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10. Siobhan O'callaghan findings from QA activities

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.

Health & Medicine◦
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Findings from QA activities Siobhan O’Callaghan Senior QA Advisor
Methodology • 30 QA visits reports • 786 QA recommendations • September 2017 to 4 July 2018 2 QA visits by region
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
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
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
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
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
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
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