"To have a significant impact on
chlamydia requires overall testing levels of 26 per cent or above.
Only half of Primary Care Trusts reached this level in 2008-09, six
years after the Programme’s launch. Combined with the local
inefficiencies and duplications, this shows that the delivery of
the Programme to date has not demonstrated value for
money."
Amyas Morse, head of the National
Audit Office, 12 November 2009
The delivery of the Government’s programme to
control chlamydia infection in young people to date has not
demonstrated value for money, a report by the National Audit Office
found today. The Department of Health implemented the
Programme in three phases. In 2008-09, six years after the
Programme’s launch, testing levels were only just beginning to
reach the point where they are likely to significantly reduce the
prevalence of chlamydia. The devolved delivery, through Primary
Care Trusts, has resulted in duplication and inefficiency.
In 2007-08, five years after the Programme’s
launch, 4.9 per cent of under-25s were being tested under the
Programme, against a target of 15 per cent. In 2007, the
Department made the Programme a priority for PCTs, which led to a
significant increase in activity; and average testing levels rose
to 15.9 per cent by the end of 2008-09, against a target of 17 per
cent. When this is combined with testing in other settings
such as genito-urinary medicine (GUM) clinics, overall testing
rates in around half of PCTs have reached 26 per cent or more, the
point at which testing is expected to begin significantly to reduce
chlamydia prevalence.
There are no exact figures available on the
costs of the Programme, but the NAO estimates that around £100
million has been spent to date. PCTs have had little guidance
on costs to help them deliver the Programme efficiently and
spending has varied from place to place. There has been
duplication of effort, with, for example, 45 different brands
developed for the Programme in different parts of England.
Savings of £17 million could have been made in
2008-09, the NAO estimates, if all PCTs had delivered tests for £33
(the Agency’s calculation of an achievable cost per test in
established local programmes), rather than the average of £56 per
test,in that year.
The NAO also revealed that not all those who
test positive for chlamydia are being treated. An estimated
6,480 people (12 per cent of those who tested positive) were not
recorded as having received treatment in 2008-09. Without
treatment, testing is wasted for the individuals concerned, since
people remain infected and may go on to infect others. Most
PCTs are not reaching the Programme’s standards for tracing and
treating the sexual partners of people who test positive.
Publication details:
HC: 963, 2008-09
ISBN: 9780102963236