NCSP audit of turnaround times, partner notification and re-testing standards, 2026
Updated 7 October 2026
Applies to England
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Executive summary
This report presents the findings of the 2026 National Chlamydia Screening Programme (NCSP) audit. It assesses performance against the British Association for Sexual Health and HIV (BASHH) Standards for the management of sexually transmitted infections (STIs) 2019 across 4 main areas:
- time to result notification
- time to treatment
- partner notification (PN)
- re-testing
None of the standards were met, and compared with the 2019 NCSP audit, performance has declined for the time to treatment, PN and re-testing standards.
The one area of improvement since the 2019 audit was the proportion of those tested that received their result within the recommended number of working days from date of test, which remained at 89% despite the recommended number of working days decreasing from 10 to 8.
Findings highlight ongoing challenges in achieving the BASHH standards, particularly in treatment and PN pathways, alongside an improvement in the efficiency of result delivery.
Providers and commissioners are encouraged to review both their local data and these national findings to inform service improvement, and to share effective practices through local, regional and national networks. Recommendations to support improvement across all standards are outlined below. Additional support is available from the UK Health Security Agency (UKHSA) regional sexual health facilitators.
Recommendations
The following recommendations apply to all areas assessed in the present audit:
- commissioners and providers should review their local performance against the national data presented in this audit
- where local performance falls below the national level, this should be treated as a minimum threshold for improvement rather than an end goal, given that national performance itself remains below acceptable standards
- all services not meeting the BASHH standards should undertake structured quality improvement activities to improve performance against the standards
- data completeness and accuracy should be treated as a clinical governance priority Incomplete recording undermines the ability of services to monitor their own performance and may indicate broader gaps in care
- services should ensure that all clinical and administrative staff involved in chlamydia testing and management are aware of current national guidelines and standards, and that processes are in place to communicate future updates in a timely manner
Introduction
This report contains the findings of the 2026 audit that measured the performance of sexual health services against the following 4 standards:
- result notification
- time to treatment
- PN
- re-testing
UKHSA supports local areas to review their local chlamydia screening activities and improve the quality of care throughout the chlamydia care pathway.
The NCSP Chlamydia Care Pathway shown in Figure 1 comprises 7 sequential components:
- A young woman is offered a test.
- A specimen is taken.
- A diagnosis is made from the specimen.
- The young woman receives their result.
- Those who test positive are given treatment.
- Index cases are offered a PN discussion and their contacts are identified and informed.
- Young women who have tested positive are offered re-testing after treatment to detect reinfection.
The 2026 audit measured performance against components 4 to 7: result notification, treatment, PN, and re-testing.
Figure 1. NCSP Chlamydia Care Pathway
Audit methodology
Audit data informing components 4 to 7 of the care pathway was collected using a bespoke tool developed in Microsoft Excel. This tool captured data on each of the auditable outcome measures shown in Table 1. Full details of the tool and process are provided in Appendix, Audit methodology.
Invitations to participate were distributed to chlamydia screening providers and commissioners via UKHSA’s network of sexual health facilitators. These were sent between 19 January and 6 February 2026. The data collection tool was shared with interested providers on 5 February.
Providers were asked to submit 50 records:
- 40 consecutive records of females with a positive test result
- 10 consecutive records of females with a negative test result
These were counted working back from 30 June 2025. The emphasis on positive cases reflects the public health importance of prompt result notification and treatment in this group. As a result, the sample is deliberately biased toward positive cases. Local outcomes calculated across all young women tested are therefore likely to differ.
Two assumptions should be noted. First, where result notification dates were missing, the standard was assumed not to have been met. Second, for PN, contacts were counted only if they attended a sexual health service within 20 working days following the PN discussion. This is consistent with the 2017 and 2019 audits. It means some contacts accessing services outside this window are not counted as meeting the standard.
Findings
This section reports on the response rate and performance against the auditable outcome standards. It presents the results against the standards and compares them with previous audit findings.
