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New fetal anomaly screening standard introduced

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Screening standards help drive progress

PHE Screening has introduced a new standard into the NHS Fetal Anomaly Screening Programme (FASP). Screening standards are a defined set of measures that providers have to meet to make sure the NHS-led screening programmes are safe and effective.

The new FASP standard FASP-S06 replaces the old standard 6, which measured completion of laboratory request forms for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome screening.

The new standard looks at the same point in the screening pathway, but measures the proportion of inadequate samples.

‘Sample’ is defined as a request form (paper and/or electronic) and blood sample for screening using the combined or quadruple tests.

The standard will also be collected as a quarterly key performance indicator (KPI) FA4, replacing the old FA1 KPI.

Screening laboratories will submit data for the first quarter of 2020 to 2021 (1 April to 30 June) in September 2020.

Need to change

The old standard helped to drive improvement over many years, but we had reached a point where performance had levelled off, and we were no longer seeing progress.

We carried out a survey of screening laboratories and midwives to find out what changes we could make.

All 21 screening laboratories and 75% of midwives who responded to our survey thought the previous data fields were insufficient to capture all the missing information on request forms. Most laboratories had parallel reporting processes in place to feed back the extra data to their maternity services.

We listened

We evaluated the feasibility of a new standard by piloting it with 3 screening laboratories. These laboratories have an annual throughput of just under 140,000 screening samples and provide screening for 58 maternity services.

Needless to say, definitions changed several times during the pilot phase. It was all worth it though, because we now have a better standard that will help drive continuous quality improvement.

It is important that we continue to improve, as inadequate samples can delay the reporting of results, causing unnecessary anxiety, and waste resources.

Thank you

We could not have done it without the enthusiasm, input and the attention to detail from the laboratories that took part in the pilot.

These were: 

  • Royal Devon and Exeter NHS Foundation Trust
  • Birmingham Women’s and Children’s NHS Foundation Trust
  • Newcastle upon Tyne Hospitals NHS Foundation Trust

The new standard and KPI

The revised standard collected as a quarterly KPI requires the screening laboratory to submit 2 sets of data for each maternity service. These are:

  1. Reason for inadequate sample. One reason is reported per sample and the laboratory will categorise these reasons in an order of priority.
  2. Data field(s) on the sample that were not correctly completed. A sample may have more than one missing or incorrect data field and the screening laboratory will report this information.

Both sets of data will be included on one data template.

Next steps

We are looking forward to getting the data to work on.

Our usual process is to collect data for at least a year and review its completeness and quality, with a view to publishing the following year.

We have not yet set performance thresholds for this standard. This is something we will determine based on the data submitted during the first year. 

PHE Screening blog

The PHE Screening blog provides up to date news from all NHS screening programmes. You can register to receive updates direct to your inbox, so there’s no need to keep checking for new blogs. If you have any questions about this blog article, or about population screening in England, please contact the PHE screening helpdesk.

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