To bring conformity at a national level, the UK National Screening Committee integrated different screening programmes into three main domains, each reflecting the stages of the health screening lifecycle. These domains are the fetal, maternal and child health group, the adult screening and cancer screening programmes. High-quality guidance, specifically policy and programme standards, is a necessity for trusts offering a screening service and, for easy access. There is much commonality between the Down syndrome screening and fetal anomaly screening programme standards, in that good screening programmes need a central coordinating group. In understanding the complexities of the woman's journey through the Down syndrome and ultrasound screening system, a number of care pathways have been produced. Since 2001, a succession of national audits has been undertaken that have proved fruitful in terms of improving services. The past 30 years have seen astonishing advances in antenatal screening.