2. NHS Infectious Diseases in Pregnancy Screening Programme
Marie Coughlin Screening Lead
September 27th 2010 2

3. Today’s Session
Fifth of 6 Antenatal & Newborn sessions throughout 2010 3

4. Reasons for Today’s Session
As a result of ChaMPs commissioned review of screening
A need to further engage public health in Antenatal & Newborn Screening Programmes
At the request of public health screening leads
Part of C&M Screening Action Plan
Thought it useful to invite commissioners also

5. Aim of the Session
To increase knowledge base within public health and commissioning

6. Session Format Overview of Programme structure
Overview of Infectious Diseases in Pregnancy Screening
Review of patient pathway
Data, performance and QA
Future developments
Questions/comments

7. Overarching Structure
UK NSC, Dept of Health & Health Protection Agency jointly responsible for Programme
National team recently formed
NWSHA team has some involvement

8. Infectious Diseases in Pregnancy Screening
Infectious Diseases in Pregnancy Programme established in 2003
Screens for Hepatitis B; HIV; Syphilis; Rubella
Programme Board responsible for overseeing national projects
Emphasis on patient choice and uptake of 90%
Objective to create focus and identity for infectious diseases in pregnancy screening

9. Programme Aims
To ensure screening is undertaken as early in the pregnancy as possible
Screen acceptance rate of at least 90%
100% of samples to be sent to Lab within 1 working day
No longer need second sample to confirm positive status
Lab to confirm receipt of 100% of samples within 10 working days
100% of referrals to be made within 6 weeks of positive result

10. Infectious Diseases in Pregnancy Statistics
In the UK in 2007/8
3091/ (0.47%) were Hepatitis B positive
1066/ (0.17%) were HIV positive
1086/ (0.17%) tested positive for syphilis
19804/ (3.06%) were susceptible to rubella

11. Patient Pathway…

12. Infectious Diseases in Pregnancy Screening Pathway
Rebecca Al-Ausi
North West Antenatal, Newborn & Child Health Deputy Screening Coordinator
Tel:

13. Aims Pathway Protocol Standards Mapping report Data returns
Quality assurance

14. Pathway

16. Four separate protocols Individual pathways Failsafe Named leads
Communication links
Accountability

17. Standards Revised June 2010
Confirmation bloods
Timeliness
Accountability

18. Maternity units, laboratory leads, PCT’s & CHRD’s Pathways
2008 Mapping Report
National
Maternity units, laboratory leads, PCT’s & CHRD’s
Pathways
North West report

19. HPA quarterly data & annual report Trust annual reports NSC’s KPI’s
Data Returns
HPA quarterly data & annual report
Trust annual reports
NSC’s KPI’s
2 infectious diseases KPI’s
Due to be reported on from Q (ie first return by Dec 2010)
HIV = Percentage of women tested (tested/eligible=%)
Hep B

20. Proportion of tested women (tested/eligible = %) 90% uptake
HIV
Quarterly returns
December 2010
Proportion of tested women (tested/eligible = %)
90% uptake

21. Proportion of Hepatitis B women who are referred in timely manner
Quarterly returns
June 2011
Proportion of Hepatitis B women who are referred in timely manner
(women referred/women with hepatits B = %)
90% uptake

22. Cross programme benchmarking Failsafe Structure Peer reviews
Quality Assurance
Cross programme benchmarking
Failsafe
Structure
Peer reviews
Governance
Improvement

23. Data & Performance
Trusts required to produce annual report – difficult to obtain copies
Programme Board produce an annual report – Details on next few slides

24. Hepatitis B Statistics – 2007/8
SHA
No. of Tests
Uptake Rate
Pos Rate
East Midlands
35621
98.4%
32988
0.22%
East of England
61457
96.4%
72397
0.25%
London
116080
95.9%
144452
1.18%
North East
23414
86.1%
30612
0.13%
North West
79909
91.8%
88255
0.31%
South East
86174
95.4%
105907
South West
47598
93.1%
50662
0.36%
West Midlands
50074
98.1%
69678
Yorkshire & Humber
60890
96.3%
66954
0.35%
NATIONAL
561,217
95.0%
661,905
0.47%

25. HIV Statistics – 2007/8 SHA No. of Tests Uptake Rate Pos Rate
East Midlands
48840
97.4%
34492
0.10%
East of England
66283
95.2%
66479
0.12%
London
119492
94.6%
138994
0.32%
North East
24165
84.7%
29976
0.08%
North West
75754
85.4%
81927
0.11%
South East
84916
94.3%
104950
0.14%
South West
47616
91.8%
49883
West Midlands
54953
97.0%
66291
0.15%
Yorkshire & Humber
60441
95.5%
64317
0.16%
NATIONAL
582,460
93.2%
637,309
0.17%

26. Syphilis Statistics – 2007/8
SHA
No. of Tests
Uptake Rate
Pos Rate
East Midlands
28145
82.3%
33009
0.12%
East of England
60719
96.9%
69100
0.10%
London
112512
95.7%
140529
0.43%
North East
23691
87.2%
29732
North West
80785
94.5%
90843
0.05%
South East
85982
96.0%
105897
South West
48861
95.6%
50644
0.07%
West Midlands
50009
98.0%
69708
0.16%
Yorkshire & Humber
56152
96.1%
67227
0.08%
NATIONAL
546,856
94.7%
656,689

27. Rubella Statistics – 2007/8 SHA No. of Tests Uptake Rate
Susceptible Rate
East Midlands
25778
78.2%
25285
1.46%
East of England
55710
97.5%
65723
2.37%
London
115315
96.2%
139331
4.10%
North East
22789
87.2%
33610
3.51%
North West
82842
95.1%
90237
2.00%
South East
85523
96.4%
106112
2.67%
South West
49112
96.1%
50883
2.68%
West Midlands
50174
98.3%
69816
2.93%
Yorkshire & Humber
62082
97.0%
66823
4.41%
NATIONAL
549,325
95.0%
647,820
3.06%

28. Key Messages in Annual Report
Need to improve communications between Labs and Maternity Units
Need to improve I.T. systems in Labs and Maternity Units
Need to improve data collection and analysis

29. Quality Assurance
QA function being developed – some in place for Labs

30. Current Projects/Future Developments
Several projects underway, including:
Improve I.T. systems
Refine complex referral system for those needing further assessment
Develop patient pathway for HIV and define roles & responsibilities in the pathway
Review of confidentiality policies for HIV

31. Questions/Comments
With regard to QA, how do we assure our Boards that local programmes run satisfactorily?
Set of recommendations re Trust data issue for all 6 programmes submitted to C&M DsPH and DoCs

32. All today’s presentations will be available on the ChaMPs
website
Next CPD – Date and title
If you would like to receive our regular bulletin,
please