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UK NSC National Hepatitis B in Pregnancy Audit

 

Hep B Audit 2014

Chronic hepatitis B infection is a major cause of liver disease worldwide and can be transmitted vertically from mother to baby. An estimated 0.4% of pregnant women in England have hepatitis B (1% in London). Routine screening for hepatitis B has been part of the Infectious Diseases in Pregnancy Screening (IDPS) programme in the UK since 2000, with around 3000 babies born to women with HBV each year. Uptake of screening is high, around 97%.

The UK National Screening Committee (UK NSC) has commissioned the first national audit of practice regarding management of hepatitis B in pregnancy. The aim is to undertake a national clinical audit of the management of pregnant women with hepatitis B infection booked to receive antenatal care over a 12 month period.

The audit will measure current practice against the IDPS Programme Standards. It will highlight aspects of service provision requiring improvement, in order to optimise current strategies for prevention of vertically-acquired hepatitis B and to inform future service planning.

Project Briefs and Newsflashes

We will keep you updated with progress in regular Project Briefs (see bottom of this page) and audit Newsflashes. 

June 2014- A huge thanks to all those who have submitted notification data for the audit so far. We received over 700 notifications by the end of May, and so are making excellent progress.

Hepatitis B in Pregnancy- 2014 and beyond: this meeting is specifically for all specialist clinical teams.  We have responded to requests from clinicians to have as much notice as possible. As such  we are rearranging this event from Thursday 10th July 2014 to a date early in September. Invitations will be sent out shortly.

Version 2 of our Project Brief is available below. In this project update you will find answers to some frequently asked questions to help with submission of notification data, and some information about the next phase of audit data collection.

7th March 2014: Thanks to everyone who has so far submitted notification data for the Hepatitis B in Pregnancy Audit. We really appreciate your support with this important study, with 137 cases reported so far.  Just a reminder to please notify us of any cases outstanding for women booking in January and February.

If your unit has not yet had any cases this year, please do let us know (if you have not already done so) - by email to this address. If you have had any women opting out, again please let us know. Please don't hesitate to get in touch if you have any queries.  
Dr Heather Bailey, UK NSC Hepatitis B in Pregnancy Audit Coordinator

 September 2013 In this our inaugural brief we provide some background to the audit.

Questions to the audit team?

The audit team will post questions and answers as they are received to further inform you on the audit. If you cannot find what you need please contact them on  phe.hepbaudit@nhs.net

What kind of approval does this audit have? 

The audit has approval from the Secretary of State Confidentiality Advisory Group (reference CAG 5-07(b)/2013) for use of patient identifiable information without consent. This approval is subject to strict conditions around the secure handling of the personal data (including the web-based system for submissions). Although eligible women are not required to give consent for their data to be used, they must be informed that the audit is taking place and given the opportunity to opt out.

We already inform all patients receiving care at our Trust that their data may be used for audit purposes. Do we need to inform eligible women separately about the Hepatitis B in Pregnancy Audit?

Yes – it is a condition of approvals for this audit that eligible women are informed that this specific audit is taking place and given the opportunity to opt out. The audit patient information leaflet should be distributed to eligible women by the screening coordinator or midwife for this purpose.

  I don’t check my @nhs.net account – can you send emails about the audit to my Trust email account instead?

No - @nhs.net accounts are the only ones which are secure enough for the transfer of patient identifiable data, required for this audit; Trust email addresses are not sufficiently secure, and cannot be used. Please check your @nhs.net address regularly for emails about the audit. More information about NHSmail is available here: http://systems.hscic.gov.uk/nhsmail

I do not have an @nhs.net account – how can I get one?

 Please request one by contacting your Local Organisation Administrator - you can find out who this is by asking your IT helpdesk at your NHS Trust, or calling the NHSmail Helpdesk on 0333 200 1133. More information about NHSmail is available here: http://systems.hscic.gov.uk/nhsmail

Is the patient information leaflet available in other languages?

No – we do not have the resources to support translation of the leaflet centrally, and so advise use of interpreting services as part of counselling where necessary. If you decide to translate the leaflet within your Trust, please use the version without logos (these can only be used on documents which have been centrally approved).

The notification form asks for the results of various tests – should all of these tests be conducted in maternity services for women eligible for the audit?

No – we have provided space for all hepatitis B-related tests that could possibly be done in maternity services, but understand that in many Trusts they will only be done after referral to a specialist. If a test has not been done, please simply report this - no additional tests should be conducted for the purposes of this audit.

What should I do if a woman opts out?

 Please document this in her notes and email us to let us know that you have had a case that has opted out (phe.hepbaudit@nhs.net); this will allow us to calculate the opt-out rate.

What should I do if a woman with hepatitis B transfers in or out of care at my maternity unit?

 Please get in touch to let us know. The audit is taking place across the whole of England, and so we will be able to match up her data if she is coming from or going to another maternity unit within England. Please help us by emailing the woman’s NHS number and the details of the maternity unit that she is transferring from / to, to our study email address (phe.hepbaudit@nhs.net).

What should I do if a woman is diagnosed with hepatitis B during labour / delivery, or very late in pregnancy?

Please complete as much of the notification form as you can (some of it won’t apply), and send us an email to let us know about this case.

 

 

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