National surveillance systems, established and managed by the UK Health Security Agency (UKHSA), are used to monitor trends, characteristics, and outcomes of Group B Streptococcus (GBS) infection, vital to prevention efforts. These include the reporting of cases diagnosed in local microbiology laboratories, and the submission of clinical isolates to the national reference laboratory. Analyses based on this surveillance is published in annual reports.

The UKHSA has jointly co-ordinated periods of enhanced surveillance with academic and public health collaborators, allowing greater understanding of risk factors and outcomes of infection, vital in identifying opportunities for prevention. Data generated through laboratory surveillance is utilised to assess the impact of prevention efforts.

The list of notifiable diseases is kept under review by the Department, with UKHSA involvement. Should GBS be added to the list of notifiable diseases, the means to assess the impact of this change on surveillance data will be considered.

Notifiable diseases, listed under schedule 1 of the Health Protection (Notification) Regulations 2010, are kept under review by the Department and the UK Health Security Agency (UKHSA). The Government published a public consultation between 12 July and 15 November 2023, seeking views on proposed amendments to the regulations, including adding diseases to schedule 1 to make them notifiable.

Adding Group B Streptococcal (GBS) Infection to schedule 1 was not included in the consultation proposals, but a small number of respondents suggested it could be suitable for inclusion. A summary of responses to the consultation has been published. The Department and the UKHSA are considering the consultation responses, and confirmation of any changes to the regulations will be published in due course.

To increase awareness and understanding of GBS, NHS England published a revised Core Competency Framework in May 2023, which covers the mandated training for all maternity services, which now includes GBS. Undertaking this training will enable midwives and doctors to be better informed when speaking to families about the risk of GBS in labour. The Core Competency Framework is incentivised through the maternity incentive scheme administrated by NHS Resolution.

No specific assessment has been made.

No specific assessment has been made.

The UK Health Security Agency (UKHSA) plays a key role in combatting Group B Streptococcus (GBS) infection both through routine service activities and innovative research. Trends, characteristics, and outcomes of infection are monitored through surveillance, vital for prevention efforts, providing means to understand differential risk within our population, which has informed guidance change. Emergence of new strains is monitored at the reference laboratory, vital to understanding the potential vaccine coverage and escape once vaccines are licensed. Furthermore, genomic assessment of strains identified the presence clusters, an important finding highlighting the potential for spread of infection within hospitals.

The Vaccine Development and Evaluation Centre at UKHSA Porton Down is part of an international consortium funded by the Gates Foundation to develop standardised assays to quantify immune responses to GBS in natural immunity studies and vaccine trials.

Following a review of the Health Protection (Notification) Regulations 2010 by the Department and the UK Health Security Agency (UKHSA), the Government published a public consultation between 12 July and 15 November 2023, seeking views on proposed amendments to the regulations.

Adding Group B Streptococcal Infection to schedule 1 of the regulations was not included in the consultation proposals, but a small number of respondents suggested it could be suitable for inclusion.

A summary of responses to the consultation has been published. The Department and UKHSA are considering the consultation responses, and confirmation of any changes to the regulations will be published in due course.

No such discussions have taken place recently.

Midwives are a key source of information for new and expectant parents on Group B Strep (GBS), so it is critical that they are well-informed, and this awareness will help eliminate these serious, yet often avoidable, infections in new-born babies.

NHS England published a revised Core Competency Framework in May 2023; it covers the mandated training for all maternity services which now includes GBS. Undertaking this training will increase awareness and understanding of GBS, enabling midwives and doctors to be better informed when speaking to families about the risk of GBS in labour. The Core Competency Framework is incentivised through the maternity incentive scheme administrated by NHS Resolution.

The Royal College of Midwives (RCM) has an evidence-based i-learn module on GBS that is freely available to RCM members. It would be beneficial for as many midwives as possible to take the training to increase awareness of GBS.

Screening for GBS is not routinely offered to all pregnant women in the United Kingdom. However, if it is detected during pregnancy through routine testing, it will be managed in accordance with Trust protocol and information leaflets will be provided on treatment and any associated risks. GBS testing is usually only offered to women who have had GBS in a previous pregnancy, in which case, testing will be carried out by the Trust providing care.

The Office for Health Improvement and Disparities and NHS England continue to work with system partners across England on the Group B Strep trial, which is currently underway as a multi-centre randomised controlled trial with 71 hospital sites included. It is looking at whether routine testing of women for GBS, either in late pregnancy or during labour, reduces the occurrence of early-onset neonatal sepsis, compared to the current risk factor-based strategy.

Midwives are a key source of information for new and expectant parents on Group B Strep (GBS), so it is critical that they are well-informed, and this awareness will help eliminate these serious, yet often avoidable, infections in new-born babies.

NHS England published a revised Core Competency Framework in May 2023; it covers the mandated training for all maternity services which now includes GBS. Undertaking this training will increase awareness and understanding of GBS, enabling midwives and doctors to be better informed when speaking to families about the risk of GBS in labour. The Core Competency Framework is incentivised through the maternity incentive scheme administrated by NHS Resolution.

