Update March 2008
Governance of the Antenatal Screening Programme
Performance Management Framework
The balanced score card (BSC) has been reported to Trusts in May and October 2007 and the pilot phase has now been completed. A review of the process has been undertaken and a review of some of the targets is currently being undertaken and will be incorporated into the next reporting round (April 2008).
Audit Framework
Trust antenatal screening coordinators now have a complete folder of recommended audits and should be undertaking and reporting audits regularly within their Trust. All of the audit proforma have been piloted and have been well received. The collation of key audits results is being considered and the audit results support the Balanced Score Card reporting process.
Education Training and Support
Education Strategy
ASW have revised the Trust antenatal screening coordinator (TASCO) education/ training resource pack and developed a toolkit to assist with planning and delivery of a multidisciplinary education programme in the Trusts. This includes updated presentations including four new fast track presentations and a coordinators handbook. The toolkit, along with a laptop and projector, has been provided to all Trust Antenatal Screening Coordinators.
Trust Antenatal Screening Coordinators Training and Support
ASW continues to provide ongoing support and professional education for the TASCOs. Quarterly meetings continue to be well attended; an education session is included in each meeting e.g. most recently covering the Mental Capacity Act.
Training Needs Analysis (TNA) for Health Professionals Involved in Antenatal Screening
A TNA has been developed to identify the learning needs of relevant health professionals employed by the NHS in Wales about antenatal screening. Data analysis will be performed by ASW and individual reports of the findings of the TNA will be sent to the Trusts by April 2008. An all Wales summary will be collated.
Programme Management
Down’s Syndrome Screening
British Medical Ultrasound Society (BMUS) have recommended that measuring the biparietal diameter (BPD) should be replaced by head circumference (HC) measurement. This will require changes to the Down’s syndrome screening programme as ultrasound biometry measurements are required for risk calculation. A revised Down’s screening request card is currently being piloted to reflect the change to HC. ASW will provide training packs to the TASCO’s to assist the implementation of this change.
Sickle Cell and Thalassaemia Screening
A workshop for sickle cell and thalassaemia stakeholders was held to assess progress with the implementation of the antenatal sickle cell and thalassaemia programme in Wales and to identify any problem areas. Further work will be developed following the publication of the updated NICE recommendations for routine antenatal care.
Ultrasound Screening for Cardiac Anomalies
ASW has a midwife sonographer and a sonographer secondee who are developing a training programme in conjunction with the charity ‘Tiny Tickers’ to improve ultrasound screening for fetal cardiac anomalies in Wales. The training will be undertaken in four pilot sites commencing 23rd January 2008. Evaluation of the training will be available in the summer.
All Wales Woman Held Maternity Records
The all Wales woman held maternity records task and finish group at the Welsh Assembly asked if ASW would develop an antenatal screening record. The record has been consulted on widely and has been piloted at Pontypridd and Rhondda NHS Trust, Conwy and Denbighshire NHS trust and Swansea NHS Trust. Although the pilot was completed in October 2007 all the Trusts have asked to continue using the ASW antenatal screening records until the all Wales woman held maternity records are developed.
Collaborative Working
Welsh Study of Mothers and Babies
ASW are working in collaboration with Cardiff University to undertake a population based study looking at the relevance of certain ultrasound markers and to determine the short, medium and long term health outcomes associate with antenatal detection of defined ultrasound findings of uncertain significance on ultrasound scan. The application for funding the project from WORD was successful and the study will commence in April 2008.
Amniocentesis and Chorionic Villus Sampling – Policy, Standards and Protocols
ASW, in collaboration with the Fetal Anomaly Screening Programme (FASP) in England developed a consultation document for amniocentesis and CVS policy, standards and protocols. The final draft document was submitted to the FASP meeting on the 19th February and ratification by the AWMMG is expected in March 2008.
Decision Aids
ASW are working in partnership with Professor Glyn Elwyn, Centre for Health Sciences Research, Cardiff University and Marie-Anne Durand (PhD student) in the development of the amniodex – decision aid tool for women who are faced with the decision of accepting an amniocentesis or not. This development work is supported by the amniocentesis and CVS policy and standards development task and finish group.
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