14	14	100.0	8
Unknown	13	14	92.9	4
England	172	202	85.1	56

†Region relates to the region of the haemoglobinopathy centre (medical) in which the infant was seen or referred to and thus may not reflect the infant’s region of residence.

In screening year 2019 to 2020, there were 56 infants where data was missing for age infant was seen in clinic or discharged for insignificant results. In screening year 2018 to 2019, there were 15 infants with missing data which was an improvement from screening year 2017 to 2018 where there were 20 infants with missing data.

Figure 34: SCT-S09: Intervention or treatment: timely follow-up, diagnosis and treatment of newborn infants with a positive screening result, screening year 2019 to 2020, England

Measure	With positive screening result who were seen at paediatric clinic or discharged for insignificant results ≤ 90 days of age	With positive screening result who were seen at paediatric clinic or discharged with insignificant results > 90 days	Number of infants with positive screening result where age at clinic attendance or discharge is missing	Total
Number of infants	172	30	56	258

Performance thresholds are:

• acceptable: ≥ 90.0%
• achievable: ≥ 95.0%

Please note that data for SCT-S09 does not include any infants with screen positive results for whom the blood spot sample was tested at Liverpool Newborn Screening Laboratory.

We do not have enough information on 56 infants to determine performance. As the SCT newborn outcomes system is implemented, the quality of the data is expected to improve.

IDPS: screen positive rates

The data collection for IDPS-S05: referral: timely assessment of women who screen positive and women who are known positive includes the collection of the breakdown of screen positive results. These breakdowns are shown below. Please note that due to data exclusions the absolute numbers reported here may differ from those reported elsewhere. Percentages have been rounded and therefore may not appear to equal 100.0%.

Table 26: Breakdown of women who screen positive for HIV, screening year 2019 to 2020, England

Breakdown of screen positives	n	% of total
Newly screened positive women	85	11.1
Previously known positive women, not re-tested	85	11.1
Previously known positive women, re-tested in this pregnancy	598	77.9
Total screen positive women	768	100.0

The above includes data submitted by 141 out of 143 maternity services in England.

Table 27: Breakdown of women who screen positive for hepatitis B, screening year 2019 to 2020, England

Breakdown of screen positives	n	% of total
Newly screened positive women	565	22.8
Previously known positive women, not re-tested	5	0.2
Previously known positive women, re-tested in this pregnancy	1,908	77.0
Total screen positive women	2,478	100.0

The above includes data submitted by 141 out of 143 maternity services in England.

Table 28: Breakdown of women who screen positive for syphilis, screening year 2019 to 2020, England

Breakdown of screen positives	n	% of total
Newly diagnosed requiring treatment	315	31.8
Previously diagnosed requiring treatment	95	9.6
Previously diagnosed not requiring treatment	556	56.0
Other treponemal infections	10	1.0
Unknown	16	1.6
Total screen positive women	992	100.0

Known false positives were excluded from the above. The above includes data submitted by 141 out of 143 maternity services in England.

Screen positive rates are calculated as the total number of screen positive women (newly positive or previously known diagnosed) per 1,000 women tested.

Rates for the 3 infections are calculated using a combination of data from:

• IDPS-S01, IDPS-S02 and IDPS-S03 – to provide numbers tested
• IDPS-S05 – to provide the number of screen positive women

Data are only included if the provider had complete data for both standards. This means that the absolute numbers reported here are lower than those reported for individual standards.

Please note that the below screen positive rates are based upon 2 separate data collections relating to the number of women who were booked for antenatal care in the reporting period and subsequently tested (including women who were known positives and not retested), and the number of women with screen positive results or known positive status reported in the reporting period. The 2 cohorts of women may therefore differ slightly, and the below should therefore be interpreted with caution.

For HIV and hepatitis B, the number of screen positive women is the total number of women who screen positive during antenatal screening which comprises:

• women newly diagnosed
• those previously diagnosed

Previously known diagnosed women may not be retested in the pregnancy but will still appear in the women tested and screen positive women totals.

All women are offered screening for syphilis in every pregnancy regardless of history of previous infection. For syphilis, the number of women with screen positive results is the total number of women who screen positive during antenatal screening. This will include women who are later found to have a treponemal infection that is not syphilis.

For all infections, the rates are calculated based on the total number of women tested.

