Official Statistics

Antenatal screening standards: data report 1 April 2020 to 31 March 2021

Published 6 October 2022

Applies to England

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In this report we use ‘screening year 2020 to 2021’ to refer to 1 April 2020 to 31 March 2021.

Introduction

This is the fourth antenatal screening standards data report. It covers the screening year 1 April 2020 to 31 March 2021 and includes trend data where appropriate.

Antenatal screening is offered for 17 different conditions to approximately 650,000 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 non-submitting providers and standards where providers were not meeting the acceptable thresholds. Progress against last year’s recommendations is provided in the accompanying update on recommendations.

Context

This report is delayed due to the abolition of Public Health England (PHE) in October 2021. We recognise that due to this lag in time, public health commissioning teams will be aware of performance reported and recommendations made are likely to be completed or already in progress. For recommendations to national screening programmes, we provide an update on progress where relevant.

This report also covers a period where health services were impacted by the COVID-19 pandemic. Technical guidance issued to antenatal screening services during this period enabled antenatal screening to continue with little impact. Where specific standards were affected, we provide details about this in the specific sections of the report.

The overall number of maternity services decreased by 1, from 143 in screening year 2019 to 2020, to 142 in screening year 2020 to 2021. Please note this when interpreting the tables and graphs in this report.

Improvements

Despite the challenges above, we continued to see improvements in antenatal screening year on year. Data completeness improved in the following areas:

  • FASP coverage data
  • standards FASP-S05 and IDPS-S04 test turnaround times, where for the first time all laboratories submitted data
  • standard SCT-S04 test turnaround time data

We also saw improvements in performance across most of the standards, including:

  • the standards for coverage and test turnaround times, where performance in England met the achievable thresholds
  • timely neonatal hepatitis B vaccination (standards IDPS-S07a), where the achievable threshold was met
  • the detection rate for specified serious cardiac anomalies (standard FASP-S04) where the threshold was exceeded

Recommendations

The 3 antenatal screening programmes and the screening quality assurance service (SQAS) working with the screening data managers reviewed the data and jointly developed these recommendations.

This year we make 21 recommendations and focus on:

  • improving data completeness and data (recommendations 1, 5, 9, 10, 20 and 21)
  • meeting the acceptable or achievable thresholds (recommendations 3, 6, 8, 11, 12, 13, 16 and 19)
  • reviewing standards definitions or data sources (recommendations 2, 4, 7, 14, 15, 17 and 18)

Acknowledgements

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 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 Diseases Registration Service (NCARDRS) and the Integrated Screening Outcomes Surveillance Service (ISOSS) in helping us to monitor and report on the outcome data.

Further information

This report should be read in conjunction with the full standards datasets for screening year 2020 to 2021 for the FASP, IDPS and SCT programmes.

Information about screening standards, service specifications and pathway requirements 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 2020 to 2021.

Terminology

We use the term ‘woman’ throughout. This includes people who do not identify as women but who are pregnant.

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 email 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 (%) 85.2 99.2

Test

The standardised screen positive rate (SPR) for T21/T18/T13 was 2.6% (standard FASP-S03a).

In 2019 to 2020, the crude detection rate (DR) was 79.9% (95% CI 77.6 to 82.3) for the T21 combined test, and 72.7% (95% CI 66.3 to 79.2) for the T21 quadruple test. The DR for the T18/T13 combined test was 85.6% (95% CI 82.5 to 88.7) (standard FASP-S03b).

NCARDRS reported a detection rate of 78.6% for serious cardiac conditions on the fetal anomaly scan in screening year 2019 to 2020 (standard FASP-S04).

Test: performance

Test T21/T18/T13
Turnaround time (FASP-S05) 99.4

In 2020 to 2021, a new standard was introduced on the proportion of inadequate samples received in the laboratory (FASP-S06). Completeness of data was 95.5%, with 21 out of 22 laboratories submitting data.

Referral

Referral Time to intervention
T21/T18/T13 (FASP-S07) 98.8
Fetal anomaly ultrasound, local referral
(FASP-S08a)		 81.1
Fetal anomaly ultrasound, tertiary referral
(FASP-S08b)		 91.6

Diagnosis or intervention

Test %
QFPCR T21/T18/T13 results reported within 3 calendar days of sample receipt (FASP-S09a) 86.3
Karyotype T21/T18/T13 results reported within 14 calendar days of sample receipt (FASP-S09b) 75.6
QFPCR fetal anomaly ultrasound results reported within 3 calendar days of sample receipt (FASP-S09c) 83.5
Karyotype fetal anomaly ultrasound reported within 14 calendar days of sample receipt (FASP-S09d) 79.3

†QFPCR is quantitative fluorescence-Polymerase chain reaction

IDPS summary

Coverage

99.8% of women had a confirmed screening result available at the day of report (IDPS-S01, IDPS-S02, IDPS-S03).

Test: turnaround times

99.4% of results were reported less than or equal to 8 working days of sample receipt (IDPS-S04).

Screen positive rates

Data shows that:

  • 0.96 per 1,000 eligible pregnant women screened positive for human immunodeficiency virus (HIV)
  • 3.38 per 1,000 eligible pregnant women screened positive for hepatitis B
  • 1.59 per 1,000 eligible pregnant women screened positive for syphilis

Referral

Condition Women with screen positive results attending a screening assessment at less than or equal to 10 working days %
HIV (IDPS-S05a) 91.6
Hepatitis B (IDPS-S05b) 93.3
Syphilis (IDPS-S05c) 93.3

Diagnosis or intervention

85.9% of women with hepatitis B attended specialist assessment within 6 weeks (IDPS-S06).

Intervention or treatment

%
Babies requiring hepatitis B vaccination receiving first dose at less than or equal to 24 hours % (IDPS-S07a) 99.2
Babies requiring immunoglobulin receiving it at less than or equal to 24 hours % (IDPS-S07b) 97.6

SCT summary

Coverage

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

Test

%
Timeliness of screening: results available at less than or equal to 10 weeks +0 days (SCT-S02) 51.3
Completion of family origin questionnaire (FOQ): antenatal samples for SCT testing received (SCT-S03) 97.7
Test turnaround time: less than or equal to 3 working days (SCT-S04) 95.3

Referral

Data shows that:

  • 47.4% of women at risk of having an infant with sickle cell disease or thalassaemia were offered prenatal diagnosis (PND) at less than or equal to 12 weeks +0 days (SCT-S05a)
  • 61.4% of couples at risk of having an infant with sickle cell disease or thalassaemia offered PND at less than or equal to 12 weeks +0 days (SCT-S05b)

Diagnosis or intervention

48.2% of PND tests performed at less than or equal to 12 weeks +6 days (SCT-S06).

Test: results

%
Women receiving PND results: at less than or equal to 5 working days of PND test (SCT-S07) 77.5
Newborn screen positive results to parents: at less than or equal to 28 days of age (SCT-S08) 85.7

Intervention or treatment

91.3% newborn infants with a positive screening result were seen at a paediatric clinic or discharged for insignificant results at less than or equal to 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 recommendation 1 (relating to coverage) in the recommendations section.

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

The overall number of maternity services decreased by 1, from 143 in screening year 2019 to 2020, to 142 in screening year 2020 to 2021. Please note this when interpreting the tables and graphs.

Figure 1: Antenatal screening, coverage standards, performance against thresholds, screening year 2020 to 2021, England

Standard Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
FASP-S02 135 1 0 6 142
IDPS-S01 139 1 0 2 142
IDPS-S02 139 1 0 2 142
IDPS-S03 139 1 0 2 142
SCT-S01 136 4 0 2 142

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

Performance thresholds for standard FASP-S02 are:

  • acceptable: greater than or equal to 90.0%
  • achievable: greater than or equal to 95.0%

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

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 99.0%

Figure 2: FASP-S01: Coverage: T21/T18/T13 screening, completeness, screening year 2020 to 2021, by region

Region Number of accepted returns No return/data excluded Total
London 26 0 26
Midlands and East 37 3 40
North 38 3 41
South 34 1 35

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 (see the screening glossary of terms for women.

