Nearly 90% of hospitals not using £11 test for strep bacteria in pregnancy

Failure to follow the national guidelines to prevent Group B Strep (GBS) infections is causing a “postcode lottery” of care and opportunities, the Group B Strep Support charity said.

A freedom of information investigation by the charity found just 13% of NHS trusts and boards in the UK used the GBS-specific enriched culture medium (ECM) when testing women late in pregnancy, in line with guidelines from Public Health England and the Royal College of Obstetricians and Gynaecologists (RCOG).

The test, which detects if the woman is a carrier of the bacteria, costs around £11 and significantly decreases false-negative results. The trusts and boards that did not use this method instead used direct culture for their testing, out of step with national guidance.

No health boards in Wales or trusts in Northern Ireland reported using ECM methodology for testing while 15% of trusts in England and 7% of regional NHS boards in England carried out this form of testing.

Jane Plumb MBE, Group B Strep Support chief executive, said: “There’s no point in expert bodies like the RCOG producing clinical best practice guidelines if they’re not being adopted on the front line.

“Our research has found many trusts and boards are not giving pregnant women information on GBS, denying them an informed choice about their care.

“Equally worryingly, a majority are using the wrong test to look for GBS carriage, potentially leaving them vulnerable to expensive legal challenge if things go wrong.”

The investigation, which received a 100% response rate from all organisations in England, Scotland and Wales, found two-thirds (66%) of trusts used the wrong swab test to try and detect GBS in a pregnant woman — just 32% of organisations took both vaginal and rectal swabs to test for the bacteria, in line with national guidance.

Less than half (46%) of the 151 organisations surveyed gave information about the bacteria to all pregnant women, with 92% saying they provided information if GBS was detected and 89% also providing it upon request.

Almost a fifth (19%) of NHS trusts had not updated their local guidelines since the RCOG guidance was published in 2017.

While women can harmlessly carry the bacteria, GBS is the UK’s most common cause of severe infection in newborn babies, causing sepsis, pneumonia and meningitis.

Approximately 800 babies a year in the UK develop the infection in their first three months of life.

Of these, 50 babies will die, with another 70 survivors left with life-changing disabilities.

The charity gave one example, Baby Quinn, who was born in January 2019 and developed GBS.

His mother, Laura Sparks, had heard about GBS in her second pregnancy and made a mental note to get tested but because she was not given any further information at the hospital, it slipped her mind.

This meant she did not know she was a carrier and could not take action to prevent his infection. Quinn did later recover.

The charity is calling on all NHS trusts and boards to adopt national guidance, with all pregnant women informed about the GBS as a routine part of their antenatal care.

Where pregnant women are offered testing for GBS carriage, the GBS-specific enriched culture medium should be offered late in pregnant and all new parents should be informed about the key signs of the infection in babies.