The Royal College of Obstetricians and Gynaecologists published their updated guidelines on prevention of group B streptococcus (GBS) on incidence of GBS infection in neonates in July 2012. The updated guideline took into account new evidence on the prevention of early-onset neonatal GBS disease. It is important that services undertake local clinical audits to ensure the effective use of intrapartum antibiotic prophylaxis recommended by the guideline.

This year The National Institute for Health and Clinical Excellence published two clinical audit tools which include clinical audit standards, a data collection form and an action plan template for use by services that care for women in labour or for babies at risk of, or being treated for, early on-set neonatal infection.

The Department has not commissioned or evaluated any research on public opinion on routine screening of pregnant women for Group B Streptococcus (GBS) carriage; or the acceptability of receiving antibiotics during labour to prevent the transmission of GBS from mother to baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) published a revised Green-Top guideline on the prevention of early-onset neonatal GBS disease on 18 July 2012. The National Institute of Health and Clinical Excellence (NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

The Department has not commissioned or evaluated any research on public opinion on routine screening of pregnant women for Group B Streptococcus (GBS) carriage; or the acceptability of receiving antibiotics during labour to prevent the transmission of GBS from mother to baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) published a revised Green-Top guideline on the prevention of early-onset neonatal GBS disease on 18 July 2012. The National Institute of Health and Clinical Excellence (NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

The national guidelines for prevention of early onset neonatal group B streptococcus disease are developed to set the standards for high quality health care. The Royal College of Obstetricians and Gynaecologists published on 18 July 2012 the revised Green-Top guideline, originally published in November 2003, to take into account new evidence on the prevention of early-onset neonatal group B streptococcus (GBS) disease. In addition, the National Institute for Health and Clinical Excellence (NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for GBS carriage in pregnancy. In 2008-09, the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again.

The UK NSC held a public consultation on its screening review from 16 July 2012 to 23 October 2012. In total, 212 written responses were received. The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC’s website following the meeting apart from those where stakeholder organisations or individuals have requested that their response is not made public. The Department expects to receive a recommendation from the UK NSC shortly.

A meeting between the former Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), and officials took place on 10 January 2012 to discuss screening for GBS carriage in pregnancy. The former Parliamentary Under-Secretary of State for Health also hosted a meeting to discuss the UK NSC’s antenatal screening for GBS carriage review on 24 January 2012. Attendees included the UK NSC, the charity Group B Strep Support and Members of Parliament.

The national guidelines for prevention of early onset neonatal group B streptococcus disease are developed to set the standards for high quality health care. The Royal College of Obstetricians and Gynaecologists published on 18 July 2012 the revised Green-Top guideline, originally published in November 2003, to take into account new evidence on the prevention of early-onset neonatal group B streptococcus (GBS) disease. In addition, the National Institute for Health and Clinical Excellence (NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for GBS carriage in pregnancy. In 2008-09, the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again.

The UK NSC held a public consultation on its screening review from 16 July 2012 to 23 October 2012. In total, 212 written responses were received. The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC’s website following the meeting apart from those where stakeholder organisations or individuals have requested that their response is not made public. The Department expects to receive a recommendation from the UK NSC shortly.

A meeting between the former Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), and officials took place on 10 January 2012 to discuss screening for GBS carriage in pregnancy. The former Parliamentary Under-Secretary of State for Health also hosted a meeting to discuss the UK NSC’s antenatal screening for GBS carriage review on 24 January 2012. Attendees included the UK NSC, the charity Group B Strep Support and Members of Parliament.

The national guidelines for prevention of early onset neonatal group B streptococcus disease are developed to set the standards for high quality health care. The Royal College of Obstetricians and Gynaecologists published on 18 July 2012 the revised Green-Top guideline, originally published in November 2003, to take into account new evidence on the prevention of early-onset neonatal group B streptococcus (GBS) disease. In addition, the National Institute for Health and Clinical Excellence (NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for GBS carriage in pregnancy. In 2008-09, the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again.