Table 29: Screen positive rates for HIV in pregnant women, screening year 2019 to 2020, England

Region (returns included/expected)	Women tested	Screen positive women (n)†	Screen positive rate/1,000 women tested	Newly diagnosed women (n)	Newly diagnosed rate/1,000 women tested
London (26/26)	143,054	270	1.89	22	0.15
Midlands and East (40/40)	191,516	235	1.23	31	0.16
North (38/41)	170,580	165	0.97	20	0.12
South (36/36)	152,224	110	0.72	12	0.08
England (140/143)	657,374	780	1.19	85	0.13

†The number of screen positive women has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data.

Table 30: Screen positive rates for hepatitis B in pregnant women, screening year 2019 to 2020, England

Region (returns included/expected)	Women tested	Screen positive women (n)†	Screen positive rate/1,000 women tested	Newly diagnosed women (n)	Newly diagnosed rate/1,000 women tested
London (26/26)	143,060	995	6.96	201	1.41
Midlands and East (40/40)	191,519	660	3.45	185	0.97
North (38/41)	170,575	470	2.76	104	0.61
South (36/36)	152,221	350	2.30	75	0.49
England (140/143)	657,375	2,480	3.77	565	0.86

†The number of screen positive women has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data.

Table 31: Screen positive rates for syphilis in pregnant women, screening year 2019 to 2020, England

Screen positive women†

Region (returns included/expected)	Women tested	n ‡	Rate/1,000 women tested
London (25/26)	135,701	270	1.99
Midlands and East (40/40)	191,515	315	1.64
North (38/41)	170,572	270	1.58
South (36/36)	152,224	120	0.79
England (139/143)	650,012	975	1.50

†Known false positive results are not included in the number of screen positives.

‡The number of screen positive women has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data. 

Confirmed syphilis positive women‡

Region (returns included/expected)	Women tested	n	Rate/1,000 women tested
London (25/26)	135,701	263	1.94
Midlands and East (40/40)	191,515	314	1.64
North (38/41)	170,572	269	1.58
South (36/36)	152,224	118	0.78
England (139/143)	650,012	964	1.48

‡Confirmed syphilis positive excludes women who are found to have a treponemal infection that is not syphilis.

Screen positive women, requiring treatment†

Region (returns included/expected)	Women tested	n	Rate/1,000 women tested
London (25/26)	135,701	112	0.83
Midlands and East (40/40)	191,515	129	0.67
North (38/41)	170,572	127	0.74
South (36/36)	152,224	39	0.26
England (139/143)	650,012	407	0.63

† Newly diagnosed syphilis infections and previously diagnosed syphilis infections requiring treatment.

The trends in screen positive rates in England in the 4 years since the IDPS programme began data collection in 2016 to 2017 are shown in tables 32 to 34. The number of maternity services for which data on screen positive rates could be included increased between 2016 to 2017 and 2019 to 2020. This must be considered when interpreting the year on year screen positive rates.

Table 32: Trends in screen positive rates for HIV in pregnant women, screening year 2016 to 2017 to screening year 2019 to 2020, England

Measure	2016 to 2017	2017 to 2018	2018 to 2019	2019 to 2020
Returns included/expected	110/145	125/147	144/146	140/143
Screen positive women†: rate/1,000 women tested	1.32	1.36	1.26†	1.19†
Newly diagnosed women: rate/1,000 women tested	0.13	0.16	0.14	0.13

Known false positive results are not included in the number of screen positives. †The rate for total screen positive women is based on a count that has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data.

Table 33: Trends in screen positive rates for hepatitis B in pregnant women, screening year 2016 to 2017 to screening year 2019 to 2020, England

Measure	2016 to 2017	2017 to 2018	2018 to 2019	2019 to 2020
Returns included/expected	90/145	125/147	144/146	140/143
Screen positive women†: rate/1,000 women tested	3.79	4.16	3.89†	3.77†
Newly diagnosed women: rate/1,000 women tested	0.89	0.96	0.89	0.86

†The rate for total screen positive women is based on a count that has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data.

Table 34: Trends in screen positive rates for syphilis in pregnant women, screening year 2016 to 2017 to screening year 2019 to 2020, England

Measure	2016 to 2017	2017 to 2018	2018 to 2019	2019 to 2020
Returns included/expected	91/145	124/147	144/146	139/143
Screen positive women†: rate/1,000 women tested	1.31	1.39	1.52	1.50†
Newly diagnosed women: rate/1,000 women tested	0.56	0.53	0.69	0.63

Known false positive results are not included in the number of screen positives. †The rate for total screen positive women is based on a count that has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data.

IDPS: outcomes

The IDPS programme commissions the ISOSS team at Great Ormond Street Institute of Child Health (ICH) to collect data on screening programme outcomes. The service helps the screening programme to meet the national requirements for high quality public health disease surveillance.

