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(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%)


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


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


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


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


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


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


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


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


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:


SRHAD



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:


SRHAD



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

[email protected]

020 8327 7556

Department of Health

[email protected]

020 7972 3023

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

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