NHS Infectious Diseases in Pregnancy Screening

ProgrammeMarie Coughlin Screening Lead

September 27th 2010

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

2010

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

Aim of the Session

To increase knowledge base within public health and commissioning

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

Overarching Structure

UK NSC, Dept of Health & Health Protection Agency jointly responsible for Programme

National team recently formed

NWSHA team has some involvement

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

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

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

Patient Pathway…

Infectious Diseases in Pregnancy Screening Pathway

Rebecca Al-Ausi

North West Antenatal, Newborn & Child Health Deputy Screening Coordinator

Rebecca.al-ausi@alwpct.nhs.uk

Tel: 07810506043

Aims

Pathway

Protocol

Standards

Mapping report

Data returns

Quality assurance

http://infectiousdiseases.screening.nhs.uk/

Pathway

Protocols

Four separate protocols

Individual pathways

Failsafe

Named leads

Communication links

Accountability

http://infectiousdiseases.screening.nhs.uk/

Standards

Revised June 2010

http://infectiousdiseases.screening.nhs.uk/standards

Confirmation bloods

Timeliness

Accountability

http://infectiousdiseases.screening.nhs.uk/

2008 Mapping Report National

Maternity units, laboratory leads, PCT’s & CHRD’s

Pathways

North West report

http://infectiousdiseases.screening.nhs.uk/

Data Returns

HPA quarterly data & annual report

Trust annual reports

NSC’s KPI’s

2 infectious diseases KPI’s

http://infectiousdiseases.screening.nhs.uk/

HIV

Quarterly returns

December 2010 Proportion of tested women (tested/eligible = %)

90% uptake

http://infectiousdiseases.screening.nhs.uk/

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/

Quality Assurance Cross programme benchmarking

Failsafe

Structure

Peer reviews

Governance

Improvement

http://infectiousdiseases.screening.nhs.uk/

Data & Performance

Trusts required to produce annual report – difficult to obtain copies

Programme Board produce an annual report – Details on next few slides

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%

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%

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%

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%

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

Quality Assurance

QA function being developed – some in place for Labs

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

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

All today’s presentations will be available on the ChaMPs

website www.champs-for-health.net

Next CPD – Date and title

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