The data collected have been presented in the ISOSS annual report.

SCT: screen positive rates

The SCT screening programme collects annual data from antenatal screening laboratories. This data is used to determine the proportion of pregnant women who are screen positive for a significant haemoglobinopathy condition or who have haemoglobin variant or thalassaemia carrier status.

When women are screened positive, testing of the biological father is recommended. Based on the results of both parents, it can be determined whether the pregnancy is at risk of a haemoglobin condition.

The table below presents the proportion of women that screened positive, and the proportion of the screen positive women with screen positive results that were found to have a pregnancy at risk of a clinically significant haemoglobin condition, which requires referral for counselling. These pregnancies are represented by the orange boxes in the breakdown table and include all pregnancies where there is a 1 in 4 chance or higher of the fetus having a clinically significant haemoglobin condition. Whilst referral for counselling is required for all of these pregnancies, PND must be offered for the serious conditions, as described in the inheritance risk table within the sickle cell and thalassaemia screening handbook.

Please note that data returns are only included in table 35 if data for the number of samples, the number of women with screen positive results, and the number of pregnancies at risk of a clinically significant condition could all be accepted. Data returns are based on the maternity provider served by the laboratory. The number and proportion of pregnancies at risk of a clinically significant condition shown in table 35 is likely to be an underestimate due to pregnancies where the baby’s biological father’s status is unknown.

Table 35: Numbers screened and proportion of women with screen positive results and pregnancies at risk of a clinically significant condition, antenatal sickle cell and thalassaemia screening, screening year 2019 to 2020, England

Region (returns included/expected)	Antenatal screening samples (n)	Screen positive women (n)	Screen positive women (% of samples)	Pregnancy at risk† (n)	Pregnancy at risk† (% of screen positives)
London (24/25)	134,584	5,924	4.40	348	5.87
Midlands and East (38/40)	190,638	3,397	1.78	193	5.68
North (34/40)	157,207	2,134	1.36	139	6.51
South (32/37)	134,144	1,653	1.23	91	5.51
England (128/142)	616,573	13,108	2.13	771	5.88

†Pregnancy at risk of a clinically significant condition, referral for counselling required.

The SCT screening programme also collects annual data from newborn screening laboratories. This data is used to determine the rate of infants screening positive for significant conditions and specified carrier results during newborn blood spot screening. Significant conditions comprise FS, FSC, FS-other and FE results. Carrier results comprise FAS, FAC, FAD, FAE and other haemoglobin variants. Data presented is from all 13 newborn screening laboratories in England.

Table 36: Numbers and rates of significant conditions and carrier screening results, newborn blood spot screening for sickle cell disease, screening year 2019 to 2020, England

Region	Babies tested (n)	Significant conditions (n)	Rate/1,000 babies screened	Carriers (n)	Rate/1,000 babies screened
London	122,270	126	1.03	3,473	28.40
Midlands and East	179,148	62	0.35	2,056	11.48
North	163,873	34	0.21	1,195	7.29
South	142,913	23	0.16	1,203	8.42
Unknown region	8,551	0	0.00	69	8.07
England	616,755	245	0.40	7,927	12.85

Region is based upon the maternity provider, clinical commissioning group or child health information service of the baby. The geography used differs according to the submitting laboratory.

Recommendations

Recommendations on coverage

Recommendation 1

NHSEI regional public health commissioning teams to work with non-submitting providers in the North and South regions to enable data submission in screening year 2020 to 2021 (FASP-S01, FASP-S02). See provider list.

Recommendation 2

NHSEI regional public health commissioning teams should continue to monitor exception reports to provide assurance that all women are accounted for (FASP-S01, FASP-S02, IDPS-S01, IDPS-S02, IDPS-S03, SCT-S01).

Recommendations on test

Recommendation 3

NHSEI regional public health commissioning teams to work with non-submitting providers in London and Midlands and East to enable data submission in screening year 2020 to 2021 (FASP-S05). See provider list.

Recommendation 4

NHSEI regional public health commissioning teams to work with the provider in Midlands and East to meet as a minimum the acceptable threshold (FASP-S05). See provider list.

Recommendation 5

NHSEI regional public health commissioning teams to work with non-submitting providers in the Midlands and East and the North to enable data submission in screening year 2020 to 2021 (IDPS-S04). See provider list.

Recommendation 6

NHSEI regional public health commissioning teams to work with providers in the North and the South to meet as a minimum the acceptable threshold (IDPS-S04a, IDPS-S04b, IDPS-S04c). See provider list.

