Population screening programmes – guidance

Fetal anomaly screening: programme overview

Read an overview of the NHS fetal anomaly screening programme (FASP), and learn how to contact the programme.

Screening is the process of identifying people who appear healthy but may be at increased risk of a disease or condition.

The NHS fetal anomaly screening programme (FASP) is one of the antenatal and newborn NHS population screening programmes.

FASP offers screening for pregnant women to check the baby for fetal anomalies, Down’s, Edwards’ and Patau’s syndromes.

Screening is different to diagnosis and there will always be some false positive and false negative results

Evidence and recommendations

The UK National Screening Committee (UK NSC) assesses evidence and makes recommendations to the 4 UK governments about population screening programmes.

The UK NSC makes separate recommendations for Down’s, Edwards’ and Patau’s syndromes and other fetal anomalies.

Screening test: fetal anomalies

The screening tests for you and your baby document explains the individual screening tests for fetal anomalies.

FASP currently offers antenatal screening to all pregnant women in England for the following conditions:

  • anencephaly
  • open spina bifida
  • cleft lip
  • diaphragamtaic hernia
  • gastrochisis
  • exomphalos
  • serious cardiac abnormalities
  • bilateral renal agenesis
  • lethal skeletal dysplasia
  • Edwards’ syndrome (T18)
  • Patau’s syndrome (T13)

The leaflets about each condition give more information about the conditions for women with a suspected abnormality.

Screening test: Down’s, Edwards’ and Patau’s syndromes

Combined test

This test is the most effective early screening test for Down’s, Edwards’ and Patau’s syndromes available on the NHS in England.

The combined test involves measuring the fluid at the back of the fetus’ neck using nuchal translucency, and taking a blood sample.

A healthcare professional offers this test to expectant mothers at between 10+0 and 14+1 weeks of their pregnancy.

The screening tests for you and your baby document explains the test in-depth.

Quadruple blood test

If a mother presents late for Down’s syndrome screening and is between 14+2 and 20+0 weeks of pregnancy, the quadruple blood test is available for screening.

A blood sample from the mother determines levels of 4 different biochemical markers that together with maternal age can indicate whether there is a higher risk of Down’s syndrome.

This test is less effective than the combined test and is fully explained in the screening tests for you and your baby document.

Diagnostic tests

If either the combined test or the quadruple blood test returns a higher risk result, the next step is to offer 1 of 2 diagnostic tests:

  • chorionic villus sampling

  • amniocentesis

The screening tests for you and your baby document explains the risks associated with these tests.

Providing prompt care

The NHS maps of medicine outline the care pathways for each condition.

Healthcare professionals provide screening using guidelines and standards along side the national service specification.

Data and quality assurance

FASP uses key performance indicators to help define standards of care required, and collects data to determine if clinics and staff are meeting those standards of practice.

Health professionals should use the national quality assurance team’s managing incidents guidance if any problems arise during the screening process.

A failsafe procedure is also in place to ensure there is a back-up for if there are any problems.

The guidelines on handling patient information explain how to use and safeguard personal data in screening.


Down’s syndrome screening has its own quality assurance system to ensure the screening offered is consistent and conforms to the standards set out for England.


Healthcare professionals can use the fetal anomaly e-learning modules to learn about and update their knowledge about the screening process.

The fetal echocardiography online training resource, produced in collaboration with the Fetal Medicine Foundation, is available as additional training on fetal cardiac screening.


Commissioners for FASP must use the 2 set service specifications and supporting documents to offer a programme that is fit for purpose and meets the standards set by the FASP national programme.

Private screening

The UK NSC has produced a guidance leaflet for people who ask about private screening options.

Non-invasive prenatal screening (NIPT) for Down’s syndrome.

This procedure is currently unavailable through the NHS, but is available privately.

The UK NSC is currently supporting a study to see if the test is viable for NHS population screening.

FASP have released a statement explaining their position on NIPT.

Contact the screening programme

NHS population screening helpdesk

Public Health England Zone B
Floor 2 Skipton House
80 London Road


The helpdesk and national programmes do not have access to screening results.

Parents: contact your midwife or health visitor for information on screening results.

Health professionals: contact the local screening team, screening laboratory or local child health records department.