The UK NSC held a public consultation on its screening review from 16 July 2012 to 23 October 2012. In total, 212 written responses were received. The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC’s website following the meeting apart from those where stakeholder organisations or individuals have requested that their response is not made public. The Department expects to receive a recommendation from the UK NSC shortly.

A meeting between the former Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), and officials took place on 10 January 2012 to discuss screening for GBS carriage in pregnancy. The former Parliamentary Under-Secretary of State for Health also hosted a meeting to discuss the UK NSC’s antenatal screening for GBS carriage review on 24 January 2012. Attendees included the UK NSC, the charity Group B Strep Support and Members of Parliament.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. A public consultation on the screening review has just closed. The Department expects to receive a recommendation from the UK NSC later this year.

The Department is not aware of any studies to understand the reason for the rise in GBS infections in newborn babies. However, the Department is aware of two publications, one which looked at the epidemiology of neonatal infection and the other which assessed the opportunities for prevention of cases of early onset GBS. These are;

“Vergnano S, Menson Et Kennea N, Embleton N, Russell AB, Watts T, Robinson M3, Collinson A, Heath PT, Neonatal infections in England: the NeonIN surveillance network and Vergnano S, Embleton N, Collinson A, Menson E, Russell AB, Heath P, Missed opportunities for preventing group B streptococcus infection.”

The Health Protection Agency's laboratory surveillance scheme provides ongoing monitoring of GBS bacteraemia. Data from the scheme indicate that the rates of early onset GBS bacteraemia (in infants 0-6 days of age) in England, Wales and Northern Ireland have fluctuated between 2003 and 2010 although showing a slight overall rise, from 0.37 to 0.41 per 1000 live births.

The Department has not conducted any research to gauge the opinions of women of childbearing age of the desirability of antenatal screening for GBS carriage in pregnancy or asked for their opinions on the use of antibiotics during labour to prevent transmission of GBS from mother to baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) published a Green-top guideline “Prevention of Early Onset Group B Streptococcal Disease” in November 2003, which provides guidance for obstetricians, midwives and neonatologists on the prevention of early-onset neonatal group B streptococcal disease. On 18 July 2012, the RCOG published a revised guideline to take into account new evidence on the prevention of early-onset neonatal GBS disease.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. A public consultation on the screening review has just closed. The Department expects to receive a recommendation from the UK NSC later this year.

The Department is not aware of any studies to understand the reason for the rise in GBS infections in newborn babies. However, the Department is aware of two publications, one which looked at the epidemiology of neonatal infection and the other which assessed the opportunities for prevention of cases of early onset GBS. These are;

“Vergnano S, Menson Et Kennea N, Embleton N, Russell AB, Watts T, Robinson M3, Collinson A, Heath PT, Neonatal infections in England: the NeonIN surveillance network and Vergnano S, Embleton N, Collinson A, Menson E, Russell AB, Heath P, Missed opportunities for preventing group B streptococcus infection.”

The Health Protection Agency's laboratory surveillance scheme provides ongoing monitoring of GBS bacteraemia. Data from the scheme indicate that the rates of early onset GBS bacteraemia (in infants 0-6 days of age) in England, Wales and Northern Ireland have fluctuated between 2003 and 2010 although showing a slight overall rise, from 0.37 to 0.41 per 1000 live births.

The Department has not conducted any research to gauge the opinions of women of childbearing age of the desirability of antenatal screening for GBS carriage in pregnancy or asked for their opinions on the use of antibiotics during labour to prevent transmission of GBS from mother to baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) published a Green-top guideline “Prevention of Early Onset Group B Streptococcal Disease” in November 2003, which provides guidance for obstetricians, midwives and neonatologists on the prevention of early-onset neonatal group B streptococcal disease. On 18 July 2012, the RCOG published a revised guideline to take into account new evidence on the prevention of early-onset neonatal GBS disease.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. A public consultation on the screening review has just closed. The Department expects to receive a recommendation from the UK NSC later this year.

