Have your say on group B Strep screening – consultation closes 25 January 2017
We are very disappointed with the recommendations of the report commissioned by the UK National Screening Committee (UK NSC) against antenatal group B Strep screening and disagree with many of the findings and conclusions.
The UK NSC looked at selected evidence published since 2012 the report they commissioned is recommending against introducing a screening programme.
We strongly disagree with this – evidence shows that screening can both save lives and reduce the risk of long-term disability by preventing devastating GBS infections.
Our expert Medical Advisory Panel is carefully examining the report and we will be submitting a detailed response. We disagree with a significant number of the UK NSC’s arguments. We believe the way in which the evidence has been assessed is sub-standard and inconsistent with that of other routine screening programmes. We believe the assessment does not include several key features of good screening programmes. The report is in our view based on very weak and wholly unconvincing evidence.
We urge everyone who wants to have their say in improving the prevention of group B Strep infections in newborn babies to submit their views to the UK NSC’s public consultation. The public consultation closes on Wednesday 25th of January.
You can download the full UK NSC Commissioned Report from https://legacyscreening.phe.org.uk/groupbstreptococcus, and this page also explains how to contribute to the public consultation.
Key Points from Group B Strep Support
The present state of affairs for preventing GBS infection in babies in the UK is neither safe nor an effective use of NHS resources. The UK NSC review is at best encouragement to do nothing, apart to wait years for yet more research that is unlikely to be funded. Group B Strep Support is not bound by officialdom and red tape, and believe that moves to block a woman’s right to have information on which to make an informed choice about her care, is completely wrong.
Few would deny that where GBS carriage is detected during pregnancy antibiotics should be offered in labour. The question is how best to find the right women to offer those antibiotics to.
The current situation with the NHS haphazardly testing some pregnant woman with a test that is right only half the time is unacceptable.
The UK NSC has a responsibility to sort this out. The Committee should have the courage be honest with the public – either they don’t consider GBS infection to be a serious enough priority and so recommend we abandon altogether this patchwork of prevention – or, as we fervently wish, recommend that universal antenatal screening for GBS carriage using the ECM test is introduced – as already happens successfully in so many other developed countries.
The UK has followed its risk-based approach to prevent group B Strep infections in newborn babies since 2003. Yet both the rate and number of potentially preventable early-onset group B Strep infections (developing in babies aged 0-6 days) have increased, not fallen. Group B Strep remains the most common cause of life-threatening infection in newborn babies and the leading cause of meningitis in babies under three months.
On average in the UK:
- One baby a day develops group B Strep infection
- One baby a week dies from group B Strep infection
- One baby a fortnight survives the infection with long-term disabilities – physical, mental, or both
If the recommendation that a screening programme to test pregnant women for GBS carriage should not be introduced is accepted by the UK National Screening Committee, many babies will suffer preventable GBS infection – many women carrying GBS won’t be identified, and will not receive safe, cheap and effective treatment during labour to prevent early-onset GBS infection in their baby. Yet were these babies born in many other developed countries, including the USA, France, Canada, Germany or Poland, it is almost certain that they and their families would be spared the trauma GBS brings.
Group B Strep Support wants all women to be given the choice of being tested for GBS carriage at 35-37 weeks of pregnancy.
As a result:
- More early-onset group B Strep infections would be prevented than using the current risk-based prevention strategy, clearly demonstrated by other developed countries
- There will be less inappropriate use of antibiotics, as women identified as not carrying group B Strep will not be offered them (unless other risk factors are present)
- The UK’s screening policy will be consistent with current movement towards helping pregnant women make informed choices about their care, and with the Government ambition to reduce significantly neonatal and maternal deaths.
We disagree in the strongest possible terms with the recommendation of the UK NSC commissioned report not to offer GBS screening.
The report contains errors and half-truths. Some key issues are:
- The evidence is inadequately assessed. The review requires new evidence (published since 2012) to demonstrate the benefit of screening, but ignores the evidence of sustained benefit of screening in countries, such as the USA, which has had a national policy of screening since 2002. This may give the impression that the report has been written with the conclusion already agreed, rather than systematically examining the evidence before coming to a conclusion.
- The methodology to assess the evidence does not follow best practice guidelines for any question, and in places appears biased in favour of studies that do not support routine antenatal screening for GBS carriage.
- We cannot be confident that the conclusions of the UK NSC in relation to the quality of the evidence are correct because there is either little or no information on who undertook the study, their qualifications, their roles, and their expertise in relation to GBS. Such information is standard when reporting the results of systematic reviews.
- The report does not examine a number of the key criteria for screening studies, which are met for a GBS screening programme.
- This report seeks much more evidence than has been required for other screening decisions, for less common conditions, which have been approved based on much less evidence.
How to take part in the consultation (closes Wed 25 Jan 2017):
You need to submit your comments by Wednesday 25 January 2017 to the UK NSC to contribute to their decision.
Go to https://legacyscreening.phe.org.uk/groupbstreptococcus and follow the instructions there. Or
Download the Comments Form:
- Click this link to download the form on which to add your comments (it’s a Word file)
- or copy/paste https://legacyscreening.phe.org.uk/policydb_download.php?doc=655 into your browser
Once you’ve added your comments and saved the file:
- Send an email to screening.evidence@nhs.net attaching the Word file with your comments.
“The UK NSC’s recommendation against routine screening for group B Strep is hugely disappointing and flies in the face of the evidence. Every year, hundreds of newborn babies suffer illness, disability and even death due to group B Strep. This recommendation would mean future babies will suffer needlessly from infections which could have and should have been prevented – some of these precious babies will die, others will survive with life-long disabilities. For all families touched by group B Strep it will be a traumatic experience.
Quite why the NSC ignores evidence from other countries, where screening programmes have led to huge reductions in group B Strep infection, is beyond me. GBS infections in babies in the UK are rising – we need to be doing more, not sticking blindly with the status quo. .
I encourage those who share our concerns to respond to the public consultation. We need a better prevention strategy to reduce the unacceptably high levels of preventable group B Strep infection in our babies.
The UK’s risk-based prevention strategy has failed to stem the rising tide of group B Strep infection in newborn babies. A safe and effective vaccine is at least a decade away.
Screening pregnant women for group B Strep carriage and offering the carriers antibiotics in labour – recognised as international best practice and undertaken for more than a decade in other developed countries – is the best way we currently have to protect our unborn babies.”
