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Checks and audits to improve quality and reduce risks in sickle cell and thalassaemia screening

Posted by: , Posted on: - Categories: NHS Sickle Cell and Thalassaemia Screening Programme

We have published new information that describes the checks and audits that are needed for the sickle cell and thalassaemia (SCT) screening pathway.

The SCT programme screens pregnant women to find out if they’re at risk of having a baby with sickle cell disease or thalassaemia major, which are serious inherited blood conditions. This gives parents time to consider the options available.

Why are the checks needed?

Every NHS screening programme has a pathway that defines each stage of the screening process. Lots of people undergo screening and move between the different stages of the pathway. The checks, known as failsafe processes, are an important way of making sure the pathway is completed safely and without delay.

The checks help us to identify and correct anything that goes wrong quickly. The quality assurance (QA) of screening programmes includes checking these failsafe processes are in place and working effectively.

Helping local areas ensure checks are in place

The SCT checks and audits document is the result of a detailed look at what can go wrong in the SCT screening pathway. It’s designed to help local areas make sure they have the correct checks in place. The document replaces the ‘SCT screening: antenatal failsafe procedures’ document.

The new publication has 2 parts. The first explains how we developed the failsafe processes. It also includes examples that explain what can go wrong if checks aren’t in place or if they’re not robust or timely. The second part of the publication is a template for local providers to use that describes the ‘what, why, how and when’ for each recommended check.

What: this is what we recommend you do.

Why: these are the reasons we are recommending this.

How: this is how you might do this.

When: this is how often we recommend you undertake the action or perform the check.

Let’s take a quick look at an example:


It is recommended that providers identify the eligible population and have systems in place to record the SCT screening offer, test or decline for each pregnancy.


We know from screening safety incident reports and key performance indicators (KPIs) that some women are not offered antenatal SCT screening and/or there are unnecessary delays in screening being carried out.


Providers can maintain an accurate list of the eligible population which includes gestation at booking, screening test and decline.


Weekly check for anyone who has not been offered screening or whose screening has been delayed.

Using the template

Local providers should use the template to record whether the correct checks are in place and if they are being done often enough. If not, they should use the template to develop an action plan (you can use completed templates and action plans as evidence for QA activities, including peer review visits). The template also describes additional annual audits that providers should undertake. These will help show if the whole system is working effectively.

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