The Department is not aware of any studies to understand the reason for the rise in GBS infections in newborn babies. However, the Department is aware of two publications, one which looked at the epidemiology of neonatal infection and the other which assessed the opportunities for prevention of cases of early onset GBS. These are;

“Vergnano S, Menson Et Kennea N, Embleton N, Russell AB, Watts T, Robinson M3, Collinson A, Heath PT, Neonatal infections in England: the NeonIN surveillance network and Vergnano S, Embleton N, Collinson A, Menson E, Russell AB, Heath P, Missed opportunities for preventing group B streptococcus infection.”

The Health Protection Agency's laboratory surveillance scheme provides ongoing monitoring of GBS bacteraemia. Data from the scheme indicate that the rates of early onset GBS bacteraemia (in infants 0-6 days of age) in England, Wales and Northern Ireland have fluctuated between 2003 and 2010 although showing a slight overall rise, from 0.37 to 0.41 per 1000 live births.

The Department has not conducted any research to gauge the opinions of women of childbearing age of the desirability of antenatal screening for GBS carriage in pregnancy or asked for their opinions on the use of antibiotics during labour to prevent transmission of GBS from mother to baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) published a Green-top guideline “Prevention of Early Onset Group B Streptococcal Disease” in November 2003, which provides guidance for obstetricians, midwives and neonatologists on the prevention of early-onset neonatal group B streptococcal disease. On 18 July 2012, the RCOG published a revised guideline to take into account new evidence on the prevention of early-onset neonatal GBS disease.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four United Kingdom countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered. The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. A public consultation on the screening review has just closed. The Department expects to receive a recommendation from the UK NSC later this year.

The Department is not aware of any studies to understand the reason for the rise in GBS infections in newborn babies. However, the Department is aware of two publications, one which looked at the epidemiology of neonatal infection and the other which assessed the opportunities for prevention of cases of early onset GBS. These are;

“Vergnano S, Menson Et Kennea N, Embleton N, Russell AB, Watts T, Robinson M3, Collinson A, Heath PT, Neonatal infections in England: the NeonIN surveillance network and Vergnano S, Embleton N, Collinson A, Menson E, Russell AB, Heath P, Missed opportunities for preventing group B streptococcus infection.”

The Health Protection Agency's laboratory surveillance scheme provides ongoing monitoring of GBS bacteraemia. Data from the scheme indicate that the rates of early onset GBS bacteraemia (in infants 0-6 days of age) in England, Wales and Northern Ireland have fluctuated between 2003 and 2010 although showing a slight overall rise, from 0.37 to 0.41 per 1000 live births.

The Department has not conducted any research to gauge the opinions of women of childbearing age of the desirability of antenatal screening for GBS carriage in pregnancy or asked for their opinions on the use of antibiotics during labour to prevent transmission of GBS from mother to baby.

The Royal College of Obstetricians and Gynaecologists (RCOG) published a Green-top guideline “Prevention of Early Onset Group B Streptococcal Disease” in November 2003, which provides guidance for obstetricians, midwives and neonatologists on the prevention of early-onset neonatal group B streptococcal disease. On 18 July 2012, the RCOG published a revised guideline to take into account new evidence on the prevention of early-onset neonatal GBS disease.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria.

In response to representations made to the Department on group B streptococcus (GBS) infection in newborn babies, during the UK NSC's consultation period, the Department has taken opportunities, for example through correspondence, to publicise that the UK NSC's review of screening for GBS carriage in pregnancy is currently open in order to ensure the widest possible engagement from stakeholder organisations and individuals during the consultation period.

The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC's website apart from those where stakeholder organisations or individuals have requested that their response is not made public.

The Department has not undertaken a comparative assessment of the cost benefit of the UK's risk-based strategy for preventing GBS infection in newborn babies with screening approaches used in other western countries.

However, a National Institute for Health Research Health Technology Assessment study: “Kaambwa B, Bryan S, Gray 3, Milner P, Daniels J, Khan K, Roberts T. Cost-effectiveness of rapid tests and other existing strategies for screening and management of early-onset group B streptococcus during labour. BJOG. 2010;117:1616-1627” suggested that assessments of screening's cost effectiveness in relation to current practice were subject to a great deal of uncertainty and were dependent on changes to clinical practice. A copy has been placed in the Library.