Recommendation 7

NHSEI regional public health commissioning teams to work with providers in London, the Midlands and East and the North to meet as a minimum the acceptable threshold (SCT-S03). See provider list.

Recommendation 8

NHSEI regional public health commissioning teams to work with non-submitting providers in the Midlands and East, the North and the South to enable data submission in screening year 2020 to 2021 (SCT-S04). See provider list.

Recommendation 9

NHSEI regional public health commissioning teams to work with providers in all regions where data was excluded to enable data submission in screening year 2020 to 2021 (SCT-S04). See provider list.

Recommendation 10

NHSEI regional public health commissioning teams to work with providers in all regions to meet as a minimum the acceptable threshold (SCT-S04). See provider list.

Recommendation 11

NHSEI regional public health commissioning teams to work with the non-submitting provider in the North to enable data submission in screening year 2020 to 2021 (IDPS-S05, IDPS-S07a, SCT-S07). See provider list.

Recommendation 12

NHSEI regional public health commissioning teams to work with providers not meeting the acceptable threshold (SCT-S07). See provider list.

Recommendations on referral

Recommendation 13

NHSEI regional public health commissioning teams to work with providers consistently (for the last 3 years) not meeting the acceptable threshold (FASP-S07). See provider list.

Recommendation 14

PHE Screening to publish the audit report in summer 2021 (FASP-S07, IDPS-S05).

Recommendation 15

NHSEI regional public health commissioning teams to work with providers in all regions to meet as a minimum the acceptable threshold (IDPS-S05). See provider list.

Recommendations on diagnosis or intervention

Recommendation 16

NHSEI regional public health commissioning teams to work with non-submitting PND laboratories to enable data submission in screening year 2020 to 2021 (FASP-S09). See provider list.

Recommendation 17

PHE Screening to review data collection arrangements as part of major review of standards in screening year 2020 to 2021.

Recommendation 18

NHSEI regional public health commissioning teams to work with providers not meeting the acceptable threshold (IDPS-S06). See provider list.

Recommendations relating to intervention or treatment

Recommendation 19

NHSEI regional public health commissioning team to work with the provider in the Midlands and East where data was excluded to enable data submission in screening year 2020 to 2021 (IDPS-S07a and IDPS-S07b). See provider list.

Recommendation 20

NHSEI regional public health commissioning teams to work with providers in all regions to meet as a minimum the acceptable threshold (IDPS-S07a, IDPS-S07b). See provider list.

Recommendation 21

NHSEI regional public health commissioning teams to work with providers to make sure all centres treating babies implement the SCT NBO system (SCT-S09).

SCT antenatal data return form

Antenatal data return form part 2 – breakdown of women with a screen positive result

A matrix grid for use to determine pregnancies at risk of a clinically significant disorder. Mother’s antenatal results are matched to the father’s antenatal result and inputted into the grid.

The matrix was changed for the 2018 to 2019 return form (see screenshot above) to include orange (for pregnancies at risk of a clinically significant disorder – PND should be offered) or white (minimal risk of a clinically significant disorder). The blue boxes indicate that the biological father is not a carrier. The yellow boxes indicate that the biological father was unavailable for testing or declined testing. The current return form is available on GOV.UK.

List of providers for each recommendation

Recommendation 1

FASP-S01

North

• Bolton NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• South Tees Hospitals NHS Foundation Trust

South

• Royal Devon and Exeter NHS Foundation Trust

FASP-S02

North

• East Lancashire Hospitals NHS Trust

Recommendation 3

London

• King’s College Hospital NHS Foundation Trust

Midlands and East

• University Hospitals Coventry and Warwickshire NHS Trust

Recommendation 4

Midlands and East

• Kettering General Hospital NHS Foundation Trust

Recommendation 5

Midlands and East

• West Suffolk NHS Foundation Trust

North

• South Tyneside and Sunderland NHS Foundation Trust

Recommendation 6

IDPS-S04a, IDPS-S04b and IDPS-S04c

North

• North Tees and Hartlepool Hospitals NHS Foundation Trust

South

• Poole Hospital NHS Foundation Trust

IDPS-S04b

North

• County Durham and Darlington NHS Foundation Trust

Recommendation 7

London

• Lewisham and Greenwich NHS Trust (Lewisham)
• Lewisham and Greenwich NHS Trust (QEH)

Midlands and East

• Milton Keynes University Hospital NHS Foundation Trust
• University Hospitals Birmingham NHS Foundation Trust

