The QA advisor summarizes findings from 30 QA visits reports between September 2017 and July 2018. A total of 786 QA recommendations were made across various themes. The top theme was infectious diseases in pregnancy, receiving 218 recommendations. Of these, 61 recommendations were specific to the laboratory, focusing on issues like properly identifying and tracking antenatal samples, notifying screening results, and ensuring UKAS accreditation. Generic recommendations that appeared across themes included formalizing governance, managing incidents, and meeting standards for staff training and turnaround times.

1. Findings from QA activities
Siobhan O’Callaghan
Senior QA Advisor

2. Methodology
• 30 QA visits reports
• 786 QA recommendations
• September 2017 to 4 July 2018
2
QA visits
by region

3. All recommendations by theme – 786
3
259
96
56
27
34
53
69
63
41 42 44
2
0
50
100
150
200
250
300
numberofrecommendations

4. Infectious diseases in pregnancy
4
218
51
40
26 22
61
93
111
42
57
63
0
50
100
150
200
250
governance
infrastructure
invitation
cohort-
antenatal
cohort-
newborn
IDPS
SCT
FASP
NBS
NHSP
NIPE
numberofrecommendations

5. Infectious diseases in pregnancy – priority
3
1
1
15
9
5
41
24
13
5
15
10
10
45
48
46
37
67
68
48
17
10
30
41
172
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Blank
NIPE
NHSP
NBS
FASP
SCT
IDPS
cohort - newborn
cohort - antenatal
invitation
infrastructure
governance
immediate high standard low blank
5

6. Infectious diseases in pregnancy – 61
6
12
8
7
1 1
7
6
5
3 3
2 2 2
1 1
0
2
4
6
8
10
12
14
numberofrecommendations
17
34
2
8
Timescales
3 months 6 months 9 months 12 months

7. Laboratory (29/61 recommendations)
• ability to identify antenatal samples as distinct from other pathology
samples
• samples to the laboratory or reference laboratory to be
tracked/booking to result tracking system
• laboratory to notify the screening team/maternity services directly of
rejected or untested samples or screen positive results
• weekly failsafe of screen positive results
• wording on reports – remove ambiguity
• do not release screening results until confirmed
• update standard operating procedures to reflect current processes
• remove reference to rubella from local documents
7

8. Laboratory (29/61 recommendations)
• store national documents on quality management systems
• commissioner to identify risks and issues in the laboratory
• UKAS accreditation
• risk assessment of screening sample in the lab
• laboratory to schedule regular audits specific to the screening
pathways (vertical audits)
• implement electronic requesting
8

9. Generic recommendations– under other themes
• formalise governance arrangements (programme boards)
• terms of reference to ensure operational oversight and
representation for all key stakeholders
• management of incidents in NHS screening programmes
https://www.gov.uk/government/publications/managing-safety-
incidents-in-nhs-screening-programmes
• staffing and job descriptions – named laboratory lead
• training and competency assessments
• standards and key performance indicators – standard 4: turn around
times
9