1. 28 January 2010 Donna Kirwan National Projects Officer 18 +0 to 20 +6 Weeks Fetal Anomaly Scan National Standards for England ‘Into the next decade’

2. 1984 - 2000

4. Donna Kirwan Professor Martin Whittle Professor Peter Soothill Professor Alan Cameron Mr Tim Overton Mrs Rita Phillips Dr. Colin Davies Dr. Trish Chudleigh Administrative support: Mrs Jackie Williams

6. Obstetric ultrasound 2008-2009 2,444,180 Department of Health

7. 1 Coordinating group

9. 2 Leadership

11. 3 Consent

12. The fetal anomaly scan should be discussed as an option, rather than an inevitable aspect of routine antenatal care for it to be meaningful

13. 4 Scan appointment

14. 30 minutes

15. 5 Scan base menu

16. Ultrasound scan base menu Head & neck Brain & nuchal fold Face Lips Chest 4 chamber view & outflow tracts Lungs Abdomen Stomach Abdominal wall Bowel Renal pelvis Bladder Spine Vertebrae Skin covering of spine Limbs (a) Limbs (b) Femur (one only) Hands (present) Feet (present) Uterine cavity Amniotic fluid (subjective volume) Placental site

17. 6 Normal variants

18. ‘Normal variants’ Increased nuchal fold > 6mm Ventriculomegaly >10 mm Echogenic bowel Brighter than bone Renal pelvic dilatation > 7mm Small size compared to the dating scan Significantly < 5 th centile on national charts

19. 7 11 conditions

20. 11 auditable conditions ConditionDetection Rate (%) Anencephaly98 Gastroschisis98 Edwards’ syndrome95 Patau’s syndrome95 Open spina bifida90 Bilateral renal agenesis84 Exomphalos80 Cleft lip75 Lethal skeletal dysplasia60 Diaphragmatic hernia60 Serious cardiac abnormalities50 ≥ 50%

21. 2010 - 2013 Where are we? Where do we want to get to? How will we get there? How will we know we’ve got there?

22. It’s not just to get a scan picture

23. Lines of accountability Standards & measures Quick wins Explicit written arrangements Coordinating group Monitoring CommissioningEducation & Training Coordinating group Leadership

24. From 1 April 2010

25. Donna.Kirwan@ansnc.co.uk 0151 280 3354