The Royal College of Midwives (RCM) has an evidence-based i-learn module on GBS that is freely available to RCM members. It would be beneficial for as many midwives as possible to take the training to increase awareness of GBS.

Screening for GBS is not routinely offered to all pregnant women in the United Kingdom. However, if it is detected during pregnancy through routine testing, it will be managed in accordance with Trust protocol and information leaflets will be provided on treatment and any associated risks. GBS testing is usually only offered to women who have had GBS in a previous pregnancy, in which case, testing will be carried out by the Trust providing care.

The Office for Health Improvement and Disparities and NHS England continue to work with system partners across England on the Group B Strep trial, which is currently underway as a multi-centre randomised controlled trial with 71 hospital sites included. It is looking at whether routine testing of women for GBS, either in late pregnancy or during labour, reduces the occurrence of early-onset neonatal sepsis, compared to the current risk factor-based strategy.

Midwives are a key source of information for new and expectant parents on Group B Strep (GBS), so it is critical that they are well-informed, and this awareness will help eliminate these serious, yet often avoidable, infections in new-born babies.

NHS England published a revised Core Competency Framework in May 2023; it covers the mandated training for all maternity services which now includes GBS. Undertaking this training will increase awareness and understanding of GBS, enabling midwives and doctors to be better informed when speaking to families about the risk of GBS in labour. The Core Competency Framework is incentivised through the maternity incentive scheme administrated by NHS Resolution.

The Royal College of Midwives (RCM) has an evidence-based i-learn module on GBS that is freely available to RCM members. It would be beneficial for as many midwives as possible to take the training to increase awareness of GBS.

Screening for GBS is not routinely offered to all pregnant women in the United Kingdom. However, if it is detected during pregnancy through routine testing, it will be managed in accordance with Trust protocol and information leaflets will be provided on treatment and any associated risks. GBS testing is usually only offered to women who have had GBS in a previous pregnancy, in which case, testing will be carried out by the Trust providing care.

The Office for Health Improvement and Disparities and NHS England continue to work with system partners across England on the Group B Strep trial, which is currently underway as a multi-centre randomised controlled trial with 71 hospital sites included. It is looking at whether routine testing of women for GBS, either in late pregnancy or during labour, reduces the occurrence of early-onset neonatal sepsis, compared to the current risk factor-based strategy.

Midwives are a key source of information for new and expectant parents on Group B Strep (GBS), so it is critical that they are well-informed, and this awareness will help eliminate these serious, yet often avoidable, infections in new-born babies.

NHS England published a revised Core Competency Framework in May 2023; it covers the mandated training for all maternity services which now includes GBS. Undertaking this training will increase awareness and understanding of GBS, enabling midwives and doctors to be better informed when speaking to families about the risk of GBS in labour. The Core Competency Framework is incentivised through the maternity incentive scheme administrated by NHS Resolution.

The Royal College of Midwives (RCM) has an evidence-based i-learn module on GBS that is freely available to RCM members. It would be beneficial for as many midwives as possible to take the training to increase awareness of GBS.

Screening for GBS is not routinely offered to all pregnant women in the United Kingdom. However, if it is detected during pregnancy through routine testing, it will be managed in accordance with Trust protocol and information leaflets will be provided on treatment and any associated risks. GBS testing is usually only offered to women who have had GBS in a previous pregnancy, in which case, testing will be carried out by the Trust providing care.

The Office for Health Improvement and Disparities and NHS England continue to work with system partners across England on the Group B Strep trial, which is currently underway as a multi-centre randomised controlled trial with 71 hospital sites included. It is looking at whether routine testing of women for GBS, either in late pregnancy or during labour, reduces the occurrence of early-onset neonatal sepsis, compared to the current risk factor-based strategy.

Midwives are a key source of information for new and expectant parents on group B Strep (GBS), so it is critical that they are well-informed. Awareness of GBS helps eliminate this serious, yet often avoidable, infections in new-born babies. An evidence-based i-learn module on GBS is freely available to all Royal College of Midwives members and midwives are encouraged to undertake this training to increase their knowledge around GBS.

Additionally, the Government’s national Start4Life programme provides advice and practical guidance to parents-to-be and families with babies and under five years old, to help them adopt healthy behaviours and build parenting skills. The Start4Life website offers guidance for all pregnant mothers, including those from Black and Asian backgrounds, on GBS. The guidance is available at the following link:

https://www.nhs.uk/start4life

Midwives are a key source of information for new and expectant parents on group B strep (GBS), so it is critical that they are well-informed and this awareness will help eliminate these serious, yet often avoidable, infections in new-born babies. Group B Strep Support and the Royal College of Midwives (RCM) have an evidence-based i-learn module on GBS that is freely available to RCM members. It would be beneficial for as many midwives as possible to take the training to increase awareness of GBS.