Table 1 (a to c): FASP-S02: Coverage: 18+0 to 20+6 week screening scan, performance, screening year 2018 to 2019 to screening year 2020 to 2021, by region


Table 1a: 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
Table 1b: 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
Table 1c: 2020 to 2021
Regional summary Numerator Denominator Performance (%)
London 108,213 109,173 99.1
Midlands and East 158,636 159,849 99.2
North 144,322 145,357 99.3
South 128,880 130,027 99.1
England 540,051 544,406 99.2

Figure 3: FASP-S02: Coverage: 18+0 to 20+6 week screening scan, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London 25 0 0 1 26
Midlands and East 39 0 0 1 40
North 38 0 0 3 41
South 33 1 0 1 35

Performance thresholds are:

  • acceptable: greater than or equal to 90.0%
  • achievable: greater than or equal to 95.0%

Table 2: IDPS-S01: Coverage: HIV, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 135,985 136,200 99.8
Midlands and East 180,671 181,076 99.8
North 172,379 172,830 99.7
South 153,399 153,750 99.8
England 642,434 643,856 99.8

Figure 4: IDPS-S01: Coverage: HIV, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London 26 0 0 0 26
Midlands and East 39 0 0 1 40
North 39 1 0 1 41
South 35 0 0 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 99.0%

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

Region Numerator Denominator Performance (%)
London 135,979 136,186 99.8
Midlands and East 180,683 181,079 99.8
North 172,384 172,831 99.7
South 153,402 153,749 99.8
England 642,448 643,845 99.8

Figure 5: IDPS-S02: Coverage: hepatitis B, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London 26 0 0 0 26
Midlands and East 39 0 0 1 40
North 39 1 0 1 41
South 35 0 0 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 99.0%

Table 4: IDPS-S03: Coverage: syphilis, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 135,971 136,180 99.8
Midlands and East 180,674 181,077 99.8
North 172,388 172,834 99.7
South 153,400 153,749 99.8
England 642,433 643,840 99.8

Figure 6: IDPS-S03: Coverage: syphilis, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London 26 0 0 0 26
Midlands and East 39 0 0 1 40
North 39 1 0 1 41
South 35 0 0 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 99.0%

Table 5: SCT-S01: Coverage: antenatal screening, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 135,896 136,125 99.8
Midlands and East 180,571 181,055 99.7
North 172,220 172,789 99.7
South 153,228 153,703 99.7
England 641,915 643,672 99.7

Figure 7: SCT-S01: Coverage: antenatal screening, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London 26 0 0 0 26
Midlands and East 38 1 0 1 40
North 38 2 0 1 41
South 34 1 0 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 99.0%

Of those submitting data:

  • all providers met the acceptable threshold for all the coverage standards
  • all regions and England met the achievable threshold for all coverage indicators

We have continued to see year on year improvement in data completeness for the FASP coverage standards. Completeness of data for standard FASP-S01 across England increased year on year in the last 3 years, from 88.8% in screening year 2019 to 2020, to 95.1% in screening year 2020 to 2021. Improvement was seen especially in the North in the last year.

There were 7 providers (3 in Midlands and East, 3 in the North, and 1 in the South) that did not submit complete data. Of these, 3 submitted no data, 3 submitted data for some quarters but not all, and 1 data return was excluded.

Performance for standard FASP-S02 increased slightly over the last year, from 99.1% in screening year 2019 to 2020 to 99.2% in screening year 2020 to 2021. Data completeness also improved from 93.7% in screening year 2019 to 2020 to 95.8% in screening year 2020 to 2021. The data shows as completeness improves, the number of eligible women having the 20-week screening scan completed increases.

The number of non-submitting providers decreased from 9 to 6 in the last year. Of the 6 providers that did not submit complete data, 2 providers submitted no data (1 in London and 1 in the North), 3 submitted for some quarters but not all (2 in the North and 1 in the South), and 1 data return from the Midlands and East was excluded.

One provider in the South did not meet the achievable threshold for standard FASP-S02.

One provider in the North did not meet the achievable threshold for standards IDPS-S01, IDPS-S02 and IDPS-S03.

One provider in the North submitted data for some quarters but not all for standards IDPS-S01, IDPS-S02, IDPS-S03 and SCT-S01.

One provider in Midlands and East was excluded due to data quality issues.

For standard SCT-S01, 4 providers (1 in Midlands and East, 2 in the North, and 1 in the South) did not meet the achievable threshold. Two of these providers also did not meet the achievable threshold in screening year 2019 to 2020.

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 11 recommendations relating to test in the recommendations section.

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 2020 to 2021, England

The line graph in Figure 8 above shows an increase in screen positive rates from 2.2% in screening year 2015 to 2016 to 3.1% in screening year 2018 to 2019. There was a decrease from screening year 2018 to 2019 to screening year 2020 to 2021 to 2.6%.

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 2019 to 2020, England

Detection rate (95% confidence interval (CI)) 2015 to 2016 2016 to 2017 2017 to 2018 2018 to 2019 2019 to 2020
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)		 79.9%
(77.6-82.3)
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)		 72.7% (66.3-79.2)
T18/T13 combined test - - 81.1%
(77.5-84.3)		 80.2%
(75.8-84.6)		 85.6% (82.5-88.7)

NCARDRS collects data on detection rates for the FASP 11 physical conditions, includes standard FASP-S04.

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 2019 to 2020, by region

The chart in Figure 9 above shows all regions had a detection rate above 65.0% within the screening window, which is higher than the acceptable threshold of 50.0%. When early detections are included, all regions had a detection rate above 75.0%.

Figure 10: FASP-S05: Test: turnaround time T21/T18/T13 screening, performance by laboratory, screening year 2020 to 2021

Data completeness and performance improved in screening year 2020 to 2021. Figure 10 above shows all laboratories submitted data for screening year 2020 to 2021, and all met or exceeded the acceptable threshold of 97.0% of results reported within 3 working days of sample receipt in the laboratory.

The overall performance for England was 99.4%, meeting the achievable threshold of 99.0%.

FASP-S06: Test: inadequate samples for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome

In April 2020, NHS FASP introduced a new standard, FASP-S06, which measures the proportion of samples received in the laboratory that were inadequate for testing either due to a problem with the blood sample or due to missing information required to calculate a screening result. The data is collected quarterly as the KPI FA4 and submitted by screening laboratories for all the maternity services in England.

In the first year of data collection, we encountered the following data quality issues:

  • some laboratories could not split the data by combined and quadruple samples
  • non or partial submission of data
  • missing data for some maternity services when testing arrangements between laboratories changed
  • data validation check failures

These issues were followed up and resolved with the individual laboratories.

On average the performance for England in screening year 2020 to 2021 was 3.9%, however there was a clear difference between samples for combined testing (average 3.5%) and quadruple testing (average 8.5%).

Completeness of data in screening year 2020 to 2021 was 95.5%, with 21 out of 22 laboratories submitting data.

As part of the KPI collection, data is also submitted on the individual data fields on the sample request forms that are essential for calculating the chance result. This data can be used by FASP and SQAS to target quality improvement work on any problem areas.

