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Sexual and Reproductive Health Datasets: Who? What? Why? When? Mandy Yung, Data Development Manager, Department of Health and HPA.

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Presentation on theme: "Sexual and Reproductive Health Datasets: Who? What? Why? When? Mandy Yung, Data Development Manager, Department of Health and HPA."— Presentation transcript:

1 Sexual and Reproductive Health Datasets: Who? What? Why? When? Mandy Yung, Data Development Manager, Department of Health and HPA

2 Overview: Background –ISB SRH Datasets – Who? What? Why? When? –GUMCAD –GUMCAD2 –CTAD –NCSP(core) and NCSP(PPNM) –Non-NCSP Non-GUM –SRHAD (NB GUMAMM, HIV and enhanced STI surveillance datasets not covered in this presentation) Summary

3 Background : Who? Cover all NHS services providing sexual and reproductive health care: GUM clinics Enhanced GPs SRH Services (ie CASH, family planning, reproductive health, contraceptive services) Brook Clinics Integrated GUM and SRH Clinics Other NCSP programme venues Other services offering sexual health care

4 Background: What? Revising existing surveillance datasets to meet new requirements and working towards a common dataset for sexual health: –GUMCAD replaces KC60 –Expansion of GUMCAD to include all other services offering STI care (GUMCAD2) –SRHAD replaces KT31 –CTAD to replace NCSP core dataset and Non-NCSP Non-GUM laboratory survey Managed by a different organisations

5 Background: Why? Surveillance - collection, collation and analysis of data to detect changes in trends or distribution in order to initiate investigative or control measures. –Plan and assess services –Inform public health action –Monitor interventions Monitor and evaluate national and local targets/guidelines Standardise data collection and reporting

6 Background : When? Varies by datasets and setting. Now: GUMCAD – all GUM clinics SRHAD/KT31 – all SRH services NCSP(core) – all NCSP programme areas NCSP(PPNM) – all NCSP programme areas Non-NCSP Non-GUM – laboratories (voluntary) Future (2011/12): GUMCAD2 – all non-GUM commissioned SH services SRHAD – all non-SRH commissioned contraceptive service (GUM, en-GP) CTAD – all laboratories that carry out testing for chlamydia

7 NHS Information Standards Board An independent mechanism for the assurance and sign off of Information Standards for use in the NHS (England) and in its work with other agencies such as social care. Demonstrate that collection of datasets are desirable, achievable and could be implemented nationally Specific objectives: –Demonstrate that clinics can collect and record data items to a high standard –Demonstrate that clinic software suppliers could produce datasets to specification –Demonstrate added public health utility of the data

8 GUMCAD and GUMCAD2: Genitourinary medicine clinic activity dataset Who? GUMCAD – All GUM clinics – 204 clinics in England – Nearly 100% clinics have GUMCAD installed – Over 90% of clinics have submitted GUMCAD for 2009 GUMCAD2 – All non-GUM commissioned SH services Enhanced GPs (53%) Sexual & Reproductive Health services (35%) Integrated (joint GUM and SRH) (4.3%) Brook (1.7%) Other (2.8%)

9 GUMCAD and GUMCAD2: Genitourinary medicine clinic activity dataset

10 What? Collection of electronic anonymised patient level data 12 data items – registration, attendance and clinical information (Clinic, patient IDs, gender, age, ethnicity, COB, PCT and LSOA of residence) (Attendance type, date of attendance) (Sexual orientation, clinical code (KC60 code) Residence based data Replaced KC60 Central Return in GUM clinics Reported quarterly

11 GUMCAD and GUMCAD2: Genitourinary medicine clinic activity dataset Why? Data collected and analysed to: Monitor trends in new STI diagnoses and other sexual health problems To determine which specific groups are at particular risk. To facilitate robust assessment of local service needs This information will be used to inform the public health response by: Improving the planning and management of services. Developing, adapting and refining interventions. Monitoring the effectiveness of sexual health policies. In addition: Electronic data collection and processing should improve the timeliness of outputs from the HPA Enables more informative epidemiological analysis and data by area of residence Core dataset from GUM for other enhanced surveillance systems (GRASP, GUMANON, Enhanced syphilis)

12 GUMCAD Reports

13 Examples of GUMCAD reports


15 GUMCAD and GUMCAD2: Genitourinary medicine clinic activity dataset When? GUMCAD Approved by the ISB in February 2008 DSCN issued in March 2008 Parallel running of KC60 and GUMCAD during 08/09 KC60 ceased in April 2009 198/204 (97%) GUM clinics have submitted a GUMCAD extract Over 90% clinics submitted a full extract GUMCAD2 ISB approval for requirement stage ISB draft and full stage submission due August 2010 Implementation date: 1 st January 2011

16 Chlamydia tests datasets: Who? NCSP(core) – all NCSP programme areas/CSO/venues NCSP(PPNM) – all NCSP programme areas/CSO/venues ` GUMCAD – GUM clinics (sexual health screens only) Non-NCSP Non-GUM – voluntary laboratories CTAD – All laboratories providing chlamydia testing

17 Chlamydia tests datasets: What? DatasetNo. of Data ItemsLevel of Data Reporting Time NCSP(core)14PatientQuarterly NCSP(PPNM) Patient Partner Notification and Management 40 (18 PM, 22 PN)AggregateQuarterly (1 mth lag) Non NCSP Non GUM-AggregateQuarterly GUMCAD12PatientQuarterly CTAD Chlamydia (and gonorrhoea) Testing Activity Dataset 16PatientQuarterly