North

• The Newcastle Upon Tyne Hospitals NHS Foundation Trust

Recommendation 8

Midlands and East

• Blood Sciences, Walsall Manor Hospital
• Haematology Laboratory, Queen’s Hospital Burton

North

• Blood Sciences, Countess of Chester Hospital
• Haematology, Doncaster Royal Infirmary
• Haematology, Royal Lancaster Infirmary

South

• Haematology Department, Basingstoke and North Hampshire Hospital
• Haematology, Maidstone Hospital
• Haematology, Stoke Mandeville Hospital

Recommendation 9

London

• Haematology, Homerton University Hospital

Midlands and East

• Haematology, Northampton General Hospital
• Pathology, Lister Hospital

North

• Haematology Department, Tameside Hospital
• Haematology, James Cook University Hospital
• Leeds Screening Laboratory, St James’ Hospital (Bradford Teaching Hospitals samples)
• Leeds Screening Laboratory, St James’ Hospital (Leeds Teaching Hospitals samples)

South

• Blood Sciences, Wexham Park Hospital
• Department of Haematology, Queen Elizabeth the Queen Mother Hospital
• Haematology Department, John Radcliffe Hospital
• Haematology, Conquest Hospital and Eastbourne District General Hospital
• Haematology, Great Western Hospital
• Haematology, Weston General Hospital

Recommendation 10

London

• Haematology, King George Hospital

Midlands and East

• Haematology Laboratory, Norfolk and Norwich University Hospital NHS Foundation Trust
• Special Haematology, Hemel Hempstead General Hospital

North

• Blood Sciences, Chesterfield Royal Hospital
• Haematology, Airedale General Hospital
• Haematology, University Hospital of North Durham
• Haematology, Whiston Hospital
• Haematology Department, North Tees and Hartlepool NHS Foundation Trust
• Haematology Laboratory, Blackpool Victoria Hospital

South

• Haematology Department, East Surrey Hospital
• Haematology, Berkshire and Surrey Pathology Services
• Haematology, North Kent Pathology Service
• Laboratory Medicine, Salisbury District Hospital

Recommendation 11

North

• Northern Lincolnshire and Goole NHS Foundation Trust

Recommendation 12

London

• Barts Health NHS Trust (Whipps Cross)
• Chelsea and Westminster Hospital NHS Foundation Trust
• Homerton University Hospital NHS Foundation Trust
• Imperial College Healthcare NHS Trust (QCCH)
• Imperial College Healthcare NHS Trust (St Mary’s)

Midlands and East

• Birmingham Women’s and Children’s NHS Foundation Trust
• East and North Hertfordshire NHS Trust
• George Eliot Hospital NHS Trust
• James Paget University Hospitals NHS Foundation Trust
• Kettering General Hospital NHS Foundation Trust
• Luton and Dunstable University Hospital NHS Foundation Trust
• North West Anglia NHS Foundation Trust (Peterborough)
• Sandwell and West Birmingham Hospitals NHS Trust
• Southend University Hospital NHS Foundation Trust
• The Dudley Group NHS Foundation Trust
• The Royal Wolverhampton NHS Trust
• University Hospitals Birmingham NHS Foundation Trust
• University Hospitals Coventry and Warwickshire NHS Trust
• University Hospitals of Leicester NHS Trust
• Walsall Healthcare NHS Trust

North

• Calderdale and Huddersfield NHS Foundation Trust
• Hull and East Yorkshire Hospitals NHS Trust
• Leeds Teaching Hospitals NHS Trust
• North Tees and Hartlepool NHS Foundation Trust
• Sheffield Teaching Hospitals NHS Foundation Trust
• South Tyneside and Sunderland NHS Foundation Trust
• The Newcastle Upon Tyne Hospitals NHS Foundation Trust

South

• Frimley Health NHS Foundation Trust (Frimley)
• North Bristol NHS Trust
• Salisbury NHS Foundation Trust
• Surrey and Sussex Healthcare NHS Trust
• Royal Berkshire NHS Foundation Trust
• University Hospital Southampton NHS Foundation Trust

Recommendation 13

London

• Barts Health NHS Trust (Newham)
• Barts Health NHS Trust (Royal London)
• Chelsea and Westminster Hospital NHS Foundation Trust
• North Middlesex University Hospital NHS Trust
• The Hillingdon Hospitals NHS Foundation Trust

North

• Bolton NHS Foundation Trust
• Liverpool Women’s NHS Foundation Trust

South

• Dartford and Gravesham NHS Trust
• Oxford University Hospitals NHS Foundation Trust

