The Department of Health is working with the Health Protection Agency to take forward plans to improve quality and cost-effectiveness in the National Chlamydia Screen Programme (NCSP). This is in line with the recommendations from the Public Accounts Committee (PAC) report and the review by Dr Ruth Hussey.
The goal of the NCSP is the control and prevention of chlamydia infection through the early detection and treatment of asymptomatic infection. In 2010/11 testing coverage was 25% (32% if the testing in GUM clinics is included). Evidence suggests that it is likely that screening levels greater than 35% will produce a faster fall in prevalence. Successful treatment and partner management of each additional chlamydia infection detected will also produce immediate direct benefit for those individuals.
Some estimates suggest the programme’s past work may have already produced a 20% fall in the prevalence of chlamydia in young adults. In order to maintain this progress, PCTs may wish to consider sustaining screening volumes within sexual and reproductive health services, GP practices and other venues where a high proportion of tests are positive.
Our vision is that all sexually active young people should be offered chlamydia testing as a routine part of every primary care and sexual health consultation. This should lead to broader conversations about sexual health and as well as preventing the long-term complications of chlamydia, should contribute to the reduction of other sexually transmitted infections and unintended pregnancies.
Current actions at national level to implement the PAC and Hussey recommendations include:
- Commissioning sexual health charity Brook to work with young people to help us find a new name for the programme and to get their views on what they want to see from the programme and how it should be delivered.
- Integrating chlamydia screening offices into sexual health and primary care services. This is substantially improving value for money. In this process, it is essential that nationally agreed specifications/recommendations for patient treatment and partner notification, are maintained. Further work is also being undertaken with PCTs on identifying overall costs and how these can be reduced.
- The HPA is undertaking a review of practice on outreach to form new guidance on this area and identify where outreach work is relevant, particularly in providing access for hard to reach, young people and responding to local needs. Guidance on this issue will be available in October this year. However, work with low risk groups that identifies small numbers of positive cases should cease.
- The HPA have developed a new evaluation framework, which includes a population based survey of prevalence, analyses of trends in chlamydia related outcomes (pelvic inflammatory disease and ectopic pregnancy) and surveys of testing behaviour, attitudes to testing and testing services.
- An evaluation of the impact of national campaigns on chlamydia testing behaviour and positivity is underway for publication in a peer viewed journal.
As highlighted in the Public Health White Paper Healthy Lives, Healthy People, a new sexual health policy document will be published later this year.
Further information on the programme is available from the Chlamydia Screening website.