Antenatal screening provision varies across the regions of the United Kingdom, with evidence of inequality of access, quality and auditing. In line with the era of Clinical Governance the Government proposed an innovative structured programme to address these issues. The National Screening Committee (NSC) and National Institute for Clinical Excellence (NICE) are formulating evidence-based guidelines with the objective being a National coordinated approach to Antenatal Screening Services.

The main emphasis of the 1st year was screening for Down's syndrome and the implementation of consistent national guidelines to achieve uniformity of detection rates and false positive rates, regardless of the screening tool i.e. serum screening or ultrasound. All units assisted in the completion of a regional mapping exercise on Down's syndrome service provision. Regional and National Reports are available here.

The 2nd Screening Report was published in May 2004 relating to the provision of Obstetric Ultrasound Services in the region. This follows extensive multidisciplinary collaboration in all maternity units to establish a baseline on which to establish policies, standards and recommendations for improvements. Future plans include moving to a first trimester Down’s Screening Service with Nuchal Translucency included as an analyte. This will need an extensive training programme for sonographers, which is anticipated to start in 2006/7.

All units in the West Midlands have now appointed their Specialist Midwives in Antenatal Screening who commenced a programme of regional training from January 2002 in order to commence local implementation strategies including clinical, audit and educational programmes. The team plays an integral part in the success of all initiatives, and should be credited with the improvements across the region.

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