Recommendation 15

IDPS-S05a

London

• Barts Health NHS Trust (Newham)
• Barts Health NHS Trust (Royal London)
• Barts Health NHS Trust (Whipps Cross)
• Croydon Health Services NHS Trust
• Guy’s and St Thomas’ NHS Foundation Trust
• Imperial College Healthcare NHS Trust (QCCH)
• King’s College Hospital NHS Foundation Trust
• Lewisham and Greenwich NHS Trust (Lewisham)
• Lewisham and Greenwich NHS Trust (QEH)
• Royal Free London NHS Foundation Trust (Barnet)
• University College London Hospitals NHS Foundation Trust

Midlands and East

• George Eliot Hospital NHS Trust
• Luton and Dunstable University Hospitals NHS Foundation Trust
• Milton Keynes University Hospital NHS Foundation Trust
• Nottingham University Hospitals NHS Trust
• Sherwood Forest Hospitals NHS Foundation Trust
• The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust
• The Royal Wolverhampton NHS Trust
• University Hospitals Birmingham NHS Foundation Trust
• Walsall Healthcare NHS Trust

North

• Bolton NHS Foundation Trust
• County Durham and Darlington NHS Foundation Trust
• Harrogate and District NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• Liverpool Women’s NHS Foundation Trust
• Northumbria Healthcare NHS Foundation Trust
• Sheffield Teaching Hospitals NHS Foundation Trust
• Warrington and Halton Hospitals NHS Foundation Trust
• York Teaching Hospital NHS Foundation Trust

South

• Brighton and Sussex University Hospitals NHS Trust
• Gloucestershire Hospitals NHS Foundation Trust
• Medway NHS Foundation Trust
• North Bristol NHS Trust
• Portsmouth Hospitals NHS Trust
• Royal Berkshire NHS Foundation Trust
• The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
• University Hospital Southampton NHS Foundation Trust
• University Hospitals Bristol NHS Foundation Trust

IDPS-S05b

London

• Barking, Havering and Redbridge University Hospitals NHS Trust
• Barts Health NHS Trust (Newham)
• Barts Health NHS Trust (Whipps Cross)
• Chelsea and Westminster Hospital NHS Foundation Trust
• Croydon Health Services NHS Trust
• Epsom and St Helier University Hospitals NHS Trust (St Helier)
• Guy’s and St Thomas’ NHS Foundation Trust
• Homerton University Hospital NHS Foundation Trust
• King’s College Hospital NHS Foundation Trust
• Kingston Hospital NHS Foundation Trust
• Lewisham and Greenwich NHS Trust (Lewisham)
• Lewisham and Greenwich NHS Trust (QEH)
• London North West University Healthcare NHS Trust
• North Middlesex University Hospital NHS Trust
• Royal Free London NHS Foundation Trust (Barnet)
• St George’s University Hospitals NHS Foundation Trust
• University College London Hospitals NHS Foundation Trust

Midlands and East

• Bedford Hospital NHS Trust
• East Suffolk and North Essex NHS Foundation Trust (Ipswich)
• James Paget University Hospitals NHS Foundation Trust
• Luton and Dunstable University Hospital NHS Foundation Trust
• Milton Keynes University Hospital NHS Foundation Trust
• North West Anglia NHS Foundation Trust (Peterborough)
• Northampton General Hospital NHS Trust
• Nottingham University Hospitals NHS Trust
• Sandwell and West Birmingham Hospitals NHS Trust
• Sherwood Forest Hospitals NHS Foundation Trust
• Shrewsbury and Telford Hospital NHS Trust
• The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust
• The Royal Wolverhampton NHS Trust
• University Hospitals Birmingham NHS Foundation Trust
• University Hospitals of Derby and Burton NHS Foundation Trust (Derby)
• University Hospitals of North Midlands NHS Trust
• Walsall Healthcare NHS Trust
• Wye Valley NHS Trust

North

• Bolton NHS Foundation Trust
• Bradford Teaching Hospitals NHS Foundation Trust
• Calderdale and Huddersfield NHS Foundation Trust
• County Durham and Darlington NHS Foundation Trust
• Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
• East Cheshire NHS Trust
• Liverpool Women’s NHS Foundation Trust
• Mid Yorkshire Hospitals NHS Trust
• Northumbria Healthcare NHS Foundation Trust
• Pennine Acute Hospitals NHS Trust
• Sheffield Teaching Hospitals NHS Foundation Trust
• Stockport NHS Foundation Trust
• The Newcastle Upton Tyne Hospitals NHS Foundation Trust
• The Rotherham NHS Foundation Trust
• Warrington and Halton Hospitals NHS Foundation Trust
• York Teaching Hospital NHS Foundation Trust

