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NHS Infectious Diseases in Pregnancy Screening
ProgrammeMarie Coughlin Screening Lead
September 27th 2010
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Today’s Session Fifth of 6 Antenatal & Newborn sessions throughout
2010
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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
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Aim of the Session
To increase knowledge base within public health and commissioning
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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
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Overarching Structure
UK NSC, Dept of Health & Health Protection Agency jointly responsible for Programme
National team recently formed
NWSHA team has some involvement
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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
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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
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Infectious Diseases in Pregnancy Statistics
In the UK in 2007/8
— 3091/661905 (0.47%) were Hepatitis B positive
— 1066/637309 (0.17%) were HIV positive
— 1086/656689 (0.17%) tested positive for syphilis
— 19804/647820 (3.06%) were susceptible to rubella
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Patient Pathway…
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Infectious Diseases in Pregnancy Screening Pathway
Rebecca Al-Ausi
North West Antenatal, Newborn & Child Health Deputy Screening Coordinator
Tel: 07810506043
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Aims
Pathway
Protocol
Standards
Mapping report
Data returns
Quality assurance
http://infectiousdiseases.screening.nhs.uk/
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Pathway
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Protocols
Four separate protocols
Individual pathways
Failsafe
Named leads
Communication links
Accountability
http://infectiousdiseases.screening.nhs.uk/
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Standards
Revised June 2010
http://infectiousdiseases.screening.nhs.uk/standards
Confirmation bloods
Timeliness
Accountability
http://infectiousdiseases.screening.nhs.uk/
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2008 Mapping Report National
Maternity units, laboratory leads, PCT’s & CHRD’s
Pathways
North West report
http://infectiousdiseases.screening.nhs.uk/
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Data Returns
HPA quarterly data & annual report
Trust annual reports
NSC’s KPI’s
2 infectious diseases KPI’s
http://infectiousdiseases.screening.nhs.uk/
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HIV
Quarterly returns
December 2010 Proportion of tested women (tested/eligible = %)
90% uptake
http://infectiousdiseases.screening.nhs.uk/
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Hepatitis B
Quarterly returns
June 2011
Proportion of Hepatitis B women who are referred in timely manner
(women referred/women with hepatits B = %)
90% uptake
http://infectiousdiseases.screening.nhs.uk/
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Quality Assurance Cross programme benchmarking
Failsafe
Structure
Peer reviews
Governance
Improvement
http://infectiousdiseases.screening.nhs.uk/
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Data & Performance
Trusts required to produce annual report – difficult to obtain copies
Programme Board produce an annual report – Details on next few slides
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Hepatitis B Statistics – 2007/8
SHA No. of Tests Uptake Rate No. of Tests 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 0.25%
South West 47598 93.1% 50662 0.36%
West Midlands 50074 98.1% 69678 0.36%
Yorkshire & Humber
60890 96.3% 66954 0.35%
NATIONAL 561,217 95.0% 661,905 0.47%
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HIV Statistics – 2007/8
SHA No. of Tests Uptake Rate No. of Tests 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 0.08%
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%
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Syphilis Statistics – 2007/8
SHA No. of Tests Uptake Rate No. of Tests 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 0.10%
North West 80785 94.5% 90843 0.05%
South East 85982 96.0% 105897 0.10%
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 0.10%
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Rubella Statistics – 2007/8
SHA No. of Tests Uptake Rate No. of Tests 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%
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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
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Quality Assurance
QA function being developed – some in place for Labs
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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
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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
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All today’s presentations will be available on the ChaMPs
website www.champs-for-health.net
Next CPD – Date and title
If you would like to receive our regular bulletin,
please e-mail [email protected]
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