sexual and reproductive health datasets: who? what? why? when? mandy yung, data development manager,...
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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(NB GUMAMM, HIV and enhanced STI surveillance datasets not covered in this presentation)
• Summary
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
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
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
Background:
When?Varies by datasets and setting.Now:GUMCAD – all GUM clinicsSRHAD/KT31 – all SRH servicesNCSP(core) – all NCSP programme areasNCSP(PPNM) – all NCSP programme areasNon-NCSP Non-GUM – laboratories (voluntary)
Future (2011/12):GUMCAD2 – all non-GUM commissioned SH servicesSRHAD – all non-SRH commissioned contraceptive service (GUM, en-GP)CTAD – all laboratories that carry out testing for chlamydia
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
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%)
GUMCAD and GUMCAD2:Genitourinary medicine clinic activity dataset
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
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)
GUMCAD Reports
Examples of GUMCAD reports
Examples of GUMCAD reports
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
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
Chlamydia tests datasets:
What?
Dataset No. of Data Items Level of Data
Reporting Time
NCSP(core) 14 Patient Quarterly
NCSP(PPNM)Patient Partner Notification and Management
40 (18 PM, 22 PN) Aggregate Quarterly (1 mth lag)
Non NCSP Non GUM - Aggregate Quarterly
GUMCAD 12 Patient Quarterly
CTADChlamydia (and gonorrhoea) Testing Activity Dataset
16 Patient Quarterly
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
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
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
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
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
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
Data Fields: STIs SRH
CHLAMYDIA DATASETS:
GUMCAD (&2) CTAD* NCSP Core
SRHAD
Responsible Organisation: HPA HPA HPA (NCSP) NHS IC
Data Submitted By: GUM & ESHSs Laboratories NCSP sites SRH services
Patient Registration/Clinic Information
Organisation ID
Clinic ID
Laboratory ID
Patient ID
NHS Number
Test Specific ID
Gender
Date of Birth
Age
Ethnicity
Country of Birth
PCT of Residence
LSOA of Residence
Postcode of Residence
Postcode of Testing Service
Responsible PCT
*Proposed CTAD data items awaiting ISB approval, maybe subject to change
Data Fields:
STIs SRH
CHLAMYDIA DATASETS:
GUMCAD (&2) CTAD* NCSP Core
SRHAD
Responsible Organisation: HPA HPA HPA (NCSP) NHS IC
Data Submitted By: GUM & ESHSs Laboratories NCSP sites SRH services
Attendance Information
First Attendance
Date of Attendance
Date Specimen Taken
Date Specimen Received
Date Result Authorised
Initial Contact
Location Type
Testing Service Type *Proposed CTAD data items awaiting ISB approval, maybe subject to change
Data Fields: STIs SRH
CHLAMYDIA DATASETS:
GUMCAD (&2) CTAD* NCSP Core
SRHAD
Responsible Organisation: HPA HPA HPA (NCSP) NHS IC
Data Submitted By: GUM & ESHSs Laboratories NCSP sites SRH services
Clinical Details
Sexual Orientation
GU Episode Type
Contraception Method Status
Contraception Main Method
Contraception Other Method
Contraception Method PC
SRH Care Activity
Type of Laboratory Test
Specimen Type
Reason for Test
Chlamydia Result
Gonorrhoea Result
New Sexual Partners in Last 3 Months
2+ Sexual Partners in Last 12 Months
*Proposed CTAD data items awaiting ISB approval, maybe subject to change
Summary:
Dataset What? Who? When?
GUMCAD STI/HIV and related diagnoses,
tests and services
All GUM clinics Now
GUMCAD2 STI/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 venues Now
Non-NCSP Non-GUM No. of CT tests and positives
All laboratories offering CT testing (voluntary)
Now
NCSP(PPNM) Patient management and partner notification data
All NCSP venues Now
SRHAD Contraception and SRH activities data
All SRH services Now
No. of CT tests and All laboratories Early 2011
CTAD positives (and GC +ve) offering CT testing
All services offering contraception services*
*Excluding non-commissioned general practices (data will be through GPES)
Summary:Setting where data is recorded:
Setting where data is reported from:
Name of dataset and when do they come into force:
Now - 2010 Future – 2011Planned
2011/2012
GUM clinics GUM clinics GUMCAD (GUMCAD) Plus SRHAD
SRH services SRH services SRHAD/KT31 Plus GUMCAD2 -
Integrated (joint GUM and SRH) services
Integrated (joint GUM and SRH) services
GUMCAD (if L3)
SRHAD/KT31
GUMCAD2 (if L2)
SRHAD/KT31-
Enhanced GPs* and other enhanced SH services
Enhanced GPs* and other enhanced SH services
- GUMCAD2 Plus SRHAD
Non-enhanced GPs NHS IC - - GPES
Third sector services† Third sector services - GUMCAD2 Plus 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
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
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.
Contact Details:
Mandy Yung
Health Protection Agency
020 8327 7556
Department of Health
020 7972 3023