South

• Brighton and Sussex University Hospitals NHS Trust
• Dorset County Hospital NHS Foundation Trust
• East Kent Hospitals University NHS Foundation Trust
• East Sussex Healthcare NHS Trust
• Frimley Health NHS Foundation Trust (Frimley)
• Gloucestershire Hospitals NHS Foundation Trust
• Great Western Hospitals NHS Foundation Trust
• Hampshire Hospitals NHS Foundation Trust
• Maidstone and Tunbridge Wells NHS Trust
• Medway NHS Foundation Trust
• North Bristol NHS Trust
• Oxford University Hospitals NHS Foundation Trust
• Portsmouth Hospitals NHS Trust
• Royal Berkshire NHS Foundation Trust
• Royal Surrey County Hospital NHS Foundation Trust
• Royal United Hospitals Bath NHS Foundation Trust
• Surrey and Sussex Healthcare NHS Trust
• University Hospital Southampton NHS Foundation Trust
• University Hospitals Bristol NHS Foundation Trust
• Western Sussex Hospitals NHS Foundation Trust

IDPS-S05c

London

• Barking, Havering and Redbridge University Hospitals NHS Trust
• Barts Health NHS Trust (Newham)
• Barts Health NHS Trust (Whipps Cross)
• Croydon Health Services NHS Trust
• Guy’s and St Thomas’ NHS Foundation Trust
• King’s College Hospital NHS Foundation Trust
• Lewisham and Greenwich NHS Trust (Lewisham)
• Lewisham and Greenwich NHS Trust (QEH)
• London North West University Healthcare NHS Trust
• North Middlesex University Hospital NHS Trust
• Royal Free London NHS Foundation Trust (Barnet)
• St George’s University Hospitals NHS Foundation Trust
• University College London Hospitals NHS Foundation Trust

Midlands and East

• Bedford Hospital NHS Trust
• George Eliot Hospital NHS Trust
• James Paget University Hospitals NHS Foundation Trust
• Luton and Dunstable University Hospital NHS Foundation Trust
• Mid Essex Hospital Services NHS Trust
• Milton Keynes University Hospital NHS Foundation Trust
• North West Anglia NHS Foundation Trust (Peterborough)
• Northampton General Hospital NHS Trust
• Nottingham University Hospitals NHS Trust
• Sandwell and West Birmingham Hospitals NHS Trust
• Sherwood Forest Hospitals NHS Foundation Trust
• The Royal Wolverhampton NHS Trust
• United Lincolnshire Hospitals NHS Trust
• University Hospitals Birmingham NHS Foundation Trust
• University Hospitals of North Midlands NHS Trust
• Walsall Healthcare NHS Trust
• West Suffolk NHS Foundation Trust
• Worcestershire Acute Hospitals NHS Trust

North

• Bolton NHS Foundation Trust
• Bradford Teaching Hospitals NHS Foundation Trust
• Harrogate and District NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• Leeds Teaching Hospitals NHS Trust
• Liverpool Women’s NHS Foundation Trust
• Mid Yorkshire Hospitals NHS Trust
• Northumbria Healthcare NHS Foundation Trust
• Pennine Acute Hospitals NHS Trust
• Sheffield Teaching Hospitals NHS Foundation Trust

South

• Brighton and Sussex University Hospitals NHS Trust
• East Kent Hospitals University NHS Foundation Trust
• East Sussex Healthcare NHS Trust
• Frimley Health NHS Foundation Trust (Wexham)
• Gloucestershire Hospitals NHS Foundation Trust
• North Bristol NHS Trust
• Portsmouth Hospitals NHS Trust
• Royal Berkshire NHS Foundation Trust
• Royal Cornwall Hospitals NHS Trust
• Salisbury NHS Foundation Trust
• Western Sussex Hospitals NHS Foundation Trust
• Yeovil District Hospital NHS Foundation Trust

Recommendation 16

• Liverpool Women’s Genetic Laboratory (North West Genomic Laboratory Hub)
• Norfolk and Norwich University Hospitals NHS Foundation Trust (East Genomic Laboratory Hub)
• Great Ormond Street Hospital for Children NHS Foundation Trust (North Thames Genomic Laboratory Hub)
• South West Thames Regional Genetics Laboratory (South East Genomic Laboratory Hub)
• The Doctor’s Laboratory (South East Genomic Laboratory Hub)

