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ST2

Anna Dellaway Balvinder Reehal

Head of Midwifery Screening Co-ordinator

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Antenatal sickle cell and thalassaemia

screening - timeliness of test ‘Women tested by 10+0 weeks’ gestation’ (numerator) is the

total number of pregnant ‘women for whom a sample was

received at the laboratory’ and for whom an antenatal sickle

cell and thalassaemia screening result was available (though

not necessarily communicated to the woman) by 10+0 weeks’

(70 days) gestation.

Performance thresholds:

Acceptable level: ≥ 50.0%

Achievable level: ≥ 75.0%

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Barriers

Two different targets

Booking by 12 weeks & 6 days was a national target,

SCAT programme standard/target is to book and have a

result by 10 weeks gestation

Locally, we knew that women

were referred early

So what and where were the

‘blockages’?

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Kingston Data

12.20%

22.30%

9.40%

3.60% 4.90%

11% 11.20%

24.35%

45%

57.70%

53.20%

47.20%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

Q1,2013/14

Q2,2013/14

Q3,2013/14

Q4,2013/14

Q1,2014/15 Q2,2014/15

Q3,2014/15

Q4,2014/15

Q1,2015/16

Q2,2015/16

Q3,2015/16

Q4,2015/16

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What happened at KH

Systems Process Mindset

We undertook an Audit to assess

* where the referrals were coming from (GP/Self)

* the gestation at time of referral

* what happened to the referrals

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Findings

We found that the majority of our referrals still came from

the GP

Our women were referred well under 10 week gestation

We have a significant number of ‘transfers in’

The delay was raised in the maternity booking office where

the appointments were made – as the clerical workers were

still working with the 12+6 target.

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The Next Steps….

To understand the detailed pathway of our referrals

To ensure that the standards of the SCAT programme

were reflected in the administrative guideline.

New guideline ‘Maternity Administration: Maternity

Referrals’ was ratified in February 2015.

Key points – all booking appointments to be completed

within 14 days of date stamped referral.

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Supportive processes

https://www.kingstonmaternity.org.uk/

On going updates for clerical colleagues – emphasis

on the relevance of the early

booking & performance

Regular monitoring

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Future Challenges

To continue to improve the early bookings

But need to take into account the ‘Continuity of Care’

agenda

Sites that do not have maternity IT System

‘Slot’ utilization

‘Fitting in’ the transfers into KH maternity

SWL Pathology

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THANK YOU

Any questions?