The Department has not held any consultations with any European Union member states on the prevention of GBS infection in newborn babies.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria.

In response to representations made to the Department on group B streptococcus (GBS) infection in newborn babies, during the UK NSC's consultation period, the Department has taken opportunities, for example through correspondence, to publicise that the UK NSC's review of screening for GBS carriage in pregnancy is currently open in order to ensure the widest possible engagement from stakeholder organisations and individuals during the consultation period.

The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC's website apart from those where stakeholder organisations or individuals have requested that their response is not made public.

The Department has not undertaken a comparative assessment of the cost benefit of the UK's risk-based strategy for preventing GBS infection in newborn babies with screening approaches used in other western countries.

However, a National Institute for Health Research Health Technology Assessment study: “Kaambwa B, Bryan S, Gray 3, Milner P, Daniels J, Khan K, Roberts T. Cost-effectiveness of rapid tests and other existing strategies for screening and management of early-onset group B streptococcus during labour. BJOG. 2010;117:1616-1627” suggested that assessments of screening's cost effectiveness in relation to current practice were subject to a great deal of uncertainty and were dependent on changes to clinical practice. A copy has been placed in the Library.

The Department has not held any consultations with any European Union member states on the prevention of GBS infection in newborn babies.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria.

In response to representations made to the Department on group B streptococcus (GBS) infection in newborn babies, during the UK NSC's consultation period, the Department has taken opportunities, for example through correspondence, to publicise that the UK NSC's review of screening for GBS carriage in pregnancy is currently open in order to ensure the widest possible engagement from stakeholder organisations and individuals during the consultation period.

The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC's website apart from those where stakeholder organisations or individuals have requested that their response is not made public.

The Department has not undertaken a comparative assessment of the cost benefit of the UK's risk-based strategy for preventing GBS infection in newborn babies with screening approaches used in other western countries.

However, a National Institute for Health Research Health Technology Assessment study: “Kaambwa B, Bryan S, Gray 3, Milner P, Daniels J, Khan K, Roberts T. Cost-effectiveness of rapid tests and other existing strategies for screening and management of early-onset group B streptococcus during labour. BJOG. 2010;117:1616-1627” suggested that assessments of screening's cost effectiveness in relation to current practice were subject to a great deal of uncertainty and were dependent on changes to clinical practice. A copy has been placed in the Library.

The Department has not held any consultations with any European Union member states on the prevention of GBS infection in newborn babies.

The UK National Screening Committee (UK NSC) advises Ministers and the national health service in all four countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria.

In response to representations made to the Department on group B streptococcus (GBS) infection in newborn babies, during the UK NSC's consultation period, the Department has taken opportunities, for example through correspondence, to publicise that the UK NSC's review of screening for GBS carriage in pregnancy is currently open in order to ensure the widest possible engagement from stakeholder organisations and individuals during the consultation period.

The UK NSC will consider all of the submissions made during the consultation at its 13 November 2012 meeting. All consultation replies will be available on the UK NSC's website apart from those where stakeholder organisations or individuals have requested that their response is not made public.

The Department has not undertaken a comparative assessment of the cost benefit of the UK's risk-based strategy for preventing GBS infection in newborn babies with screening approaches used in other western countries.

However, a National Institute for Health Research Health Technology Assessment study: “Kaambwa B, Bryan S, Gray 3, Milner P, Daniels J, Khan K, Roberts T. Cost-effectiveness of rapid tests and other existing strategies for screening and management of early-onset group B streptococcus during labour. BJOG. 2010;117:1616-1627” suggested that assessments of screening's cost effectiveness in relation to current practice were subject to a great deal of uncertainty and were dependent on changes to clinical practice. A copy has been placed in the Library.

The Department has not held any consultations with any European Union member states on the prevention of GBS infection in newborn babies.

The United Kingdom National Screening Committee (UK NSC) advises Ministers and the national health service in all four UK countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered.