Recommendation 18

London

• Chelsea and Westminster Hospital NHS Foundation Trust
• Chelsea and Westminster Hospital NHS Foundation Trust (West Middlesex)
• Epsom and St Helier University Hospitals NHS Trust (St Helier)
• Lewisham and Greenwich NHS Trust (QEH)
• St George’s University Hospital NHS Foundation Trust

Midlands and East

• Kettering General Hospital NHS Foundation Trust
• Mid Essex Hospital Services NHS Trust
• Norfolk and Norwich University Hospitals NHS Foundation Trust
• North West Anglia NHS Foundation Trust (Hinchingbrooke)
• United Lincolnshire Hospitals NHS Trust
• University Hospitals of Derby and Burton NHS Foundation Trust (Derby)

North

• County Durham and Darlington NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• Mid Cheshire Hospitals NHS Foundation Trust
• South Tees Hospitals NHS Foundation Trust
• St Helens and Knowsley Teaching Hospitals NHS Trust
• Tameside and Glossop Integrated Care NHS Foundation Trust
• The Rotherham NHS Foundation Trust
• York Teaching Hospital NHS Foundation Trust

South

• Dorset County Hospital NHS Foundation Trust
• East Sussex Healthcare NHS Trust
• Great Western Hospitals NHS Foundation Trust
• Maidstone and Tunbridge Wells NHS Trust
• North Bristol NHS Trust
• Poole Hospital NHS Foundation Trust
• Portsmouth Hospitals NHS Trust
• Royal Devon and Exeter NHS Foundation Trust
• Western Sussex Hospitals NHS Foundation Trust

Recommendation 19

Midlands and East

• West Suffolk NHS Foundation Trust

Recommendation 20

IDPS-S07a

London

• Barts Health NHS Trust (Newham)
• Homerton University Hospital NHS Foundation Trust
• Imperial College Healthcare NHS Trust (QCCH)
• King’s College Hospital NHS Foundation Trust (PRUH)

Midlands and East

• George Eliot Hospital NHS Trust
• North West Anglia NHS Foundation Trust (Peterborough)
• Nottingham University Hospitals NHS Trust
• Southend University Hospital NHS Foundation Trust
• University Hospitals of North Midlands NHS Trust
• Walsall Healthcare NHS Trust

North

• Bolton NHS Foundation Trust
• East Lancashire Hospitals NHS Trust
• Liverpool Women’s NHS Foundation Trust
• Mid Yorkshire Hospitals NHS Trust
• Sheffield Teaching Hospitals NHS Foundation Trust
• York Teaching Hospital NHS Foundation Trust

South

• East Kent Hospitals University NHS Foundation Trust
• Maidstone and Tunbridge Wells NHS Trust
• Royal Devon and Exeter NHS Foundation Trust
• Salisbury NHS Foundation Trust
• University Hospitals Bristol NHS Foundation Trust

IDPS-S07b:

London

• Barts Health NHS Trust (Newham)
• Croydon Health Services NHS Trust
• Imperial College Healthcare NHS Trust (QCCH)

Midlands and East

• George Eliot Hospital NHS Trust
• Milton Keynes University Hospital NHS Foundation Trust
• The Royal Wolverhampton NHS Trust
• Walsall Healthcare NHS Trust

North

• Sheffield Teaching Hospitals NHS Foundation Trust

South

• Portsmouth Hospitals NHS Trust

Providers where data was excluded for IDPS-S04

• Royal Free London Hospital NHS Foundation Trust (Royal Free)
• Royal Free London Hospital NHS Foundation Trust (Barnet)
• Gateshead Health NHS Foundation Trust
• Northern Lincolnshire and Goole NHS Foundation Trust

Providers where data was excluded for SCT-S04

Reported in calendar days instead of working days

• East and North Hertfordshire NHS Trust
• Tameside and Glossop Integrated Care NHS Foundation Trust

Did not have systems in place that allowed this data to be provided

• East Kent Hospitals
• Great Western Hospitals NHS Foundation Trust
• Oxford University Hospital NHS Foundation Trust
• Northampton General Hospital NHS Trust
• South Tees Hospitals NHS Foundation Trust

Could not separate the referred work from the in-house work

• Leeds Teaching Hospital NHS Trust (Leeds)
• Leeds Teaching Hospital NHS Trust (Bradford)

Only reported samples tested by HPLC

• Weston Area Health NHS Trust

Reported turnaround times that were not based on annual samples

• Frimley Health NHS Foundation Trust (Wexham)
• East Sussex Healthcare Trust

Data quality reasons

• Homerton University Hospital