The Fetal Anomaly Screening Programme. Data Collection and Improvement Methodology to raise standards - A Case Study

Chelsea Hinton, Derriford Hospital 


A cleft lip is a gap in the top lip of a fetus. It is a congenital defect where the face did not join together sufficiently during development and it affects one in every seven hundred babies. National guidelines by the Fetal Anomaly Screening Programme (FASP) state that detection rates should be at least 75% for cleft lips during the anomaly scan performed at 18-20+6 weeks gestation. We have undertaken annual audits since 2010 to assess adherence to FASP detection standards.

Prenatal detection of cleft lips rates shows significant year on year variability within our unit and we are not consistently meeting the target every year. In 2017, we decided to reduce the variation in detection rates of cleft lips by working to improve standards in this area of fetal anomaly ultrasound. This triggered a Plan-Do-Study-Act (PDSA) cycle with the intention of making improvements.

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