Re-instated link to template result letter after pregnancy loss. Added additional risk factor in section 8.

Chapter Describe any changes Reason for change Contents Updated to include new content More accessible and easier to read Equality and diversity Wording added to make sure the handbook meets equality requirements Includes information about the 2010 equality act and language used in the handbook Introduction and programme overview Replaces Executive Summary Chronology removed Use of plain English, governance section updated to reflect NHSE processes. Chronology removed as not needed. Related documents Updated list and links Links updated and new guidance/standards issued since last iteration included Infections screened for - HIV All information updated, written more clearly and consistently, reflects revised programme screening standards with effect from April 2023 and published screening data from last few years Published data included to reflect changing picture, national guidance for managing HIV in pregnancy included, resources updated. Duplication removed and signpost to already published guidance Hepatitis B As above Updated to include the IDPS enhanced hepatitis B pathway, duplication removed and signpost to already published guidance Syphilis As above Includes the IDPS new syphilis pathway issued in May 2023, duplication removed and signpost to already published guidance IDPS screening pathway Link added and information updated, information about immunisation in pregnancy updated to include COVID-19 Pathway updated since last iteration and all information updated. COVID-19 information added from NHSE COVID team. All links updated and checked. Information and guidance about MDT working updated to reflect national guidance and finding from clinical expert reviews. Screening declines Reinforced previous handbook guidance that all women who decline screening should be referred to the MDT for further guidance and risk assessment Increased cases of vertical transmission where women have declined the formal reoffer but clinicians such as sexual health consultants have not been consulted and plans for babies/alerts not put in place Addressing inequalities for women with confirmed screen positive results Information added now it is known via published outcome reports Addition of national guidance (CORE20PLUS5) and findings from clinical expert review panels, as well as published outcome reports. Urgent screening Information added to reflect laboratory handbook New guidance on screening for women in labour with no previous results, taken from IDPS laboratory handbook published May 2022 Managing non-attendance Information added Guidance added about referral to MDT and encouraging collaboration with sexual health services Education and training Information added E-learning developed since last iteration, including ANNB e-learning, IDPS specific e-learning, resources for GPs and neonatal/paediatric intensive care units ISOSS Updated This service now covers all three infections and will be reporting 4 screening standards Quality assurance Updated with guidance from SQAS Links to updated resources Further resources Updated Further links added and updated to existing guidance to reduce repetitiveness

First published.