GAP-SCORE (Standardised Clinical Outcome Review and Evaluation) is an integral part of the GAP programme and is an electronic audit tool which aims to assist clinicians in reviewing clinical care in the ‘missed case’ of fetal growth restriction. From booking risk assessment for SGA and care pathways throughout pregnancy, the care is reviewed in a standardised way. The software guides clinicians through the review process by examining potential factors which may have improved the referral rate for suspicion and detection of fetal growth restriction.

The aims of the audit are:

  • To potentially identify why the fetal growth restriction was missed
  • To identify if there are any training issues 
  • To identify any themes/system failures
  • To focus service provision
  • To provide evidence for commissioning support/services within Trusts

The audit uses the NHS England Saving Babies’ Lives care bundle (element 2) algorithm for identification of increased and low risk pregnancies: Care Bundle Algorithm

GAP-SCORE includes a systematic review of:

Maternal Summary

Flexible Image

Birth Details

Flexible Image


Flexible Image

Action Plans

Flexible Image

We would recommend a team of clinicians audit a number of randomly selected ‘missed cases’ in each 6 month period, dependent on unit delivery rates; individual access is via username and password which are issues following over the telephone training.

For further information and access to GAP-SCORE please email

Please note, this tool is not designed to audit care following a stillbirth or neonatal death. A full clinical review of care provision is required as this is an adverse outcome. GAP SCORE is aimed at the ‘missed case’ of fetal growth restriction only.