Table 7 (a to c): IDPS-S04: Test: turnaround times for HIV, hepatitis B, and syphilis, performance, screening year 2020 to 2021, by region


Table 7a: IDPS-S04a: HIV
Region Numerator Denominator Performance (%)
London 134,974 135,376 99.7
Midlands and East 200,858 201,369 99.7
North 160,979 163,608 98.4
South 163,545 163,940 99.8
England 660,356 664,293 99.4
Table 7b: IDPS-S04b: hepatitis B
Region Numerator Denominator Performance (%)
London 135,604 136,074 99.7
Midlands and East 198,483 198,958 99.8
North 161,120 163,992 98.2
South 163,642 164,012 99.8
England 658,849 663,036 99.4
Table 7c: IDPS-S04c: syphilis
Region Numerator Denominator Performance (%)
London 134,199 134,769 99.6
Midlands and East 198,976 199,472 99.8
North 161,087 163,631 98.4
South 163,542 163,996 99.7
England 657,804 661,868 99.4

Figure 11: IDPS-S04: Test: turnaround times for HIV, hepatitis B, and syphilis, performance against thresholds, screening year 2020 to 2021, by region

Region and Standard Performance greater than or equal to acceptable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London IDPS-S04a 25 1 0 0 26
London IDPS-S04b 25 1 0 0 26
London IDPS-S04c 26 0 0 0 26
Midlands and East IDPS-S04a 39 0 0 1 40
Midlands and East IDPS-S04b 39 0 0 1 40
Midlands and East IDPS-S04c 39 0 0 1 40
North IDPS-S04a 35 1 2 3 41
North IDPS-S04b 35 1 2 3 41
North IDPS-S04c 34 2 2 3 41
South IDPS-S04a 34 0 1 0 35
South IDPS-S04b 34 0 1 0 35
South IDPS-S04c 34 0 1 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 97.0%

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

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

All providers submitted data in screening year 2020 to 2021.

Some data submissions were excluded as the laboratories:

  • had a system change therefore could not provide data for the whole year (1 laboratory)
  • could not distinguish antenatal samples from all samples received in the laboratory (1 laboratory)
  • did not have full data available (1 laboratory)

Three laboratories did not meet the acceptable threshold for at least one part of standard IDPS-S04. This was due to:

  • the impact of the COVID-19 pandemic (1 laboratory)
  • instrument failure which mean samples were sent to an external laboratory for analysis (1 laboratory)
  • not having an electronic link between the screening laboratory and maternity services (1 laboratory)

The line graph in Figure 12 above shows 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. There was a decrease in performance to 51.3% for screening year 2020 to 2021.

Performance thresholds are:

  • acceptable: greater than or equal to 50.0%
  • achievable: greater than or equal to 75.0%

Data suggests that while services were maintained, performance for this standard was affected during the COVID-19 pandemic. This is not unexpected as technical guidance in place at the time meant that services could offer screening later than the specified timeframes.

Due to inconsistencies in the way that standard 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 7 years is shown above.

Table 8: SCT-S03: Test: completion of family origin questionnaire (FOQ), performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 125,989 129,509 97.3
Midlands and East 185,904 189,134 98.3
North 169,559 173,846 97.5
South 151,823 155,687 97.5
England 633,275 648,176 97.7

Figure 13: SCT-S03: Test: completion of family origin questionnaire (FOQ), performance against thresholds, screening year 2020 to 2021, by region

Region Performance over achievable Performance between acceptable and achievable Performance less than acceptable No return/data excluded Total
London 17 4 4 1 26
Midlands and East 15 22 2 1 40
North 12 25 3 1 41
South 11 19 5 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 95.0%
  • achievable: greater than or equal to 99.0%

Of those submitting data, 39.3% (55 out of 139) met the achievable threshold, but no region nor England met this threshold (see figure 13 above).

Figure 14: SCT-S03: Test: completion of FOQ, performance against thresholds, screening year 2017 to 2018 to screening year 2020 to 2021

Figure 14 above shows that 2 providers, compared to 7 last year, did not submit data; these were providers that submitted data for some quarters but not all. One provider in Midlands and East was excluded due to data quality issues.

Of those providers submitting data in screening year 2020 to 2021, 14 did not meet the acceptable threshold. Three of these also did not meet the acceptable threshold in screening year 2019 to 2020, and 3 also did not meet the acceptable threshold in both screening years 2019 to 2020 and 2018 to 2019.

Table 9: SCT-S04: Test: turnaround time (antenatal screening), performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 109,518 110,264 99.3
Midlands and East 175,100 180,514 97.0
North 174,237 184,526 94.4
South 110,657 122,376 90.4
England 569,512 597,680 95.3

Figure 15: SCT-S04: Test: turnaround time (antenatal screening), performance against thresholds, screening year 2020 to 2021.

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable Data excluded No return Total
London 12 0 0 1 1 14
Midlands and East 26 2 2 2 2 34
North 27 1 7 2 0 37
South 18 0 6 4 1 29

Performance thresholds are:

  • acceptable: greater than or equal to 90.0%
  • achievable: greater than or equal to 95.0%

The number of non-submitting laboratory providers decreased by half from the previous screening year (2019 to 2020). Four laboratories (1 in London, 2 in the Midlands and East, and 1 in the South) did not submit data.

The number of data submissions excluded because they did not meet the definition of the standard has reduced from 13 in screening year 2019 to 2020 to 9 in screening year 2020 to 2021. Of these 9 laboratories, the reasons for exclusion were because they:

  • reported turnaround times that were not based on annual samples (3 laboratories)
  • did not have systems that allowed this data to be provided (2 laboratories)
  • reported in calendar days instead of working days (1 laboratory)
  • had data quality issues (3 laboratories). One of these is the same as screening year 2019 to 2020.

The number of data submissions excluded because they did not meet the definition of the standard has reduced from 13 in screening year 2019 to 2020 to 9 in screening year 2020 to 2021.

Region 2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021
London 90.6 98.5 97.7 99.3
Midlands and East 93.4 94.0 96.8 96.1
North 95.8 95.3 93.7 94.4
South 94.6 96.5 89.9 90.4
England 93.9 95.8 94.9 95.0

In screening year 2020 to 2021, 95.3% of tests were turned around in 3 working days (meeting the achievable threshold), a slight increase from 94.9% in screening year 2019 to 2020. London and Midlands and East improved their performance between screening year 2017 to 2018 and screening year 2020 to 2021.

Figure 16 above shows that of those laboratories submitting data, 15 did not meet the acceptable threshold in 2020 to 2021, an increase compared to 13 in screening year 2019 to 2020.

Table 11 (a to c): SCT-S07: Test: timely reporting of PND results to parents, performance, screening years 2018 to 2019 to 2020 to 2021, by region


Table 11a: 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
Table 11b: 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 11c: 2020 to 2021
Region Number of no returns Numerator Denominator Performance (%)
London 0 150 194 77.3
Midlands and East 0 56 75 74.7
North 0 42 51 82.4
South 0 38 49 77.6
England 0 286 369 77.5

Performance for England overall has decreased from 80.3% in screening year 2019 to 2020 to 77.5% in screening year 2020 to 2021. This decrease is most likely due to the impact of the national genomics reconfiguration. All regions met the acceptable threshold in screening year 2020 to 2021 but performance in all regions decreased, apart from Midlands and East that improved from screening year 2019 to 2020.

Figure 17: SCT-S07: Test: timely reporting of PND results to parents, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No cases identified No return / data excluded Total
London 11 2 12 1 0 26
Midlands and East 17 1 9 13 0 40
North 13 1 5 21 0 40
South 11 0 5 19 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 70.0%
  • achievable: greater than or equal to 90.0%

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

This is a small number standard and all regions had providers with no cases in 2020 to 2021.

Table 12: SCT-S08: Test: reporting newborn screen positive results to parents, performance, screening year 2020 to 2021, England

Numerator Denominator Performance (%) Exclusions from the denominator due to missing data
168 296 85.7 43

NCARDRS collects data on newborn outcomes for the SCT programme, including SCT-S08.