The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. As part of the UK NSC's review the following National Institute for Health Research Health Technology Assessment (NIHR HTA) reports have been considered by the UK NSC:

Colbourn T, Asseberg C, Bojke L et al. Prenatal screening and treatment strategies to prevent group B streptococcal and other bacterial infections in early infancy: cost effectiveness and expected value of information analyses. Health Technol Assess (Winchester, England). 2007;11(29).

Daniels J, Gray J, Pattison H et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess (Winchester, England). 2009;13(42)

The UK NSC's internationally recognised criteria for appraising the viability, effectiveness and appropriateness of a screening programme states that there should be evidence from high quality randomised controlled trials (RCTs) that the screening programme is effective in reducing mortality or morbidity. The UK NSC acknowledges that undertaking RCTs is problematic in some areas and has used other types of evidence where RCTs are not feasible. However, in common with other organisations that give evidence based policy advice, the UK NSC recognise that these kinds of studies represent the gold standard.

For recommended standards of care the Royal College of Obstetricians and Gynaecologists (RCOG) published a revised Green-Top clinical guideline, on 18 July 2012, to take into account any new evidence on the prevention of early-onset neonatal GBS disease. In addition, the National Institute for Health and Clinical Excellence

(NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

National guidelines are developed to set the standards for high quality health care. In the prevention of early onset GBS disease, local maternity services should develop local guidelines (based on the RCOG's and NICE's national guideline) which all medical and midwifery staff would be expected to follow. The implementation of all guidelines should be audited regularly to confirm compliance and formulate an action plan for change in areas such as service provision education and training if the results of the audit are not satisfactory.

The United Kingdom Standards for Microbiology Investigation B 58 is for processing swabs. The B 58's use would be restricted to specific requests rather than for routine ‘checking’. In such circumstances, the laboratory may decide whether to follow the United Kingdom Standards for Microbiology Investigation B 58 or their own standard operating procedure. The United Kingdom Standards for Microbiology Investigation (BSOP58-Processing Swabs for Group B Streptococcal Carriage) provides a standardised method for culture where clinicians decide to investigate specific patients with conditions considered to confer a high risk of infection.

Data on the rates of potentially preventable early onset GBS infection is not collected. Laboratories across England, Wales and Northern Ireland submit data to the Health Protection Agency on .GBS infection. Submission of data is voluntary, therefore completeness of reporting has varied over time and across different parts of the country.

The UK NSC's review focussed its detailed assessment on screening in the United States of America as this has been documented in the literature in some detail. However, the review also includes information on GBS across the world from a systematic review published in The Lancet.

The United Kingdom National Screening Committee (UK NSC) advises Ministers and the national health service in all four UK countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered.

The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. As part of the UK NSC's review the following National Institute for Health Research Health Technology Assessment (NIHR HTA) reports have been considered by the UK NSC:

Colbourn T, Asseberg C, Bojke L et al. Prenatal screening and treatment strategies to prevent group B streptococcal and other bacterial infections in early infancy: cost effectiveness and expected value of information analyses. Health Technol Assess (Winchester, England). 2007;11(29).

Daniels J, Gray J, Pattison H et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess (Winchester, England). 2009;13(42)

The UK NSC's internationally recognised criteria for appraising the viability, effectiveness and appropriateness of a screening programme states that there should be evidence from high quality randomised controlled trials (RCTs) that the screening programme is effective in reducing mortality or morbidity. The UK NSC acknowledges that undertaking RCTs is problematic in some areas and has used other types of evidence where RCTs are not feasible. However, in common with other organisations that give evidence based policy advice, the UK NSC recognise that these kinds of studies represent the gold standard.

For recommended standards of care the Royal College of Obstetricians and Gynaecologists (RCOG) published a revised Green-Top clinical guideline, on 18 July 2012, to take into account any new evidence on the prevention of early-onset neonatal GBS disease. In addition, the National Institute for Health and Clinical Excellence

(NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

National guidelines are developed to set the standards for high quality health care. In the prevention of early onset GBS disease, local maternity services should develop local guidelines (based on the RCOG's and NICE's national guideline) which all medical and midwifery staff would be expected to follow. The implementation of all guidelines should be audited regularly to confirm compliance and formulate an action plan for change in areas such as service provision education and training if the results of the audit are not satisfactory.