Response rate
Out of 150 upper tier local authorities, data returns that were included in this audit covered just over a third (39%) of upper tier local authorities (52% in 2019). A total of 42 providers participated, resulting in 2,900 patient records (as some providers cover more than one upper tier local authorities). Table 1 shows the variation in local authority coverage by UKHSA region, ranging from 83% in East of England to 14% in South West.
Table 1. Audit participation by UKHSA region, 2026
| UKHSA region | Number of local authorities |
Number of local authorities in audit |
Proportion participating | Number of providers in audit |
Number of patient records |
|---|---|---|---|---|---|
| North East | 12 | 5 | 42% | 3 | 250 |
| North West | 23 | 9 | 39% | 7 | 450 |
| Yorkshire and Humber | 15 | 6 | 40% | 5 | 300 |
| East Midlands | 10 | 5 | 50% | 4 | 250 |
| West Midlands | 14 | 8 | 57% | 4 | 400 |
| East of England | 12 | 10 | 83% | 7 | 500 |
| London | 33 | 8 | 24% | 6 | 400 |
| South East | 18 | 5 | 28% | 5 | 250 |
| South West | 14 | 2 | 14% | 1 | 100 |
| England | 150 | 58 | 39% | 42 | 2,900 |
The audit sample of 2,900 cases contains 2,318 (80%) young women who tested positive for chlamydia and 571 (20%) who tested negative. For result notification, all 2,900 records have been used for the analysis. For the time to treatment, PN and re-testing, where available, the data relating to young women with chlamydia (2,318) has been used.
Overall results
The audit results show that none of the standards of the auditable outcome measures have been met. When compared to the previous audit results, performance has deteriorated across 3 of the 4 standards (time to treatment standard, proportion of index cases offered a PN discussion and the number of contacts per index case that attended a sexual health service).
The one area of improvement since the 2019 audit was the proportion of those tested that received their result within the recommended number of working days from date of test, which remained at 89% despite the recommended number of working days decreasing from 10 to 8. The proportion of young women with chlamydia who were re-tested in the recommended period after treatment also declined from 10% in 2019 to 8%. These are presented in Figure 2. Table 2 shows the auditable outcome measures and the standards for that audit year.
Figure 2. NCSP audit measures by year, England, 2017 to 2026
Table 2. Auditable outcome measures and standards for each audit year, 2015 to 2019 and 2026
| Component | Previous measure and standard from 2015 to 2019 | Updated measure and standard (where applicable) in 2026 |
|---|---|---|
| Result notification | Measure: proportion of those tested that received their result within 10 working days from date of test Standard: 95% |
Measure: proportion of women tested that received their result within 8 working days from date of test Standard: 95% |
| Time to treatment | Measure: proportion of young women found to be positive that received treatment within 6 working weeks from date of test Standard: 95% |
Measure: proportion of women found to be positive that received treatment within 3 working weeks from date of test Standard: 85% |
| Partner notification | Measure: the proportion of index cases that were offered a PN discussion Standard: 97% |
Not changed |
| Partner notification | Measure: the number of contacts per index case that were reported as having attended a sexual health service within 4 working weeks of date of PN discussion Standard: 0.6 |
Not changed |
| Re-testing | Measure: the proportion of young women with chlamydia that re-turned for a re-test around 3 months after treatment Standard: not applicable |
Measure: the proportion of young women with chlamydia that re-turned for a re-test between 3 to 6 months after treatment Standard: not applicable |
In the following 3 sections, more detailed analyses are presented for each of the standards relating to turnaround time (result notification and time to treatment), PN and re-testing. Almost all providers were integrated sexual health services (total number (N) = 54, 93%), so analyses by provider type have not been included, consistent with previous audits.
Turnaround time standards
Result notification
89% of young women received their result within 8 working days of the test being taken. This represents an improvement compared to previous audit results (89% received their result within 10 working days in 2019) but is just below the updated BASHH standard of 95%. Of all patients, 173 young women received their result after more than 8 days (6.3%), an improvement compared to 9% in 2019. For 166 young women (5.7%), the result notification date was missing, these were considered as ‘standard not met’. These numbers are shown in Figure 3a as the frequency distribution in number of days between date of test and date of result notification. Figure 3b shows the cumulative percentage of patients receiving their result within each number of working days.