There were 43 infants with missing data. This is similar to screening year 2019 to 2020, when there were 46 infants with missing data.

Figure 18: SCT-S08: Test: reporting newborn screen positive results to parents, screening year 2020 to 2021, England

Measure Where parents received newborn screen positive results at less than or equal to 28 days of age Where parents received newborn screen positive results at greater than 28 days of age With newborn screen positive result where age parents received result is missing Total
Number of infants 168 28 43 239

Performance thresholds are:

  • acceptable: greater than or equal to 90.0%
  • achievable: greater than or equal to 95.0%

The data is incomplete for screening year 2020 to 2021 and work is ongoing to capture complete data through the newborn outcomes (NBO) system in the future.

Referral

This section covers standards FASP-S07, FASP-S08, IDPS-S05, and SCT-S05. See the 5 recommendations relating to referral in the recommendations section.

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

Table 13: FASP-S07: Referral: time to intervention T21/T18/T13 screening, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 3,367 3,429 98.2
Midlands and East 4,177 4,211 99.2
North 3,437 3,473 99.0
South 3,984 4,030 98.9
England 14,965 15,143 98.8

Figure 19: FASP-S07: Referral: time to intervention T21/T18/T13 screening, performance against thresholds, screening year 2020 to 2021, by region

Region Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No return/data excluded Total
London 16 2 8 0 26
Midlands and East 27 10 3 0 40
North 30 4 6 0 40
South 25 5 5 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 97.0%
  • achievable: greater than or equal to 99.0%

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

All providers submitted data.

Performance for England improved from 98.1% in screening year 2019 to 2020, to 98.8% in screening year 2020 to 2021.

The North and Midlands and East regions met the achievable threshold of 99.0%.

All regions met the acceptable threshold with the number of providers meeting this threshold increasing compared to last year (31 compared to 22). All regions had providers that did not meet the acceptable threshold.

Of the 22 providers not meeting the acceptable threshold, 15 providers did not meet the acceptable threshold the previous year, and 10 of these have not met the acceptable threshold for 4 consecutive years.

There is inconsistency with some providers counting the offer of the appointment and others counting the appointment date being within 3 working days.

Table 14: FASP-S08a: Referral: time to intervention 18+0 to 20+6 fetal anomaly ultrasound, local referral, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 733 829 88.4
Midlands and East 2,108 2,619 80.5
North 1,325 1,844 71.9
South 1,121 1,231 91.1
England 5,287 6,523 81.1

Figure 20: FASP-S08a: Referral: time to intervention 18+0 to 20+6 fetal anomaly ultrasound), local referral, performance against threshold, screening year 2020 to 2021, by region

Region Performance ≥ acceptable Performance < acceptable No cases identified No return/data excluded Total
London 15 9 1 1 26
Midlands and East 9 25 6 0 40
North 13 19 6 2 40
South 13 16 6 0 35

Performance threshold:

  • acceptable: greater than or equal to 97.0%

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

Table 15: FASP-S08b: Referral: time to intervention 18+0 to 20+6 fetal anomaly ultrasound, tertiary referral, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 370 379 97.6
Midlands and East 1,005 1,099 91.4
North 979 1,128 86.8
South 758 792 95.7
England 3,112 3,398 91.6

Figure 21: FASP-S08b: Referral: time to intervention 18+0 to 20+6 fetal anomaly ultrasound, tertiary referral, performance against threshold, screening year 2020 to 2021, by region

Region Performance greater than or equal to acceptable Performance less than acceptable No cases identified No return/data excluded Total
London 14 3 8 1 26
Midlands and East 21 11 8 0 40
North 7 24 7 2 40
South 21 6 8 0 35

Performance threshold:

  • acceptable: greater than or equal to 97.0%

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

Completeness of data improved for this standard. In screening year 2020 to 2021, there were 3 providers that did not report for standard FASP-S08a and 2 providers who did not report for standard FASP-S08b.

The acceptable threshold was not met for 69 providers (49.3%) for standard FASP-S08a and 44 providers (31.4%) for standard FASP-S08b. No region met the acceptable threshold for FASP-S08a. London was the only region that met the acceptable threshold for standard FASP-S08b.

We are aware that there are data quality issues for this standard.

Table 16 (a to c): IDPS-S05: Referral: timely assessment of screen positive and known positive women, performance, screening year 2020 to 2021, by region


Table 16a: IDPS-S05a: HIV
Region Numerator Denominator Performance (%)
London 195 200 97.5
Midlands and East 150 177 84.7
North 125 131 95.4
South 99 113 87.6
England 569 621 91.6
Table 16b: IDPS-S05b: hepatitis B
Region Numerator Denominator Performance (%)
London 831 878 94.6
Midlands and East 540 602 89.7
North 399 421 94.8
South 295 313 94.2
England 2,065 2,214 93.3
Table 16c: IDPS-S05c: syphilis
Region Numerator Denominator Performance (%)
London 226 238 95.0
Midlands and East 251 286 87.8
North 325 336 96.7
South 149 159 93.7
England 951 1,019 93.3

Figure 22: IDPS-S05: Referral: timely assessment of screen positive and known positive women, performance against thresholds, screening year 2020 to 2021, by region


Region and Standard Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No cases identified No return / data excluded Total
London IDPS-S05a 19 0 5 2 0 26
London IDPS-S05b 11 2 13 0 0 26
London IDPS-S05c 17 0 9 0 0 26
Midlands and East IDPS-S05a 28 0 8 4 0 40
Midlands and East IDPS-S05b 25 1 14 0 0 40
Midlands and East IDPS-S05c 25 0 11 3 1 40
North IDPS-S05a 22 0 5 13 0 40
North IDPS-S05b 26 1 10 3 0 40
North IDPS-S05c 31 1 6 2 0 40
South IDPS-S05a 24 0 7 4 0 35
South IDPS-S05b 25 0 8 2 0 35
South IDPS-S05c 24 0 9 2 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 97.0%
  • achievable: greater than or equal to 99.0%

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

Due to the COVID-19 pandemic, guidance was changed to include virtual as well as face to face appointments for women with a screen positive result. Women who were contacted within 10 working days by phone have been included in table 18.

Phone appointments were added for 2 women who screened positive for HIV, 40 for hepatitis B, and 18 for syphilis. Performance reduces for standards IDPS-S05a and IDPS-S05b to 91.4%, and to 90.9% for standard IDPS-S05c when these women are removed from the numerator.

In previous years, the performance for those submitting data shows that standard IDPS-S05a (HIV) performs better than those for hepatitis B (S05b) and syphilis (S05c). This likely reflects long established pathways for HIV. The pathways for hepatitis B and syphilis continue to improve, and performance is now closer between the 3 infections.

Performance remained below the acceptable threshold for every region for the last 5 years, apart from London, who met the threshold for standard IDPS-S05a in screening year 2020 to 2021.

All providers submitted data for this standard. Data was excluded for one provider due to data quality issues.

The line graph in Figure 23 above shows that performance for standard IDPS-S05 for women who screen positive for HIV is better than women who screen positive for hepatitis B and syphilis. Performance for each infection has become more similar since screening year 2019 to 2020.


The line graphs in Figure 24 (a to c) above show the regional trend lines for each part of standard IDPS-S05 separately (for HIV, hepatitis B and syphilis).

We identified 2 antenatal screening standards (FASP-S07 and IDPS-S05) where the thresholds for England were not being met. We wanted to better understand the reasons for this, so we carried out an audit on maternity services, with the aim of driving improvement. We set out to identify if non-attainment of the standard was due to a service issue, such as capacity, or whether some form of health inequity existed. The audit report will be published on GOV.UK in due course.

