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 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
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)
40 (18 PM, 22 PN)
Aggregate
Quarterly (1 mth lag)
Non NCSP Non GUM
-
Aggregate
Quarterly
GUMCAD
12
Patient
Quarterly
CTAD
16
Patient
Quarterly
Patient Partner Notification and
Management
Chlamydia (and gonorrhoea)
Testing Activity Dataset
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 agespecific, 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:

DATASETS:
Responsible Organisation:
Data Submitted By:
GUMCAD
(&2)
STIs
CHLAMYDIA
CTAD*
NCSP Core
SRH
SRHAD
HPA
HPA
HPA (NCSP)
NHS IC
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
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*Proposed CTAD data items awaiting ISB approval, maybe subject to change
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Data Fields:

DATASETS:
Responsible Organisation:
Data Submitted By:
GUMCAD
(&2)
STIs
CHLAMYDIA
CTAD*
NCSP Core
SRH
SRHAD
HPA
HPA
HPA (NCSP)
NHS IC
GUM & ESHSs
Laboratories
NCSP sites
SRH services
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Attendance Information
First Attendance
Date of Attendance
Date Specimen Taken
Date Specimen Received
Date Result Authorised
Initial Contact
Location Type
Testing Service Type
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*Proposed CTAD data items awaiting ISB approval, maybe subject to change
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Data Fields:

DATASETS:
Responsible Organisation:
Data Submitted By:
GUMCAD
(&2)
STIs
CHLAMYDIA
CTAD*
NCSP Core
SRH
SRHAD
HPA
HPA
HPA (NCSP)
NHS IC
GUM & ESHSs
Laboratories
NCSP sites
SRH services
Clinical Details
Sexual Orientation
GU Episode Type
Contraception Method
Status
Contraception Main Method

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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
2+Months
Sexual Partners in Last
12 Months
*Proposed
CTAD data items awaiting ISB approval, maybe subject to change
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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
of CT
CT tests
tests and
and
No.
positives (and GC +ve)
CTAD
positives
Non-NCSP Non-GUM No. of CT tests and
positives
All
venues Now
All NCSP
laboratories
Early 2011
offering CT
testing
All
laboratories
Now
offering CT
testing (voluntary)
NCSP(PPNM)
Patient management
and partner notification
data
All NCSP venues
SRHAD
Contraception and SRH
activities data
All SRH services Now
All services offering
contraception services*
*Excluding non-commissioned general practices (data will be through GPES)
Now
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 – 2011
Planned
2011/2012
GUM clinics
GUM clinics
GUMCAD
(GUMCAD)
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
Non-enhanced GPs
NHS IC
-
-
Third sector services†
Third sector services
-
GUMCAD2
Now: NCSP venues
and voluntary CT
testing labs
NCSP venues
Future: All chlamydia
testing labs
NCSP(core)
NCSP(PPNM)
Non-NCSP Non
GUM
-
Sentinel PPNM only
CTAD (replaces
NCSP(core) and NonNCSP 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
Plus SRHAD
Plus SRHAD
GPES
Plus SRHAD
-
-
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
mandy.yung@hpa.org.uk
020 8327 7556
Department of Health
mandy.yung@dh.gsi.gov.uk
020 7972 3023