Prenatal and neonatal screening 2026: what changes in the NHS

Key data

The prenatal, neonatal and colorectal cancer screening programs of the National Health System change in 2026. The Order SND/356/2026, of April 13, modifies annexes I, II and III of the Royal Decree 1030/2006, which regulates the common portfolio of services of the NHS, and introduces new tests and public health surveillance criteria that directly affect the protocols of all public healthcare centers in the country.

This is not a minor adjustment. The modification requires all autonomous communities to review and update their procedures, from primary care to specialized prenatal diagnosis units and neonatal screening laboratories.

What does this regulation establish?

Order SND/356/2026 acts on three simultaneous fronts within the common portfolio of services of the NHS:

The Royal Decree 1030/2006 is the regulation that defines what healthcare services all citizens in Spain have the right to receive regardless of their autonomous community. Modifying its annexes means that the new standards become mandatory throughout the national territory.

The Order SND/606/2024, of June 13, which created the Advisory Committee for the Common Portfolio of Services in the Area of Genetics, is also modified. Although the exact details of the changes in composition or functions require consulting the full text, this modification affects the body that provides technical advice on what genetic tests are incorporated into the public portfolio.

Economic and operational impact

This regulation does not generate direct costs for private companies, but it does have relevant operational and budgetary implications for managers of public healthcare centers and regional administrations:

• Review of clinical protocols: Primary and specialized care centers must update their internal procedures to adapt to the new tests incorporated into screening.
• Laboratories and prenatal diagnosis units: Prenatal diagnosis units and neonatal screening laboratories must review their workflows, equipment and referral criteria.
• Training of healthcare personnel: The incorporation of new tests may require specific training for professionals involved in screening programs.
• Coordination between autonomous communities: As this is a modification of the common portfolio, autonomous communities must ensure that their services meet the new minimum required standard, which may involve additional investment in those starting from a situation further from the new threshold.

For private healthcare sector companies that provide complementary services or collaborate with the NHS in screening programs, this update may require reviewing contracts and service provision conditions to align with the new public standards.

Who does it affect?

• Pregnant women: Will have access to new prenatal screening tests within public healthcare.
• Newborns: Neonatal screening programs incorporate new detection standards.
• People over 50 years old: Affected by changes in the colorectal cancer screening program.
• NHS healthcare professionals: Doctors, midwives, nurses and laboratory personnel participating in screening programs must adapt their procedures.
• Managers of public healthcare centers: Responsible for implementing changes in primary care, specialized care and laboratories.
• Autonomous communities: Required to adapt their healthcare services to the new national standard.
• Advisory Committee for the Common Portfolio of Services in the Area of Genetics: Sees its composition or functions modified by this order.
• Private companies collaborating with the NHS: Those providing diagnosis or laboratory services linked to screening programs must review their alignment with the new standards.

Practical example

A public hospital in an autonomous community that manages a prenatal diagnosis unit currently receives pregnant women for first trimester screening tests. With the entry into force of Order SND/356/2026, the unit must review whether the tests it offers cover the new criteria incorporated into Annex I of Royal Decree 1030/2006.

If the current protocol does not include any of the new required tests, the center will need to update its portfolio of services, adapt referral circuits and, where appropriate, train the personnel involved. The same applies to the neonatal screening laboratory regarding Annex II, and to the gastroenterology unit or primary care that manages the colorectal cancer program regarding Annex III.

The center manager cannot wait for the autonomous community to issue internal instructions: the obligation to comply derives directly from the modification of the NHS common portfolio, which applies throughout the national territory.

What should healthcare centers do now?

1. Consult the full text of Order SND/356/2026 in the BOE to identify exactly what new tests and criteria are incorporated into each annex of Royal Decree 1030/2006.
2. Review current protocols for prenatal, neonatal and colorectal cancer screening to identify gaps with respect to the new required standards.
3. Update internal procedures in primary care, specialized care and prenatal diagnosis laboratories to comply with the new requirements.
4. Assess training needs for healthcare personnel involved in the affected screening programs.
5. Coordinate with the regional health department to align with implementation instructions that each autonomous community issues in development of this order.
6. Review contracts with external service providers of laboratory or diagnosis services participating in screening programs, to ensure that their services comply with the new standards.