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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.

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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.

"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


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