Implementing the NCSP
Chlamydia screening in general practice

General practice has an important part to play in the delivery of the National Chlamydia Screening Programme. Between 60 and 75 per cent of young people visit their GP every year and this is an ideal opportunity to offer chlamydia screening.

The offer of screening can come from any one of the practice team, including receptionists, and should be accompanied by appropriate written information such as the NCSP leaflet. In addition GPs can encourage screening by sending information about testing with a link to a website to obtain postal kits or sending out postal kits directly to those on their list in the target age range. Pathways for the management of positives including partner notification should be agreed.

General practitioners may need training to provide chlamydia screening, particularly on methods to raise the importance of screening during non sexual health consultations.

Practices also appreciate regular updating and support and feedback on their performance. This work can be delivered by a GP ‘Clinical Champion’.

Since 2004, I have been working as the GP-champion in Lambeth. The pilot GP-champion scheme was initially set up by the Modernisation Initiative.

At the start of the pilot, the concept was that a GP-champion would be ideally placed to provide peer support to other local GPs, motivating practices to take on and offer chlamydia screening to their patients.

Three years on and the programme is now well established and part of the LES. In Lambeth all 53 practices are now signed up and over 8000 young patients have been screened to date.

The success of the programme appears to be a result of the following key points:
  • GPs get paid a financial incentive when they reach an agreed screening target (17 per cent in 2008/09).
  • A local GP is appointed as GP-champion for one session per week.
  • Practices are free to choose ways to offer screening to their patients.
  • Practice staff gain training in screening.
  • Regular feedback.
  • League table.
  • Focus on practices with low screening numbers, often due to a practical issue.
Evaluation of the GP-champion model:

An evaluation of the role of the GP-champion has been undertaken via a comparison between the neighbouring borough Southwark and Lambeth PCTs. Both PCTs offer a financial incentive for screening in general practice but only Lambeth use the GP-champion model.

The results are significant. This endorses the view that money alone is not enough to engage general practice in to screening.

For more information please contact: sebastiankalwij@mac.com

A Chlamydia screening module written by Sebastian Kalwij, the NCSP GP Lead, is available via the BMJ learning website. Responses from GPs who have used this since it became available have been very positive. To access this please click here.
Since the launch of the NCSP in 2003, general practice has played an important role in providing chlamydia screening to young people. The proportion of screens done in general practice has gradually increased from 10 per cent in Years 1 and 2, to 14 per cent in Years 3 and 4 but decreased slightly in Year 5 to 13 per cent. Positivity among those screened in general practice each year has remained fairly consistent around 10 per cent although in Years 4 and 5 positivity dipped to 8.7 per cent.
Source: Data as of 20.08.08. National Chlamydia Screening Programme, England

There have consistently been large disparities between Programme Areas in the engagement of general practice. During April 2007 – March 2008 nationally 13 per cent of tests were carried out in general practice. Thirty Programme Areas were at or above the national figure. Some areas such as Torbay and Lincolnshire reported as much as 50 per cent (330/663) and 82 per cent (501/601) of tests being done in general practice and Lambeth and Southwark reported 37 per cent (3,827/10,465). On the other hand, six Programme Areas did not report any testing carried out in general practice which is of concern.

Across Southwark there are also differences in the proportion of screens being done in general practice. This demonstrates the need to consistently improve general practice involvement among Programme Areas.
Source: Data as of 20.08.08. National Chlamydia Screening Programme, England

Among those screened in general practice in the last year, 79 per cent were female (33,944/43,040). The majority (57 per cent) of those screened were aged between 20-24 years although a large proportion was also seen in the 16-19 year age group (39 per cent).

The role of general practice in the NCSP is clear. General practice offers an ideal opportunity to screen young people on an annual basis and we need to continue to engage with these services.



Be proactive
The National Chlamydia Screening Programme (NCSP) is a control and prevention programme targeted at the highest risk group for chlamydia infection in England, young people under 25 who are sexually active.

Chlamydia is often asymptomatic so a large proportion of cases remain undiagnosed, but infection can be diagnosed easily (young people can do the test themselves), and treated effectively.

To find your local Chlamydia Screening Office or to register with us enter your post code or select your region on the map

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