Table 17 (a to b): 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 2020 to 2021, by region


Table 17a: SCT-S05a: The proportion of women at risk offered PND by 12 weeks + 0 days gestation
Region Numerator Denominator Performance (%)
London 547 1,115 49.1
Midlands and East 216 514 42.0
North 104 176 59.7
South 56 143 39.2
England 924 1,948 47.4
Table 17b: SCT-S05b: The proportion of couples at risk offered PND by 12 weeks + 0 days gestation
Region Numerator Denominator Performance (%)
London 272 455 59.8
Midlands and East 144 248 58.1
North 126 178 70.8
South 70 116 60.3
England 612 997 61.4

Figure 25: 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 2020 to 2021, by region


Region Data included No cases identified One or more return missing Total
London SCT-S05a 26 0 0 26
London SCT-S05b 26 0 0 26
Midlands and East SCT-S05a 29 10 1 40
Midlands and East SCT-S05b 32 7 1 40
North SCT-S05a 22 18 1 41
North SCT-S05b 27 13 1 41
South SCT-S05a 24 11 0 35
South SCT-S05b 22 13 0 35

We have identified data quality issues with the submitted data for standard SCT-S05 (ST4) and recommend you do not compare regional or individual maternity service performances. The above figure presents the data completeness for this standard.

There was 1 provider that submitted data for some quarters but not all. One provider was excluded due to data quality issues.

Diagnosis or intervention

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

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

Table 18: FASP-S09: Diagnosis or intervention: diagnostic tests, screening year 2015 to 2016 to screening year 2020 to 2021, England

Standard 2015 to 2016 2016 to 2017 2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021
9a – QFPCR† testing for higher chance T21/T18/T13 97.1 89.8 90.1 87.7 86.7 86.3
9b – Karyotype testing for higher chance T21/T18/T13 82.1 82.7 81.0 86.0 76.8 75.6
9c – QFPCR† testing for 18+0 to 20+6 week screening scan 91.3 84.0 84.2 83.9 77.2 83.5
9d – Karyotype testing for 18+0 to 20+6 week screening scan 82.2 86.2 86.8 87.9 82.5 79.3
Number of submissions 15/18 16/18 15/18 15/18 13/18 13/18

Figure 26: FASP-S09: Diagnosis or intervention: diagnostic tests, screening year 2020 to 2021, England


Standard Performance greater than or equal to acceptable Performance less than acceptable No cases identified No return/data excluded Total
FASP-S09a 4 7 0 1 12
FASP-S09b 3 9 0 1 13
FASP-S09c 4 6 0 2 12
FASP-S09d 4 8 0 1 13

Please note that for Figure 26, standards FASP-S09a and FASP-S09c have 2 laboratory’s data combined.

Performance threshold:

  • acceptable: greater than or equal to 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 T21, T18 or T13.

Data for 2020 to 2021 was submitted by a combination of both individual laboratories and Genomic Laboratory Hubs which reported data for more than one laboratory. Only 1 laboratory did not return data for standard FASP-S09 in screening year 2020 to 2021.

Table 19: IDPS-S06: Diagnosis or intervention: timely assessment of women with hepatitis B, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%)
London 218 249 87.6
Midlands and East 221 270 81.9
North 142 159 89.3
South 90 103 87.4
England 671 781 85.9

Figure 27: IDPS-S06: Diagnosis or intervention: timely assessment of women with hepatitis B, performance against thresholds, screening year 2020 to 2021, by region


Region Performance greater than or equal to achievable Performance greater than or equal to achievable and less than acceptable Performance less than acceptable No cases identified No return/data excluded Total
London 13 6 6 1 0 26
Midlands and East 23 7 7 2 1 40
North 23 3 5 9 1 41
South 22 1 7 5 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 70.0%
  • achievable: greater than or equal to 90.0%

Since 2016 to 2017, standard 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.

The line graph in Figure 28 above shows that performance for standard IDPS-S06 in England improved from screening year 2014 to 2015 to screening year 2017 to 2018 and has since remained stable up to screening year 2020 to 2021.

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

The line graph in Figure 29 above shows the regional performance for standard IDPS-S06 between screening year 2014 to 2015 and screening year 2020 to 2021.

Of those submitting data, the number of providers not meeting the acceptable threshold decreased from 28 in screening year 2019 to 2020 to 25 in screening year 2020 to 2021.

The number of providers submitting data that met the achievable threshold has increased from 75 in screening year 2019 to 2020 to 81 in screening year 2020 to 2021.

There was 1 provider that submitted data for some quarters but not all. One provider excluded due to data quality issues.

Figure 30: IDPS-S06: Diagnosis or intervention: the number of women newly diagnosed with hepatitis B or known to be living with hepatitis B with high infectivity markers not seen within the timeframe, England, screening year 2016 to 2017 to screening year 2020 to 2021

The line graph in Figure 30 above shows that overall in screening year 2020 to 2021, 110 women who were newly diagnosed with hepatitis B or known to be living with hepatitis B with high infectivity markers were not seen within the target timeframe. This is an improvement from screening year 2019 to 2020 when 130 women were not seen within the target timeframe.

Note that IDPS-S06 is a small number standard and should be interpreted with caution.

Table 20: SCT-S06: Diagnosis or intervention: timeliness of PND, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%) Exclusions from the denominator due to missing data
London 107 213 50.2 4
Midlands and East 29 72 40.3 6
North 21 46 45.7 3
South 28 51 54.9 0
Unknown 1 4 25.0 0
England 186 386 48.2* 13

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


Measure Performed at less than or equal to 12 weeks + 6 days gestation Performed at greater than 12 weeks + 6 days gestation Where gestation at PND is unknown Total
Number of PND tests 186 200 13 399

NCARDRS collects data on PND procedures and outcomes for the SCT programme, including SCT-S06.

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, and hospital is where the PND sample was taken, or CCG information if booking hospital information was unavailable.

This standard was collected at the national level for the first time in 2017 to 2018. There were 13 women where gestation at time of PND test was unknown. This has increased from screening year 2019 to 2020 when there were 4 women whose gestation was unknown at time of PND test.

Figure 32: Proportion of PND tests performed by gestation, England, screening year 2008 to 2009 to screening year 2020 to 2021

Figure 32 above shows that the performance for standard SCT-S06 in screening year 2020 to 2021 has improved from screening year 2019 to 2020 where performance was 41.4%.

Figure 33: Number of PND tests performed, England, screening year 2008 to 2009 to screening year 2020 to 2021

The line chart in Figure 33 above shows that since data collection in 2008 to 2009, the number of PND tests performed peaked in 2014 to 2015 (433 tests), and had the lowest number in 2018 to 2019 (341). Numbers increased to 360 in 2019 to 2020 and again to 399 in 2020 to 2021.

Intervention or treatment

This section relates to standards IDPS-S07 and SCT-S09. See the 1 recommendation related to intervention or treatment in the recommendations section below.

