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Chlamydia screening failures

NAO report reveals that infection control initiative is poor value for money and is failing patients

The UK government's national Chlamydia screening programme is not providing value for money, according to a report from the National Audit Office (NAO).

Estimates from the NAO put the total cost to date of the programme at £100m. The report suggests that devolved delivery through Primary Care Trusts (PCTs) has resulted in inefficiency and duplication – 45 different brands have been developed for the initiative across England.

“To have a significant impact on Chlamydia requires overall testing levels of 26 per cent or above,” said Amyas Morse, head of the NAO. “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 programme to date has not demonstrated value for money.”

According to the NAO, PCTs had little guidance on costs to help deliver the initiative efficiently and spending had varied dramatically across the country. The NAO estimates that savings of £17m could have been made in 2008-09 if all PCTs had delivered tests for £33 (the agency's calculation of an achievable cost per test in established local programmes) rather than an average of £56 per test.

The NAO report also suggests that not all those who tested positive for Chlamydia are being treated. Around 6,480 people (12 per cent of those who tested positive) were not recorded as having received treatment in 2008-09 and many PCTs are failing to reach the programme's standards for tracing and treating the sexual partners of people who tested positive.

In 2008-09, six years after the infection control initiative was launched, testing levels are only now reaching the point where they are likely to reduce significantly the prevalence of Chlamydia.

Five years into the programme, just 4.9 per cent of under-25s were being tested for the infection, against a target of 15 per cent. This rose to 15.9 per cent in 2008-09, against a target of 17 per cent, after the Department of Health made the programme a priority for PCTs.  

12th November 2009


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