The United Kingdom Standards for Microbiology Investigation B 58 is for processing swabs. The B 58's use would be restricted to specific requests rather than for routine ‘checking’. In such circumstances, the laboratory may decide whether to follow the United Kingdom Standards for Microbiology Investigation B 58 or their own standard operating procedure. The United Kingdom Standards for Microbiology Investigation (BSOP58-Processing Swabs for Group B Streptococcal Carriage) provides a standardised method for culture where clinicians decide to investigate specific patients with conditions considered to confer a high risk of infection.

Data on the rates of potentially preventable early onset GBS infection is not collected. Laboratories across England, Wales and Northern Ireland submit data to the Health Protection Agency on .GBS infection. Submission of data is voluntary, therefore completeness of reporting has varied over time and across different parts of the country.

The UK NSC's review focussed its detailed assessment on screening in the United States of America as this has been documented in the literature in some detail. However, the review also includes information on GBS across the world from a systematic review published in The Lancet.

The United Kingdom National Screening Committee (UK NSC) advises Ministers and the national health service in all four UK countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy. In 2008-09 the UK NSC recommended that a national screening programme to test for GBS carriage in pregnancy using the enriched culture medium test should not be offered.

The UK NSC is currently reviewing the evidence for screening for GBS carriage in pregnancy against its criteria again. As part of the UK NSC's review the following National Institute for Health Research Health Technology Assessment (NIHR HTA) reports have been considered by the UK NSC:

Colbourn T, Asseberg C, Bojke L et al. Prenatal screening and treatment strategies to prevent group B streptococcal and other bacterial infections in early infancy: cost effectiveness and expected value of information analyses. Health Technol Assess (Winchester, England). 2007;11(29).

Daniels J, Gray J, Pattison H et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess (Winchester, England). 2009;13(42)

The UK NSC's internationally recognised criteria for appraising the viability, effectiveness and appropriateness of a screening programme states that there should be evidence from high quality randomised controlled trials (RCTs) that the screening programme is effective in reducing mortality or morbidity. The UK NSC acknowledges that undertaking RCTs is problematic in some areas and has used other types of evidence where RCTs are not feasible. However, in common with other organisations that give evidence based policy advice, the UK NSC recognise that these kinds of studies represent the gold standard.

For recommended standards of care the Royal College of Obstetricians and Gynaecologists (RCOG) published a revised Green-Top clinical guideline, on 18 July 2012, to take into account any new evidence on the prevention of early-onset neonatal GBS disease. In addition, the National Institute for Health and Clinical Excellence

(NICE) published a new guideline on antibiotics for the prevention and treatment of early-onset neonatal infection, including GBS on 22 August 2012.

National guidelines are developed to set the standards for high quality health care. In the prevention of early onset GBS disease, local maternity services should develop local guidelines (based on the RCOG's and NICE's national guideline) which all medical and midwifery staff would be expected to follow. The implementation of all guidelines should be audited regularly to confirm compliance and formulate an action plan for change in areas such as service provision education and training if the results of the audit are not satisfactory.

The United Kingdom Standards for Microbiology Investigation B 58 is for processing swabs. The B 58's use would be restricted to specific requests rather than for routine ‘checking’. In such circumstances, the laboratory may decide whether to follow the United Kingdom Standards for Microbiology Investigation B 58 or their own standard operating procedure. The United Kingdom Standards for Microbiology Investigation (BSOP58-Processing Swabs for Group B Streptococcal Carriage) provides a standardised method for culture where clinicians decide to investigate specific patients with conditions considered to confer a high risk of infection.

Data on the rates of potentially preventable early onset GBS infection is not collected. Laboratories across England, Wales and Northern Ireland submit data to the Health Protection Agency on .GBS infection. Submission of data is voluntary, therefore completeness of reporting has varied over time and across different parts of the country.

The UK NSC's review focussed its detailed assessment on screening in the United States of America as this has been documented in the literature in some detail. However, the review also includes information on GBS across the world from a systematic review published in The Lancet.