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

Table 21 (a to b): IDPS-S07: Intervention or treatment: timely neonatal hepatitis B vaccination and immunoglobulin, performance, screening year 2020 to 2021, by region


Table 21a: IDPS-S07a: vaccination
Region Numerator Denominator Performance (%)
London 756 760 99.5
Midlands and East 484 489 99.0
North 319 322 99.1
South 275 278 98.9
England 1,834 1,849 99.2
Table 21b: IDPS-S07b: immunoglobulin
Region Numerator Denominator Performance (%)
London 84 86 97.7
Midlands and East 46 46 100.0
North 37 37 100.0
South 36 39 92.3
England 203 208 97.6

Figure 34: IDPS-S07: Intervention or treatment: timely neonatal hepatitis B vaccination (a) and immunoglobulin (b), performance against thresholds, screening year 2020 to 2021, by region


Region and Standard Performance greater than or equal to achievable Performance greater than or equal to acceptable and less than achievable Performance less than acceptable No cases identified No return or data excluded Total
London IDPS-S07a 22 1 3 0 0 26
London IDPS-S07b 21 0 2 3 0 26
Midlands and East IDPS-S07a 35 0 5 0 0 40
Midlands and East IDPS-S07b 20 0 0 20 0 40
North IDPS-S07a 33 1 2 4 0 40
North IDPS-S07b 15 0 0 25 0 40
South IDPS-S07a 28 0 2 4 0 35
South IDPS-S07b 13 0 3 19 0 35

Performance thresholds are:

  • acceptable: greater than or equal to 97.0%
  • achievable: greater than or equal to 99.0%

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

Note that IDPS-S07 is a small number standard and should be interpreted with caution.

All regions apart from the South met the acceptable threshold for standards IDPS-S07a and IDPS-S07b.

There were 13 providers that did not meet the acceptable threshold for standard IDPS-S07a and 5 providers that did not meet the acceptable threshold for standard IDPS-S07b. Four of the providers not meeting the acceptable threshold for standard IDPS-S07a also did not meet the acceptable threshold in screening year 2019 to 2020.

Figure 35: IDPS-S07: Intervention or treatment: timely neonatal hepatitis B vaccination (a) and immunoglobulin (b), performance, screening year 2016 to 2017 to screening year 2020 to 2021, England

The line chart in Figure 35 above shows that overall, England met the achievable threshold (97.0%) for standard IDPS-S07a and the acceptable threshold (99.0%) for standard IDPS-S07b in 2020 to 2021.

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

Table 22: SCT-S09: Intervention or treatment: timely follow-up, diagnosis and treatment of newborn infants with a positive screening result, performance, screening year 2020 to 2021, by region

Region Numerator Denominator Performance (%) Exclusions from the denominator due to missing data
London 71 82 86.6 35
Midlands and East 40 41 97.6 16
North 22 23 95.7 17
South 14 15 93.3 10
England 147 161 91.3 78

Figure 36: SCT-S09: Intervention or treatment: timely follow-up, diagnosis and treatment of newborn infants with a positive screening result, screening year 2020 to 2021, England


Measure With positive screening result who were seen at paediatric clinic or discharged for insignificant results at less than or equal to 90 days of age With positive screening result who were seen at paediatric clinic or discharged with insignificant results at greater than 90 days Number of infants with positive screening result where age at clinic attendance or discharge is missing Total
Number of infants 147 14 78 239

Performance thresholds are:

  • acceptable: greater than or equal to 90.0%
  • achievable: greater than or equal to 95.0%

NCARDRS collects data on newborn outcomes for the SCT programme, including standard SCT-S09.

In screening year 2020 to 2021, there were 78 infants where data was missing for the age when infant was seen in clinic or discharged for insignificant results. This is more than screening year 2019 to 2020, where there were 56 infants with missing data.

The data is incomplete for screening year 2020 to 2021 and work is ongoing to capture complete data through the NBO system in the future.

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 23: Breakdown of women who screen positive for HIV, screening year 2020 to 2021, England

Breakdown of screen positives n % of total
Newly screened positive women 72 11.6
Previously known positive women, not re-tested 47 7.6
Previously known positive women, re-tested in this pregnancy 501 80.8
Total screen positive women 620 100.0

The above includes data submitted by 141 out of 142 maternity services in England. Known false positives are excluded from the above.

Table 24: Breakdown of women who screen positive for hepatitis B, screening year 2020 to 2021, England

Breakdown of screen positives n % of total
Newly screened positive women 459 20.7
Previously known positive women, not re-tested 18 0.8
Previously known positive women, re-tested in this pregnancy 1,730 78.1
Other 7 0.3
Total screen positive women 2,214 100.0

The above includes data submitted by 141 out of 142 maternity services in England. Other includes women who later miscarried, or time of diagnosis was unknown.

Table 25: Breakdown of women who screen positive for syphilis, screening year 2020 to 2021, England

Breakdown of screen positives n % of total
Newly diagnosed requiring treatment 354 34.2
Previously diagnosed requiring treatment 126 12.2
Previously diagnosed not requiring treatment 538 52.0
Other treponemal infections 3 0.3
Unknown 14 1.4
Total screen positive women 1,035 100.0

Known false positives were excluded from the above. The above includes data submitted by 141 out of 142 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:

  • standards IDPS-S01, IDPS-S02 and IDPS-S03 (coverage), which provides the numbers tested
  • standard IDPS-S05, which provides 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 any previous testing or treatment. For syphilis, the number of women with screen positive results is the total number of women who screen positive during antenatal screening. This includes 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 26: Screen positive rates for HIV in pregnant women, screening year 2020 to 2021, 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) 136,200 200 1.47 20 0.15
Midlands and East (39/40) 181,076 165 0.95 22 0.12
North (39/41) 167,762 130 0.77 17 0.10
South (35/35) 153,750 115 0.75 11 0.07
England (139/142) 638,788 610 0.95 70 0.11

†The number of screen positive women has been rounded to the nearest multiple of 5 to prevent disclosure by comparison with other published data. Known false positive results are not included in the number of screen positives.

Table 27: Screen positive rates for hepatitis B in pregnant women, screening year 2020 to 2021, 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) 136,186 880 6.46 174 1.28
Midlands and East (39/40) 181,079 570 3.15 135 0.75
North (39/41) 171,607 410 2.39 86 0.50
South (35/35) 153,749 315 2.05 55 0.36
England (139/142) 642,621 2,170 3.38 450 0.70

†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 28 (a to c): Screen positive rates for syphilis in pregnant women, screening year 2020 to 2021, England


Table 28a: Screen positive women†
Region (returns included/expected) Women tested n ‡ Rate/1,000 women tested
London (26/26) 136,180 240 1.76
Midlands and East (39/40) 181,077 285 1.57
North (39/41) 171,610 320 1.86
South (35/35) 153,749 160 1.04
England (139/142) 642,616 1,005 1.56

†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. 

Table 28b: Confirmed syphilis positive women‡
Region (returns included/expected) Women tested n Rate/1,000 women tested
London (26/26) 136,180 237 1.74
Midlands and East (39/40) 181,077 285 1.57
North (39/41) 171,610 320 1.86
South (35/35) 153,749 159 1.03
England (139/142) 642,616 1,001 1.56

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

Table 28c: Screen positive women, requiring treatment†
Region (returns included/expected) Women tested n Rate/1,000 women tested
London (26/26) 136,180 113 0.83
Midlands and East (39/40) 181,077 118 0.65
North (39/41) 171,610 163 0.95
South (35/35) 153,749 62 0.40
England (139/142) 642,616 456 0.71

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

The trends in screen positive rates in England in the last 4 years are shown in tables 32 to 34. The number of maternity services for which data on screen positive rates is included increased between 2017 to 2018 and 2020 to 2021. This must be considered when interpreting the year-on-year screen positive rates.

Measure 2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021
Returns included/expected 125/147 144/146 140/143 139/142
Screen positive women†: rate/1,000 women tested 1.36 1.26† 1.19† 0.97†
Newly diagnosed women: rate/1,000 women tested 0.16 0.14 0.13 0.11

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.

Measure 2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021
Returns included/expected 125/147 144/146 140/143 139/142
Screen positive women†: rate/1,000 women tested 4.16 3.89† 3.77† 3.38†
Newly diagnosed women: rate/1,000 women tested 0.96 0.89 0.86 0.70

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

Measure 2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021
Returns included/expected 124/147 144/146 139/143 139/142
Screen positive women†: rate/1,000 women tested 1.39 1.52 1.50† 1.56†
Screen positive women requiring treatment: rate/1,000 women tested 0.53 0.69 0.63 0.71

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 is 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 in the SCT antenatal data return form section 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 (see section on inheritance of haemoglobinopathies).