Public Health England’s national programme Start4Life provides advice and practical guidance to parents-to-be and families with babies and under five years old, to help them adopt healthy behaviours and build parenting skills. The Start4Life website offers guidance for pregnant mothers on GBS which is available at the following link:

https://www.nhs.uk/start4life

Screening for GBS is not routinely offered to all pregnant women in the United Kingdom. A risk-based approach has been adopted, whereby those women identified as at risk of having a baby affected by GBS are offered antibiotics in labour.

The GBS carriage rate varies among racial groups, however the highest rates occur within people of black African ancestry and the lowest in people of South Asian ancestry. Evidence shows that continuity of carer can significantly improve outcomes for women and their babies from ethnic minorities and those living in deprived areas. NHS England wrote to all trusts regarding the Midwifery Continuity of Carer (MCoC) stating that where locally it is decided that provision of MCoC can continue, NHS England continues to encourage prioritised rollout to areas with a high proportion of Black, Asian and mixed ethnicity women, as well as areas of high deprivation.

Midwives are a key source of information for new and expectant parents on group B strep (GBS), so it is critical that they are well-informed and this awareness will help eliminate these serious, yet often avoidable, infections in new-born babies. Group B Strep Support and the Royal College of Midwives (RCM) have an evidence-based i-learn module on GBS that is freely available to RCM members. It would be beneficial for as many midwives as possible to take the training to increase awareness of GBS.

Public Health England’s national programme Start4Life provides advice and practical guidance to parents-to-be and families with babies and under five years old, to help them adopt healthy behaviours and build parenting skills. The Start4Life website offers guidance for pregnant mothers on GBS which is available at the following link:

https://www.nhs.uk/start4life

Screening for GBS is not routinely offered to all pregnant women in the United Kingdom. A risk-based approach has been adopted, whereby those women identified as at risk of having a baby affected by GBS are offered antibiotics in labour.

The GBS carriage rate varies among racial groups, however the highest rates occur within people of black African ancestry and the lowest in people of South Asian ancestry. Evidence shows that continuity of carer can significantly improve outcomes for women and their babies from ethnic minorities and those living in deprived areas. NHS England wrote to all trusts regarding the Midwifery Continuity of Carer (MCoC) stating that where locally it is decided that provision of MCoC can continue, NHS England continues to encourage prioritised rollout to areas with a high proportion of Black, Asian and mixed ethnicity women, as well as areas of high deprivation.

The Department has no plans to do so at present.

Should the evidence base develop further, clinical policy may be updated by relevant organisations such as the National Institute for Health and Care Excellence. NHS England would then consider the development of care pathways for those living with paediatric acute-onset neuropsychiatric syndrome and paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. In the meantime, integrated care systems are responsible for planning care for their populations.

Medical professionals, such as general practitioners, are responsible for ensuring their own clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance to ensure that they can continue to provide high quality care to all patients.

Supply issues affecting antibiotics used to treat Strep A appear to be improving, as decisive action has been taken to boost supply and demand has reduced. We are continuing to work with manufacturers and wholesalers to ensure that they expedite deliveries, bring forward stock they have to make sure it gets to where it is needed, and boost supply to meet demand.

We have issued eight Serious Shortage Protocols (SSPs) to allow pharmacists to supply an alternative form of penicillin V, or alternative antibiotic, to make things easier for them, patients, and GPs.

Supply issues affecting antibiotics used to treat Strep A appear to be improving, as decisive action has been taken to boost supply and demand has reduced. We are continuing to work with manufacturers and wholesalers to ensure that they expedite deliveries, bring forward stock they have to make sure it gets to where it is needed, and boost supply to meet demand.

We have issued eight Serious Shortage Protocols (SSPs) to allow pharmacists to supply an alternative form of penicillin V, or alternative antibiotic, to make things easier for them, patients, and GPs.

The UK Health Security Agency (UKHSA) has declared a national enhanced incident to co-ordinate the public health response. The UKHSA is working with schools and general practitioners to provide information on scarlet fever and Group A streptococcus, including relevant information for parents to understand the symptoms for urgent referrals for children with more serious cases. We are undertaking research to understand how parents are responding to this information.

A surveillance report and communications for the health system have been published to raise awareness among frontline clinicians. On 2 December, an alert was issued to remind clinicians of their legal duty to notify cases. Guidance has been issued to support clinical diagnosis, promote appropriate use of antimicrobials whilst ensuring patient safety.

As health is a devolved matter, the devolved administrations are responsible for responding appropriately to the needs of the respective populations, including addressing outbreaks of scarlet fever and Group A streptococcus (GAS).

The UK Health Security Agency (UKHSA) collaborates with the devolved administrations and the relevant public health agencies. Representatives from the devolved administrations attend the UKHSA’s incident management team meetings, including for the GAS incident. Information on serious cross‑border threats to health, new and emerging threats, surveillance and response coordination is also shared.