Press Release - Young people’s sexual health:
the National Chlamydia Screening Programme
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.
Mr Amyas Morse, head of the National Audit Office, said
today:
“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.”
Notes for Editors
-
The Department of Health launched the National
Chlamydia Screening Programme, to identify, treat and control
chlamydia infection in young people under 25, in England in
2003. £150 million has been allocated to NHS budgets for the
Programme, of which around £100 million has been spent (the budget
was not ‘ring-fenced’). The Programme aims to identify, treat
and control chlamydia and has taken an ‘opportunistic approach’ to
testing in settings such as schools and youth centres as well as
NHS venues.
-
Chlamydia is the most commonly diagnosed
sexually transmitted bacterial infection and is increasing,
especially amongst people under the age of 25. Chlamydia is
often symptom-less and can cause serious health problems, including
ectopic pregnancy and infertility.
-
From 2008-09 the Department set a new ‘Tier 2
Vital Signs indicator’ for the Programme which set Primary Care
Trusts progressively increasing annual testing rates of 17, 25 and
35 per cent of their under-25 population, for the three years
2008-09 to 2010-11.
-
Press notices and reports are available from
the date of publication on the NAO website, which is at http://www.nao.org.uk/.
Hard copies can be obtained from The Stationery Office on 0845 702
3474.
-
The Comptroller and Auditor General, Amyas
Morse, is the head of the National Audit Office which employs some
900 staff. He and the NAO are totally independent of
Government. He certifies the accounts of all Government
departments and a wide range of other public sector bodies; and he
has statutory authority to report to Parliament on the economy,
efficiency and effectiveness with which departments and other
bodies have used their resources.
Press Notice
57/09
All enquiries to Sarah Farndale, NAO
Press Office:
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5350
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