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 32: 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 2020 to 2021, 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 (20/25) 109,194 4,400 4.0 337 7.7
Midlands and East (34/39) 179,285 3,410 1.9 220 6.5
North (39/40) 178,881 2,283 1.3 140 6.1
South (32/35) 143,380 1,650 1.2 113 6.8
England (125/139) 610,740 11,743 1.9 810 6.9

†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 33: Numbers and rates of significant conditions and carrier screening results, newborn blood spot screening for sickle cell disease, screening year 2020 to 2021, England

Region Babies tested (n) Significant conditions (n) Rate/1,000 babies screened Carriers (n) Rate/1,000 babies screened
London 115,666 116 1.00 3,143 27.17
Midlands and East 164,869 49 0.30 1,954 11.85
North 154,497 31 0.20 1,195 7.73
South 135,254 22 0.16 1,031 7.62
Unknown region 19,256 9 0.47 250 12.98
England 589,542 227 0.39 7,573 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

This report is delayed due to the abolition of PHE in October 2021. We recognise that due to this lag in time, public health commissioning teams will be aware of the performance reported and recommendations made are likely to be completed or already in progress. For recommendations to national screening programmes, we provide an update on progress where relevant.

Recommendations on coverage

Please see the list of providers for each recommendation section at the end of this report for details on which recommendation relates to which provider.

Recommendation 1

NHSEI regional public health commissioning teams to work with the 5 maternity providers that did not submit data, to enable data submission in screening year 2021 to 2022 (FASP-S01, FASP-S02).

Recommendations on test

Recommendation 2

NHS FASP should review the thresholds of this standard as part of the major review (FASP-S04). This is complete.

Recommendation 3

NHSEI regional public health commissioning teams to work with the 4 screening laboratories to meet the achievable threshold (FASP-S05).

Recommendation 4

NHS FASP should use the data submitted in screening year 2020 to 2021 to set thresholds for combined and quadruple samples (FASP-S06). This is complete.

Recommendation 5

NHSEI regional public health commissioning teams to work with the 3 screening laboratories where data was excluded to enable data submission in screening year 2021 to 2022 (IDPS-S04).

Recommendation 6

NHSEI regional public health commissioning teams to work with the 3 screening laboratories in the North and South to meet the acceptable threshold (IDPS-S04a, IDPS-S04b, IDPS-S04c).

Recommendation 7

NHS SCT should review the definition of this standard as part of the major review (SCT-S02). This is in progress).

Recommendation 8

NHSEI regional public health commissioning teams to work with the 14 maternity providers to meet the acceptable threshold (SCT-S03).

Recommendation 9

NHSEI regional public health commissioning teams to work with the 4 screening laboratories that did not submit data to enable data submission in screening year 2021 to 2022 (SCT-S04).

Recommendation 10

NHSEI regional public health commissioning teams to work with the 9 screening laboratories where data was excluded to enable data submission in screening year 2021 to 2022 (SCT-S04).

Recommendation 11

NHSEI regional public health commissioning teams to work with the 15 screening laboratories to meet the acceptable threshold (SCT-S04).

Recommendation 12

NHSEI regional public health commissioning teams to work with the 31 maternity providers to meet the acceptable threshold (SCT-S07).

Recommendations on referral

Recommendation 13

NHSEI regional public health commissioning teams to work with the 10 maternity providers not meeting the acceptable threshold consistently (for the last 4 years) (FASP-S07).

Recommendation 14

NHS FASP should review the definition of this standard as part of the major review (FASP-S07). This is complete.

Recommendation 15

NHS FASP should review the definition and data source of this standard as part of the major review (FASP-S08). This is complete.

Recommendation 16

NHSEI regional public health commissioning teams to work with the 7 maternity providers who have not met the acceptable threshold for all 3 parts of IDPS-S05.

Recommendation 17

NHS SCT should review the definition of this standard as part of the major review (SCT-S05). This is in progress).

Recommendations on diagnosis or intervention

Recommendation 18

NHS FASP should review the definition and data source for this standard as part of the major review (FASP-S09). This is complete.

Recommendation 19

NHSEI regional public health commissioning teams to work with the 25 maternity providers to meet the acceptable threshold (IDPS-S06).

Recommendation 20

Maternity providers and fetal medicine services must complete the gestation at time of prenatal diagnosis on request forms sent to genomic laboratories, to improve data completeness (SCT-S06).

Recommendations on intervention or treatment

Recommendation 21

NHSEI regional public health commissioning teams to work with providers to improve the data quality in the SCT NBO system; data fields that need improving relate to the age of the infant with a screen positive result when:

  • parents receive the result

  • attending clinic or discharge

SCT antenatal data return form

Figure 37: Antenatal data return form part 2 – breakdown of women with a screen positive result

Figure 37 above shows a screen shot of the matrix grid used to determine pregnancies at risk of a clinically significant condition. The mother’s antenatal results are matched to the biological father’s antenatal result and inputted into the grid.

The matrix was changed for the 2018 to 2019 return form to include orange (for pregnancies at risk of a clinically significant condition – PND should be offered) or white (minimal risk of a clinically significant condition). Blue boxes indicate that the biological father is not a carrier. 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

  • East Lancashire Hospitals NHS Trust

  • Lancashire Teaching Hospitals NHS Foundation Trust

FASP-S02

London

  • The Hillingdon Hospitals NHS Foundation Trust

North

  • East Lancashire Hospitals NHS Trust

Recommendation 3

Midlands and East

  • University Hospital Coventry and Warwickshire NHS Foundation Trust

North

  • Bolton NHS Foundation Trust

  • Leeds Teaching Hospitals NHS Foundation Trust

South

  • Portsmouth Hospitals NHS Trust

Recommendation 5

Midlands and East

  • Bedfordshire Hospitals NHS Foundation Trust (Bedford)

North

  • South Tyneside and Sunderland NHS Foundation Trust

  • Gateshead Health NHS Foundation Trust

Recommendation 6

North

  • Bradford Teaching Hospitals NHS Foundation Trust

  • North Tees and Hartlepool NHS Foundation Trust

South

  • Northern Devon Healthcare NHS Trust

Recommendation 8

London

  • Barts Health NHS Trust (Newham)

  • Barts Health NHS Trust (Royal London)

  • Barts Health NHS Trust (Whipps Cross)

  • Lewisham and Greenwich NHS Trust (Lewisham)

