Guidance

NHS Fetal Anomaly Screening Programme (FASP): programme overview

Information on the programme, including commissioning, quality assurance, education and training.

Public information about FASP is available on the NHS website.

Healthcare professionals, including midwives, should offer screening for Down’s syndrome, Edward’s syndrome, Patau’s syndrome and 11 physical conditions to all eligible pregnant women as part of their usual antenatal care.

Information about the screening tests should be provided to each pregnant woman so she is able to make a personal informed choice about the tests.

The FASP handbook brings together all the guidelines and recommendations that relate to the screening pathway and are not covered in detail in the other handbooks.

The FASP laboratory handbook: Down’s syndrome, Edwards’ syndrome and Patau’s syndrome sets out the requirements for laboratory staff involved in the pathways for first trimester screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome and second trimester biochemical screening for Down’s.

The FASP ultrasound practitioners handbook sets requirements for ultrasound practitioners involved in the pathway for first trimester screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome.

Public Health England (PHE) is committed to reducing inequalities and variation in participation to help make sure everyone has fair and equal access to screening services.

PHE has also published information about patient confidentiality in population screening programmes.

Target population

Screening for Down’s syndrome is offered to all eligible pregnant women, and takes place between 10⁺⁰ and 20⁺⁰ weeks of pregnancy.

Screening for Edwards’ syndrome and Patau’s syndrome is offered to all eligible pregnant women and takes place between 10⁺⁰ and 14⁺¹ weeks of pregnancy.

Screening for 11 physical conditions as part of the 20-week scan is offered to all pregnant women and takes place between 18⁺⁰ and 20⁺⁶ weeks of pregnancy. Scans can be completed up to 23⁺⁰ weeks of pregnancy.

Conditions screened for

Information leaflets are available for the conditions screened for in the 20-week scan:

Care pathways are available for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome screening, as well as for the 20-week scan.

Screening test

The screening tests for you and your baby leaflet sets out the test process and purpose.

The combined test is offered in the first trimester to assess the chance of the baby having Down’s syndrome, Edwards’ syndrome or Patau’s syndrome, and is the test of choice.

The quadruple test is offered in the second trimester to assess the chance of the baby having Down’s syndrome.

The 20-week scan is offered to screen for Edwards’ syndrome and Patau’s syndrome, and 11 physical conditions.

Private screening

The private screening: important information leaflet provides information for people who ask about private screening options.

Non-invasive prenatal screening test (NIPT)

NIPT for Down’s syndrome Edwards’ syndrome and Patau’s syndrome is not currently available as part of FASP.

The UK National Screening Committee (UK NSC) has recommended introducing NIPT as an evaluative rollout, so that any necessary changes to the pathway can be made in a timely manner.

FASP is currently planning for the introduction of the offer of NIPT following a higher chance (1 in 2 to 1 in 150) of the baby having Down’s syndrome, Edwards’ syndrome or Patau’s syndrome following combined or quadruple screening.

Find out more about the plans for NIPT on the PHE Screening blog.

Diagnostic tests

A diagnostic test is offered where a woman has received a higher chance screening test result for Down’s syndrome and/or Edwards’ syndrome and Patau’s syndrome, and if there are unexpected findings at the time of the ultrasound scan. This could be:

  • chorionic villus sampling
  • amniocentesis

CVS and amniocentesis: information for parents explains more about these tests .

Evidence base

FASP is one of 11 NHS national population screening programmes available in England.

The UK NSC makes recommendations to ministers in the 4 UK countries on all aspects of population screening. It ensures that screening provides more benefit than harm, at a reasonable cost to the NHS.

Recommendations are based on internationally recognised criteria and a rigorous evidence review process.

You can read the:

Data and intelligence

PHE publishes reports setting out annual data collected from FASP.

For 1 April 2017 to 31 March 2018 data onwards, PHE publishes a joint antenatal screening standards data report.

Key performance indicator (KPI) data reports are available for all 11 national screening programmes.

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

Requests for screening data and research

All requests for access to FASP data for research purposes need to be approved by the antenatal and newborn screening research advisory committee (RAC).

PHE also has terms of reference for NHS population screening programme RACs.

All routine data requests (not research) should go via the PHE Screening helpdesk.

Commissioning

The purpose of the service specifications for the FASP programme (specification numbers 16 and 17) are to outline the service and quality indicators expected by NHS England.

Quality assurance

Guidance is available on the FASP programme’s processes for ensuring seamless and safe screening across the whole pathway.

The programme specific operating model for quality assurance of the FASP programme should be read in conjunction with the latest SQAS operating model and the relevant programme standards.

Down’s syndrome quality assurance support service (DQASS)

The Down’s syndrome screening quality assurance support service (DQASS) is commissioned by PHE to support FASP.

The main aim of DQASS is to monitor and support the quality and effectiveness of Down’s syndrome, Edward’s syndrome and Patau’s syndrome screening in England.

Workforce – education and training

Education and training resources are available for healthcare professionals working in FASP.

There are also more general resources to support screening professionals in their initial training and continuing professional development (CPD).

Keep up to date

Visit the PHE Screening blog to keep up to date with what is new in FASP, including the latest guidance and good practice. You can register to receive blog updates direct to your inbox. Follow PHE Screening on Twitter for information and news on all national screening programmes.

Contact the screening team

Population screening helpdesk

PHE Screening
Floor 5
Wellington House
133-155 Waterloo Road

London
SE1 8UG

The helpdesk is not for media enquiries and does not have access to screening results. For queries about results, contact your GP or local screening service. Order screening leaflets at www.gov.uk/phe/screening-leaflets.

Published 1 January 2013