Figure 3a. Frequency distribution in number of days to result notification, England, 2026
Figure 3b. Cumulative percentage of patients receiving their test results within each number of days, England, 2026
Note that the cumulative percentage shown in Figure 3b includes ‘not recorded’ values in the denominator.
There was a difference between young people with a positive and negative test result for this indicator. Of those with a negative result, 83% were notified within 8 working days, compared to 90% of those with a positive result. 142 patients (6%) with a positive result received their result after more than 8 days, for those with a negative result this was 31 patients (5%). Result provision dates were missing for 4% of positive and 12% of negative results.
Fast result notification is essential to enable quicker access to treatment and minimise the likelihood of an infection causing harm, as well as the likelihood of onward transmission. Clinics need to ensure they can record the date of result notification and that results can be notified within 8 working days.
Time to treatment
1,951 young women (1,951 out of 2,318, 84%) of individuals testing positive for chlamydia were treated within 3 weeks (15 working days) of the test date. This is just below the standard of 85%. 144 patients received treatment after more than 15 working days (6%). There was a small decrease in the proportion of patients reported as accepting treatment from 93% in 2019 to 92% in 2025.
Figure 4 shows that 2,900 patients were tested of whom 581 received a negative result, 2,318 received a positive result and the result of one individual was not recorded. Of those receiving a positive result, 189 did not accept treatment, the treatment date was not recorded for 34, 144 were treated more than 15 working days after their test date, and 1,951 were treated within 15 working days of their test date.
Figure 4. Proportion of young women treated within 3 working weeks, England, 2026
Figure 5a shows the frequency distribution of patients treated by number of working days. Those treated on the day of the test likely represent epidemiological treatment (n=23). Figure 5b shows the cumulative percentage of patients receiving treatment within each number of days of their test.
Figure 5a. Frequency distribution in number of days between test and treatment, England, 2026
Figure 5b. Cumulative percentage of patients receiving treatment within each number of days of their test, England, 2026
Note that the cumulative percentage shown in Figure 5b includes ‘not recorded’ values in the denominator.
Partner notification
The standards for PN (UKHSA NCSP Standards) were not met and have deteriorated compared to the 2019 results. 87% of individuals who tested positive for chlamydia had the offer of PN discussion documented in their records (standard 97%). The number of contacts per index case that were reported as having attended a sexual health service within 4 working weeks of the date of PN discussion was 0.29 in 2026, see Table 3.
Table 3. PN standards measured in this audit, England, 2015 to 2026
| Measure and standard | 2015 | 2017 | 2019 | 2026 |
|---|---|---|---|---|
| Measure: the proportion of index cases that were offered a PN discussion Standard: 97% |
92% | 94% | 93% | 87% |
| Measure: the number of contacts per index case that were reported as having attended a sexual health service within 4 working weeks of date of PN discussion Standard: 0.6 |
0.53 | 0.42 | 0.32 | 0.29 |
| Measure | Standard | 2015 | 2017 | 2019 | 2026 |
|---|---|---|---|---|---|
| The proportion of index cases that were offered a PN discussion | 97% | 92% | 94% | 93% | 87% |
| The number of contacts per index case that were reported as having attended a sexual health service within 4 working weeks of date of PN discussion | 0.6 | 0.53 | 0.42 | 0.32 | 0.29 |
Offer of PN
Of all index cases, 2,024 (2,024 out of 2,318, 87%) had a documented offer of PN, not meeting the standard of 97%.
203 were not offered PN (203 out of 2,318, 9%), and for a further 91 index cases (91 out of 2,318, 4%) this field was left blank. The main reasons for not offering PN were ‘no documented evidence of PN’ (82 out of 203, 46%), ‘lost to follow-up before PN initiated’ (47 out of 203, 23%), and ‘other’ (36 out of 203, 18%).