Midlands and East

  • Chesterfield Royal Hospital NHS Foundation Trust

  • University Hospitals Birmingham NHS Foundation Trust

North

  • Pennine Acute Hospitals NHS Trust

  • Southport and Ormskirk Hospital NHS Trust

  • The Newcastle Upon Tyne Hospitals NHS Foundation Trust

South

  • Buckinghamshire Healthcare NHS Trust

  • Dartford and Gravesham NHS Trust

  • Portsmouth Hospitals NHS Trust

  • Royal United Hospitals Bath NHS Foundation Trust

  • Torbay and South Devon NHS Foundation Trust

Recommendation 9

London

  • Health Services Laboratories, Special Haematology, 1 Mabledon Place, London

Midlands and East

  • Blood Sciences, Walsall Manor Hospital

  • Haematology Laboratory, Queen’s Hospital Burton

South

  • Haematology Department, Basingstoke and North Hampshire Hospital

Recommendation 10

London

  • Haematology, Homerton University Hospital

Midlands and East

  • Coventry and Warwickshire Pathology Network, George Eliot Hospital

  • Haematology, Bedford Hospital

North

  • Haematology Department, Tameside Hospital

  • Haematology, Royal Lancaster Infirmary

South

  • Blood Sciences, Wexham Park Hospital

  • Haematology Department, John Radcliffe Hospital

  • Haematology, Conquest Hospital and Eastbourne District General Hospital

  • Haematology, Maidstone Hospital

Recommendation 11

Midlands and East

  • Blood Sciences, Derbyshire Pathology, Chesterfield Royal Hospital

  • Haematology, Northampton General Hospital NHS Trust

North

  • Department of Blood Sciences, Stepping Hill Hospital

  • Haematology Department, North Tees and Hartlepool NHS Foundation Trust

  • Haematology Department, Royal Liverpool University Hospital

  • Haematology Laboratory, Blackpool Victoria Hospital

  • Haematology, Doncaster Royal Infirmary

  • Haematology, James Cook University Hospital

  • Haematology, University Hospital of North Durham

South

  • Blood Sciences, Queen Alexandra Hospital, Portsmouth

  • Haematology Department, East Surrey Hospital

  • Haematology, Great Western Hospital

  • Haematology, North Kent Pathology Service

  • Haematology, Stoke Mandeville Hospital

  • Laboratory Medicine, Salisbury District Hospital

Recommendation 12

London

  • Barts Health NHS Trust (Royal London)

  • Barts Health NHS Trust (Whipps Cross)

  • Chelsea and Westminster Hospital NHS Foundation Trust

  • Chelsea and Westminster Hospital NHS Foundation Trust (West Middlesex)

  • Epsom and St Helier University Hospitals NHS Trust (Epsom)

  • Epsom and St Helier University Hospitals NHS Trust (St Helier)

  • Homerton University Hospital NHS Foundation Trust

  • Imperial College Healthcare NHS Trust (QCCH)

  • Imperial College Healthcare NHS Trust (St Mary’s)

  • Kingston Hospital NHS Foundation Trust

  • Lewisham and Greenwich NHS Trust (Lewisham)

  • London North West University Healthcare NHS Trust

Midlands and East

  • Bedfordshire Hospitals NHS Foundation Trust (Luton and Dunstable)

  • Birmingham Women’s and Children’s NHS Foundation Trust

  • East and North Hertfordshire NHS Trust

  • Nottingham University Hospitals NHS Trust

  • Sandwell and West Birmingham Hospitals NHS Trust

  • The Royal Wolverhampton NHS Trust

  • University Hospitals Birmingham NHS Foundation Trust

  • University Hospitals of Leicester NHS Trust

  • Walsall Healthcare NHS Trust

North

  • Hull University Teaching Hospitals NHS Trust

  • Leeds Teaching Hospitals NHS Trust

  • Mid Yorkshire Hospitals NHS Trust

  • Sheffield Teaching Hospitals NHS Foundation Trust

  • St Helens and Knowsley Teaching Hospitas NHS Trust

South

  • Frimley Health NHS Foundation Trust (Frimley)

  • Frimley Health NHS Foundation Trust (Wexham)

  • Royal Berkshire NHS Foundation Trust

  • Royal Surrey County Hospital NHS Foundation Trust

  • University Hospital Southampton NHS Foundation Trust

Recommendation 13

London

  • Barts Health NHS Trust (Newham)

  • Barts Health NHS Trust (Royal London

  • Lewisham and Greenwich NHS Trust (Lewisham)

  • North Middlesex University Hospital NHS Trust

Midlands and East

  • University Hospitals of Derby and Burton NHS Foundation Trust (Derby)

North

  • Bolton NHS Foundation Trust

  • Liverpool Women’s NHS Foundation Trust

South

  • East Kent Hospitals University NHS Foundation Trust

  • Gloucestershire Hospitals NHS Foundation Trust

  • Oxford University Hospitals NHS Foundation Trust

Recommendation 16

London

  • King’s College Hospital NHS Foundation Trust

Midlands and East

  • Bedfordshire Hospitals NHS Foundation Trust (Luton and Dunstable)

  • George Eliot Hospital NHS Trust

  • The Royal Wolverhampton NHS Trust

North

  • Bolton NHS Foundation Trust

South

  • Brighton and Sussex University Hospitals NHS Trust

  • Royal Cornwall Hospitals NHS Trust

Recommendation 19

London

  • Barts Health NHS Trust (Newham)

  • Epsom and St Helier University Hospitals NHS Trust (St Helier)

  • Imperial College Healthcare NHS Trust (QCCH)

  • Lewisham and Greenwich NHS Trust (Lewisham)

  • University College London Hospitals NHS Foundation Trust

  • Whittington Health NHS Trust

Midlands and East

  • Bedfordshire Hospitals NHS Foundation Trust (Bedford)

  • East Suffolk and North Essex NHS Foundation Trust (Colchester)

  • George Eliot Hospital NHS Trust

  • North West Anglia NHS Foundation Trust (Peterborough)

  • Sandwell and West Birmingham Hospitals NHS Trust

  • Shrewsbury and Telford Hospital NHS Trust

  • United Lincolnshire Hospitals NHS Trust

North

  • Harrogate and District NHS Foundation Trust

  • Lancashire Teaching Hospitals NHS Foundation Trust

  • Mid Cheshire Hospitals NHS Foundation Trust

  • St Helens and Knowsley Teaching Hospitals NHS Trust

  • York Teaching Hospital NHS Foundation Trust

South

  • Brighton and Sussex University Hospitals NHS Trust

  • Great Western Hospitals NHS Foundation Trust

  • Royal Cornwall Hospitals NHS Trust

  • Royal Surrey County Hospital NHS Foundation Trust

  • Torbay and South Devon NHS Foundation Trust

  • University Hospitals Bristol and Weston NHS Foundation Trust

  • University Hospitals Plymouth NHS Trust

Data exclusions

Providers where data was excluded for IDPS-S04

System change therefore could not provide data for the whole year:

  • Bedfordshire Hospital NHS Foundation Trust

Could not distinguish antenatal samples from all samples received in the laboratory:

  • South Tyneside and Sunderland NHS Foundation Trust

Did not have full data available:

  • Gateshead Health NHS Foundation Trust

Providers not meeting acceptable threshold for IDPS-S04

Due to the impact of the COVID-19 pandemic:

  • Bradford Teaching Hospitals NHS Foundation Trust

Instrument failure leading to samples being sent to an external laboratory for analysis:

  • Northern Devon Healthcare NHS Trust

Not having an electronic link between the screening laboratory and maternity services:

  • North Tees and Hartlepool NHS Foundation Trust

Providers that did not submit data for SCT-S04

London

  • Health Services Laboratories, Special Haematology, 1 Mabledon Place, London

Midlands and East

  • Blood Sciences, Walsall Manor Hospital

  • Haematology Laboratory, Queen’s Hospital Burton

South

  • Haematology Department, Basingstoke and North Hampshire Hospital

Providers where data was excluded for SCT-S04

Reported turnaround times that were not based on annual samples:

Midlands and East

  • Haematology, Bedford Hospital

South

  • Blood Sciences, Wexham Park Hospital

  • Haematology, Conquest Hospital and Eastbourne District General Hospital

Did not have a system that allowed this data to be provided:

North

  • Haematology, Royal Lancaster Infirmary

South

  • Haematology Department, John Radcliffe Hospital

Reported in calendar days instead of working days

North

  • Haematology Department, Tameside Hospital

Data quality reasons:

London

  • Haematology, Homerton University Hospital (same as screening year 2019 to 2020)

Midlands and East

  • Coventry and Warwickshire Pathology Network, George Eliot Hospital

South

  • Haematology, Maidstone Hospital
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