18 Chlamydia tests datasets: Why? Monitor the extent of coverage of the NCSP target population (VSI) to assess the effectiveness of chlamydia control strategies CTAD: Current CT tests datasets are not wholly comparable (reported from different sources covering different geographical areas, in different ways) Possible incomplete or double reporting Due to the aggregate nature of the Non-NCSP Non-GUM return, it is not possible to carry out validation of the data submitted Data from the NCSP and the Non-NCSP Non-GUM return are age- specific, therefore not providing a comprehensive picture of all chlamydia testing and diagnoses

19 Chlamydia tests datasets: When? NOW: NCSP(core), NCSP (PPNM), Non-NCSP Non-GUM and GUMCAD FUTURE: CTAD ISB requirements stage application submitted Implementation date schedule for early 2011 Concurrent running of NCSP(core) and Non-NCSP Non-GUM for min 6 mths NCSP(PPNM) Sentinel surveillance GUMCAD GUMCAD & GUMCAD2 – New SHHAPT codes (revised KC60 codes) will be launched 1 st January 2011: allows recording of chlamydia test only

20 SRHAD: Sexual and Reproductive Health Activity Dataset Who? All SRH services (e.g. family planning clinics, CASH, commissioned Brook) In the future look to expand to other services e.g. GUM, enhanced GPs and other services offering contraception & reproductive care Managed by NHS Information Centre

21 SRHAD: Sexual and Reproductive Health Activity Dataset What? Disaggregate patient level data Replaced KT31 Central Return (aggregate paper-based return) 16 data items – registration, attendance, contraception and other SRH activities information Residence based data Reported quarterly

22 SRHAD: Sexual and Reproductive Health Activity Dataset Why? Ensure more relevant and timely electronic data that supports local service development Reflects current data collection practices and requirements at SRH Services. Allow monitoring of key policy initiatives such as promotion of Long Acting Reversible Contraception (LARC), reducing teenage conceptions, reduce rate of unintended pregnancies, modernisation of SRH services. Support commissioners in understanding which population groups are accessing SRH services and which services they are receiving (including uptake of LARC methods as recommended by NICE) and thus allow for improved long-term commissioning of services Develop, over time, indicators of quality and outcome in service delivery

23 SRHAD: Sexual and Reproductive Health Activity Dataset When? ISB approval November 2009 Implemented 1st April 2010 Concurrent running of KT31 and SRHAD for 1 year where possible –Sites unable to submit SRHAD due to lack of IT system can continue to submit a KT31 (1-2 years) KT31 collated by PCT, SRHAD to be sent directly to NHS IC

24 Data Fields: *Proposed CTAD data items awaiting ISB approval, maybe subject to change

25 Data Fields: *Proposed CTAD data items awaiting ISB approval, maybe subject to change

26 Data Fields : *Proposed CTAD data items awaiting ISB approval, maybe subject to change

27 Summary: DatasetWhat?Who?When? GUMCADSTI/HIV and related diagnoses, tests and services All GUM clinicsNow GUMCAD2STI/HIV and related diagnoses, tests and services All non-GUM commissioned SH services January 2011 NCSP(core)No. of CT tests and positives All NCSP venuesNow Non-NCSP Non-GUMNo. of CT tests and positives All laboratories offering CT testing (voluntary) Now NCSP(PPNM)Patient management and partner notification data All NCSP venuesNow SRHADContraception and SRH activities data All SRH servicesNow No. of CT tests and All laboratoriesEarly 2011 CTAD positives (and GC +ve) offering CT testing All services offering contraception services* *Excluding non-commissioned general practices (data will be through GPES)

28 Summary: Setting where data is recorded: Setting where data is reported from: Name of dataset and when do they come into force: Now - 2010Future – 2011 Planned 2011/2012 GUM clinics GUMCAD(GUMCAD)Plus SRHAD SRH services SRHAD/KT31Plus GUMCAD2- Integrated (joint GUM and SRH) services GUMCAD (if L3) SRHAD/KT31 GUMCAD2 (if L2) SRHAD/KT31 - Enhanced GPs* and other enhanced SH services -GUMCAD2Plus SRHAD Non-enhanced GPsNHS IC--GPES Third sector services -GUMCAD2Plus SRHAD NCSP venues Now: NCSP venues and voluntary CT testing labs NCSP(core) NCSP(PPNM) Non-NCSP Non GUM Sentinel PPNM only - Future: All chlamydia testing labs - CTAD (replaces NCSP(core) and Non- NCSP Non-GUM) - *General practices commissioned to provide an enhanced sexual health service E.g. Brook or other voluntary/charity organisation commissioned to provide a sexual and reproductive health service

29 Other Sources of SH Data: GPES GUMCAD2 only collects data from enhanced GPs, standard GPs are not included Only oral contraception and LARCs are collected through prescribing data NHS Information Centre initiative GPES –GPES will provide a centrally managed data extraction service for England. The Service will access information in electronic patient records held in GP clinical computer systems to help inform and deliver improvements in healthcare –8,500 GP practices in England and ~30,000 GPs Sentinel GP Databases GPRD, Thin, QResearch Laboratory Reporting Voluntary reporting of main STIs Local Reporting requirements

30 Acknowledgements: We are extremely grateful to: All staff involved in the pilots, GUM clinics, SRH services, NCSP venues for their time, effort and patience. All software providers and clinic IT staff for their hard work in developing the data extracts. GUMCAD, CTAD and SRHAD consultation and steering group members.

31 Contact Details: Mandy Yung Health Protection Agency 020 8327 7556 Department of Health 020 7972 3023

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