PN standard
There were a total of 2,692 contacts for the 2,318 young women with chlamydia, of whom 1,967 (73%) were contactable. For 339 out of the 2,318 (15%) patients with a positive chlamydia result, there was no PN discussion date. As the standard requires to calculate the time difference between date of PN with the index case, and date of attendance of a contact, it cannot be established whether the PN standard was met.
676 contacts (25% of all contacts and 34% of contactable contacts) had an attendance at a sexual health service within 4 weeks following the PN discussion date with the index patient, a PN ratio of 0.29 contacts (676 out of 2,318) per index case. If the 339 index cases for which no PN date was provided are excluded from the denominator, the ratio is 0.34 (676 out of 1,979). Neither meet the standard of 0.6 and have deteriorated compared to previous audits in 2015 and 2017. More detail on how the data has been used to measure against the PN standard are provided in Appendix, PN standard calculation.
Those contacts that have an attendance date at a sexual health service within 4 working weeks, usually attend within one week of the PN discussion with the index patient: the median number of working days between date of PN discussion with the index and date of attendance of the contact is 1 day (interquartile range: 1 to 6). Out of all contacts, 747 (747 out of 2,692, 28%) attended a sexual health service at any time, which represents 38% of contactable contacts (747 out of 1,967). The distribution of working days between the PN discussion and attendance at a sexual health service for every contact is shown in Figure 6.
Figure 6. Frequency distribution of working days between date of PN discussion with index patient and date of contact’s attendance at a SHS, England, 2026
PN outcomes and positivity of contacts
For 80% of all contacts, a PN outcome had been recorded (2,152 out of 2,692). This is shown in Table 4 in decreasing order. The most frequent was ‘recorded that contact informed of risk of chlamydia infection but not known to have had a chlamydia test’ (823 out of 2,152, 38%), followed by ‘contact not known to have been informed of risk of chlamydia infection’ (331 out of 2,152, 15%).
Table 4. PN outcomes of the contacts, England, 2026
| PN outcome | Number | Percentage |
|---|---|---|
| Record made that contact informed of risk of chlamydia infection, but not known to have had a chlamydia test | 823 | 38% |
| Contact not known to have been informed of risk of chlamydia infection | 331 | 15% |
| Contact already known to have chlamydia infection | 252 | 12% |
| Contact had a positive test in your service (a) | 162 | 8% |
| Contact had a chlamydia test, but result not known (e) | 136 | 6% |
| Contact had a positive test in another service (b) | 134 | 6% |
| Contact treated but not tested | 106 | 5% |
| Contact had a negative test in another service (c) | 69 | 3% |
| Contact had a negative test in your service (d) | 60 | 3% |
| Other | 79 | 4% |
| Total | 2,152 | 100% |
From the above table, it can be deduced that a total of 296 new people with a positive test result (a + b) were found, out of a total of 425 (a + b + c + d) who proceeded to have a test (and whose test result is known) due to PN, a positivity of 70%. Even if those who tested but whose test result is unknown (e) are included in the calculation, the positivity remains high at 53%, indicating that PN is effective at finding people at high risk of infection.
PN outcomes among contacts tested through PN are shown in Figure 7 and an accessible text description is available in the Appendix.
Figure 7. PN outcomes among contacts, England, 2026
Re-testing
While there is no standard for re-testing (component 7 of the chlamydia care pathway), the BASHH recommends that all young people with a positive test have a re-test between 3 and 6 months (calculated as 84 to 188 days inclusive) after the date of treatment due to the high rates of re-infection (BASHH Standards for the management of STIs 2019).
Offer of a re-test
Two-thirds of young women with chlamydia (1,481 out of 2,318, 64%) were offered a re-test which is lower compared to the 72% in the 2019 audit. 24% (n=560) were not offered a re-test (28% in 2019, n=929) and for 160 cases (7%) (1% in 2019, n= 26) this was unknown or not recorded.
