Hello New World !

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Hello New World !

• Meroe Bleasdille, NCSP Facilitator- London

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NCSP - The vision in 2003
To introduce a national screening programme for
all sexually active women and men under 25 years
to control Chlamydia.

• Opportunistic
• Targeted at ALL young persons -
  asymptomatic
• Delivered locally
• Community based

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Localism and innovative practices

• Fast tracking clinical pathways
• Texting results
• Development of web services for testing and
  treatment
• Trials of accelerated partner management
• Collaborative work
• young persons services, colleges, further
  education, military, third sector
• Young person friendly
• Local branding, festivals, sporting events

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Involving men
Year Males Females Community Coverage - Male Community Coverage - Female
2003-4 213 4,286 0.04 0.87
2004-5 1,677 14,772 0.34 2.99
2005-6 3,863 22,468 0.78 4.55
2006-7 6,409 29,055 1.29 5.89
2007-8 13,559 40,948 2.73 8.30
2008-9 53,006 130,052 10.69 26.35
2009-10 94,029 163,279 18.96 33.08
2010-11 113,871 175,215 22.96 35.50
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Lets Celebrate Londons Successes

• 2010/11 we conducted 291,130 tests and achieved a
  29.5 testing coverage in the community
• 13,664 of which were positive diagnoses
• Londons diagnostic rates was 2469 per 100,000
  population year end across all testing venues
• In 2011/12 changes to commissioning arrangements
  for the better
• Positivity and core service engagement have
  increased and we are commissioning less low
  positive yielding outreach

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Diagnostic Rates Explained

• Chlamydia diagnostic rate is a new outcome
  measure to assess progress in controlling
  chlamydia in young persons under 25 years old.
• If selected for the final public health outcomes
  framework the new outcome measure to be
  introduced in 2012/13 will be the annual
  diagnostic rate amongst the resident 15-24 year
  old population.
• This measure reflects both coverage and
  positivity of testing at all sites, includes
  genito-urinary medicine (GUM) diagnoses as well
  as those made outside of GUM, and is linked to
  expected falls in chlamydia prevalence

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Diagnostic Rates Explained

• Diagnostic rate positive tests
  x 100,000
• Population 15-24 year olds
  
• This counts all tests and positives amongst
  15-24 year olds, and includes symptomatic and
  asymptomatic test, and contacts (excluding
  confirmatory testing) from all testing venues
  combined.
• The diagnosis rate can be linked to falls in
  prevalence.

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Commissioning tips for diagnostic rates

• Get to grips with the total numbers of positives
  this translates to for your areas
• Estimate how many positives are guaranteed from
  GUM settings the remainder will need to be
  acquired through community activity
• See how you can target high risk groups whilst
  maintaining open access and improving your
  partner notification rates
• Use your JSNAs to inform commissioning of
  services

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Improving cost effectiveness of Chlamydia testing

• CTAD will mean Chlamydia testing and diagnoses
  data is collected from NHS commissioned
  laboratories and national abortion services.
• Alternative ways of monitoring treatment (PMPN)
  are currently being explored at national level
• No reason as to why Chlamydia administration and
  testing cannot be integrated into the local
  sexual health and primary care economy
• 2009 NCSP costing study is being refreshed some
  testing streams are more cost effective than
  others
• Lets minimise duplication wherever possible

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NCSP future direction

• Transition to Public Health England - HPA
  colleagues and NCSP team work to support the
  development of the Programme through the changes
  in the NHS in relation to commissioning, local
  delivery and monitoring of testing activity and
  outcomes
• New operating framework diagnostic rates as a
  proposed new outcomes indicator
• Vision focus INTEGRATION - commissioning, sexual
  health clinical pathways, data outputs for
  chlamydia testing
• Working with YP Programme has to be acceptable
  to young people, new charter developed in
  collaboration with Brook
• Cost effectiveness - Focus on cost per diagnosis
  rather than cost per test Support cost effective
  delivery of the Programme with emphasis on QIPP
• Provide ongoing commissioning support Links with
  DPHs, commissioning pack to support the
  implementation of and transition to CTAD, lab
  spec, new LES template, integration guidance etc.
  

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Thank you

• meroe.bleasdille_at_hpa.org.uk