WIREDGOV

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

1.    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.

2.    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.  

3.    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.

4.    Press notices and reports are available from the date of publication on the NAO website, which is at www.nao.org.uk.  Hard copies can be obtained from The Stationery Office on 0845 702 3474.

5.    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.Sarah Farndale

Press officer
National Audit Office
151 Buckingham Palace Road
London, SW1W 9SS
Tel: 020 7798 5350
www.nao.org.uk