"the systematic application of a test or inquiry, to identify individuals at sufficient risk of a specific disorder to warrant further investigation or direct preventative action, amongst persons who have not sought medical attention on account of symptoms of that disorder" (1)

Wolverhampton presently is involved in a screening programme, which involves testing at the following stages, the programme in Wolverhampton is opportunistic at Antenatal and Neonatal stages, although targeted screening is not solely dependent upon ethnic origin

Antenatal screening allows women to undergo a simple blood test to detect carrier parents and provide genetic counselling, and offer the carrier couples the choice of prenatal diagnosis. Testing should be conducted at Antenatal clinic (community or hospital based).

The primary aim of cord blood screening is to identify babies with sickle cell in order to commence relevant treatment and identify a comprehensive care programme. The Project will invite you in for counselling to explain the process and an opportunity for you to ask any questions.

Thalassaemia can not be detected at this cord screening stage, but testing is recommended at age one to give a clear diagnosis of carrier status. Recall letters will be sent out to remind parents to have the child tested.

There are occasions when although individuals have not expected to be tested for sickle cell and thalassaemia, but have been contacted by the Project advising them of the blood tests results or inviting them in for counselling. The Haematology Laboratory follows national screening guidelines that enable them to test any individual for a haemoglobinopathy if the sample indicates any variance that may not be assumed as normal.

Recently the Project in partnership with Medical Assessment Unit, Pain Management Team and Haematology dept. have developed a Pain management protocol, for adults who have been admitted to hospital following a crisis, this formalises the process of hospital admissions and administrating pain relief.

We hope this information together with the flow chart provides you with a clearer picture of our involvement with the screening and counselling of individuals.