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Sexual and Reproductive Health Datasets: Who? What? Why? When?

Sexual and Reproductive Health Datasets: Who? What? Why? When?. Mandy Yung, Data Development Manager, Department of Health and HPA. Overview:. Background ISB SRH Datasets – Who? What? Why? When? GUMCAD GUMCAD2 CTAD NCSP(core) and NCSP(PPNM) Non-NCSP Non-GUM SRHAD

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Sexual and Reproductive Health Datasets: Who? What? Why? When?

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  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. GUMCAD and GUMCAD2:Genitourinary medicine clinic activity dataset 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

  14. 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: 1st 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?

  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 1st 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. No. of CT tests and All laboratories Early 2011 CTAD positives (and GC +ve) offering CT testing Summary: All services offering contraception services* *Excluding non-commissioned general practices (data will be through GPES)

  28. Summary: *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 mandy.yung@hpa.org.uk 020 8327 7556 Department of Health mandy.yung@dh.gsi.gov.uk 020 7972 3023

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