Re-testing rates and positivity
The re-testing results are presented over 2 time periods:
- 3 to 6 months after treatment (BASHH recommendation, 84 to 188 days inclusive)
- at any time after treatment
The calculation takes the number of days difference between date of treatment and date of re-test. If treatment date is missing (n=19, 3%), then the difference between date of test and date of re-test has been used.
Table 5 shows that the proportion of patients re-testing between 3 and 6 months after treatment has decreased from 10% in 2019 to 8% in 2025, a small decrease is also found in the proportion of patients re-testing in those re-testing at any time.
The positivity of those re-testing between 3 to 6 months after treatment has increased from 10% in 2019 to 13% in 2025. Among those re-testing at any time following treatment, the positivity was 8%, a slight decrease from 10% in 2019. These test positivity values compare with a national positivity at first chlamydia test of 8% in 2025 (Sexually transmitted infections and screening for chlamydia in England: 2025 report).
Table 5. Re-testing by time after treatment, England, 2026
| Outcome | Re-test between 3 and 6 months 2019 | Re-test between 3 and 6 months 2025 | Re-test at any time 2019 | Re-test at any time 2025 |
|---|---|---|---|---|
| Number re-testing (percentage of all patients with a positive test in audit sample) | 591 out of 3,360 (-18%) |
189 out of 2,318 (-8%) |
1,116 out of 3,360 (-33%) |
674 out of 2,318 (-29%) |
| Positive at re-test (percentage of those re-testing in that period) | 57 out of 591 (-10%) |
24 out of 189 (-13%) |
109 out of 1,116 (-10%) |
54 out of 674 (-8%) |
Figure 8 shows the frequency distribution in the number of weeks that a patient returned for a re-test, either from date of treatment (n=655) or date of test (n=19). 111 re-tests were done before 6 weeks (17%). These tests may result in a positive test result from the initial infection, not a re-infection and are not recommended.
Figure 8. Frequency distribution of number of weeks to re-test, England, 2026
Some service providers reported offering a test of cure (ToC) before 3 months post-treatment for certain patient groups, including pregnant patients, those aged 17 years and under, and patients with rectal infection treated with single-dose azithromycin or a one-week course of doxycycline. Where a ToC was performed, providers would not routinely offer an additional re-test, which may account for some cases in which no re-test was recorded. Additionally, some re-tests recorded earlier than the recommended interval may reflect providers documenting a ToC as a re-test.
Research has shown that there is confusion about the definition of a re-test (Cabecinha and others, 2026). Figure 9 reframes the re-testing recommendations as recommended frequency of asymptomatic testing dependent on test result. Sexually active females aged 15 to 24 years are tested annually or following a change of sexual partner. A negative test result leads back to the routine testing schedule of annual testing or upon change of sexual partner.
Following a positive test result, individuals are recommended to have another test 3 to 6 months after treatment. A negative post-treatment test returns them to the routine testing pathway of annual testing or upon change of sexual partner. A positive repeat test result continues with a recommended test again 3 to 6 months following treatment. This reframing allows services and clinicians to move away from the language of ‘re-testing’ and avoid confusion or misunderstanding.
Figure 9. Testing pathway for young women aged 15 to 24 years, England, 2026
Source: flowchart adapted from Cabecinha and others (2026).
Re-testing rates by recall method
Several different methods were used to recall young women for re-testing. For over a third of those recalled (36%, n=844 out of 2,318), the recall method was not recorded. As in 2019, text messaging was most frequently used (26.4% of index cases) and 14% of these returned for a re-test between 3 and 6 months, as is recommended. Almost a quarter (24%) of those testing positive were informed of the need for a re-test at the time of result notification without a further reminder. 13% of these came back between 3 and 6 months after treatment, similar to in 2019.
The highest return rate (40%) was observed for those advised re-testing at the time of the follow-up call. However, only 6 patients were recalled by this method so the observed return rate might not accurately reflect of the general effectiveness of the recall method.
Table 6 shows, for each recall method, the number of patients with a positive test recalled and the proportion this represents of all patients with positive tests. It also shows, for each method, how many of those patients returned for a re-test between 3 and 6 months, expressed as a proportion of all patients recalled by that method.
Table 6. Re-testing between 3 and 6 months by recall method, England, 2026
| Recall method | Number of positive index cases (percentage of positive cases) (a) |
Number re-testing between 3 and 6 months (b) |
Return rate (percentage) by recall method (b divided by a) |
|---|---|---|---|
| Audit sample (those with a positive result only) | 2,318 (100%) |
189 | 8% |
| Method not recorded | 844 (36%) |
1 | <1% |
| Sent text message when you should test again | 613 (26%) |
88 | 14% |
| Conversation about re-testing when given your test result and no further reminder | 553 (24%) |
72 | 13% |
| Appointment to be re-tested made when given your test result | 133 (6%) |
7 | 5% |
| Invited by phone call when you should test again | 116 (5%) |
12 | 10% |
| Given testing kit when given your test result and no further reminder | 17 (1%) |
2 | 12% |
| Re-testing advised at follow-up call (text message will be sent at 3 months) | 15 (<1%) |
6 | 40% |
| Given testing kit when given your test result and later reminded when you should test again | 9 (<1%) |
0 | 0% |
| Testing kit posted to an address of your choice when you should test again | 9 (<1%) |
1 | 11% |
| Reminder card when given your test result and no further reminder | 6 (<1%) |
0 | 0% |
| Sent email when you should test again | 3 (<1%) |
0 | 0% |
Conclusions
This 2026 audit found that none of the standards for result notification, time to treatment, or PN were met. Performance declined across several indicators since 2019, including time to treatment, the proportion of index cases offered a PN discussion, contacts attending per index case, and re-testing uptake. However, it should be noted that the standards for time to treatment and result notification have become more stringent over this period. Encouragingly, result notification timeliness improved, remained at 89%, even as the standard tightened from 10 to 8 working days. To build on this and address the areas of decline, providers and commissioners are encouraged to review their local data alongside these national findings and act on the Recommendations set out above.
Appendix
Audit methodology
To obtain the audit data informing components 4 to 7 of the care pathway, an audit tool was developed in Microsoft Excel. It collected data on each of the auditable outcome measures set out in Table A1, taken from the UKHSA NCSP Standards.
Table A1. Auditable outcome measures, England, 2026
| Component | Auditable outcome measure | Standard |
|---|---|---|
| Result notification | Proportion of those tested that receive their result within 8 working days from the date of the test | 95% |
| Time to treatment | Proportion of young women found to be positive that received treatment within 3 working weeks from the date of the test | 85% |
| Partner notification | Proportion of index cases that were offered a PN discussion | 97% |
| Partner notification | The number of contacts per index case that were reported as having attended a sexual health | 0.6 |
| Re-testing | Proportion of young women with chlamydia that returned for a re-test at 3 to 6 months after treatment | Not applicable |
Invitations to participate were emailed to a distribution list of chlamydia screening providers by UKHSA’s network of sexual health facilitators across England between 19 January and 6 February 2026. Invitations were also copied to sexual health commissioners so they could forward them to contracted providers. The data collection tool was shared with interested providers on 5 February. Participation rates for the audit are reported in Table 1.
Providers were asked to submit 50 records: 40 consecutive positive and 10 consecutive negative female patients (for whom not all data fields were required), identified by case note review or analysis of electronic patient record (EPR) systems, working back from 30 June 2025 until the required sample was reached.
The emphasis on positive cases reflects the particular public health importance of prompt result notification and treatment in this group, where timely treatment reduces the risk of infection-related harms and onward transmission. The sample is weighted toward positive cases, therefore the results are biased toward patients with a positive test result. Services typically test more young women who are negative than positive, so outcomes calculated across all young women tested in a given period are likely to differ.
Data items collected
The following items were required for all 50 patients (10 with negative test results and 40 with positive test results):
- name of commissioning authority
- name of service provider
- type of service provider: genitourinary medicine (GUM) clinic, sexual and reproductive health or contraceptive and sexual health (CASH) clinic, integrated sexual health service, GP, pharmacy, internet, termination of pregnancy (TOP), or ‘other’ (including chlamydia screening offices, military, education, prison)
- index patient number (1 to 50)
- date of test
- age
- date of result notification
- test result (positive, negative)
The following additional items were required for the 40 positive cases only:
- treatment accepted
- date of treatment
- type of treatment site (categories as for service provider type, above)
- offered PN? (yes, no, unknown)
- date of PN discussion
- if no PN offered, reason: no documented evidence of PN, patient routinely seen for sexual health care elsewhere, patient transferred care, documented that PN performed elsewhere, lost to follow-up before PN initiated, or other
- total number of contacts
- total number of contactable contacts
- date of index patient or HCW reported attendance for testing and treating each contact (up to 5 contacts)
- PN outcome: contact already known to have chlamydia infection, negative test in your service, negative test in another service, positive test in your service, positive test in another service, chlamydia test taken but result not known, record made that contact was informed of risk but not known to have been tested, contact not known to have been informed of risk, or other
- offered re-test? (yes, no, unknown)
- method used to recall the patient: conversation at the time of result with no further reminder, reminder card with no further reminder, appointment made at the time of result, testing kit given with no further reminder, testing kit given with a later reminder, text message when re-testing due, phone call invitation, postal invitation, email invitation, testing kit posted to an address of the patient’s choice, or re-testing advised at follow-up call with a text reminder at 3 months
- date of re-test
- re-testing service type (categories as for service provider type, above)
- result of re-test (positive, negative, equivocal or inhibitory, insufficient, unknown)
Analytical assumptions
Where result notification dates were missing, the standard was assumed not to have been met. Missing dates are likely to include cases where the young women could not be contacted or where a ‘no news is good news’ policy was used. For PN, contacts were counted only if they attended a sexual health service within 20 days following the date of the PN discussion with the index patient. Contacts seen before the discussion or more than 20 days afterwards were excluded, consistent with the 2017 and 2019 audits.
‘Attendance at a sexual health service’ was interpreted as the attendance date the provider entered on the audit form, which was used to calculate against the 20-day window period. Some contacts may therefore have accessed sexual health services outside this window without being counted toward the PN ratio of 0.6.
All analyses were performed using the statistical software R (version 4.5.3).
PN standard calculation
For the 2017 audit, guidance was sought from the BASHH Clinical Effectiveness Group on how to calculate the PN standard. If a contact attends a sexual health service is before the date of the index cases’ PN discussion, they are not counted as meeting the PN standard. If a contact attends a sexual health service between the date of the index cases’ PN discussion and 20 working days (28 calendar days) afterwards, they are counted as meeting the PN standard. If a contact attends a sexual health service 20 or more working days (28 or more calendar days) after the index cases’ PN discussion, they are not counted as meeting the PN standard. Finally, if a contact has no recorded attendance at a sexual health service, they are not counted as meeting the PN standard.
Accessible text description: PN outcomes among contacts tested through PN
The audit findings show that 2,152 chlamydia contacts were traced. Figure 7 in this report shows the outcomes for these contacts. Out of 2,152 contacts, 561 (26%) were tested and 1,591 (74%) were not tested.
Among those tested:
- 296 contacts tested positive (53%), comprising 134 with positive tests in another service and 162 with positive tests in the index service
- a further 129 tested negative (23%), split between 69 with negative results in another service and 60 in the index service
- the remaining 136 contacts (24%) had results classified as unknown, meaning a chlamydia test was performed but the result was not available
Contact positivity was calculated as 296 ÷ (296 + 129) = 69.6%
Those not tested comprised several groups:
- 252 contacts already known to have chlamydia infection
- 331 contacts not known to have been informed of infection risk
- 106 contacts who were treated but not tested
- 79 contacts with other documented reasons for non-testing
- 823 records indicating the contact was informed of risk but was not known to have had a chlamydia test
Acknowledgements
UKHSA wishes to acknowledge and thank sexual health services providers for submitting data returns for this audit.