Genitourinary Medicine Clinic Activity Dataset (GUMCAD)
GUMCAD guidance for clinic staff
GUMCAD Pilot in Enhanced Sexual Health Services
Background
Currently, the KC60 statistical return collects data on diagnoses of sexually transmitted infections (STIs) and other services provided by all genitourinary medicine (GUM) clinics in England. KC60 data are submitted to the Health Protection Agency where they are collated and analysed in order to identify emerging public health problems, to monitor trends in STI diagnoses and other sexual health problems, and to determine which specific population groups are at particular risk of STI. The reporting system is paper-based and is mandatory for all GUM clinics. However, despite being the mainstay of STI surveillance in England, the KC60 return has several major limitations: (1) It collects no information on patient area of residence, so that Primary Care Trusts (PCTs) are unable to determine the extent and nature of sexual health problems in their residents, (2) it collects only limited information on patient characteristics which are critical for identifying population groups at high risk (“core groups”), and (3) as the KC60 return is aggregated it is not possible to link individual patient records. It is therefore not possible to count the actual number of patients attending GUM clinics, only the number of diagnoses made.
Recently, the structure and format of the KC60 statistical return has been revised to address these concerns. The data-set is now electronic rather than paper-based, and collects disaggregated, patient-level information on area of residence, age, sexual orientation, ethnic group and country of birth for all patients attending GUM clinics. The revised KC60 return has approval from the NHS Information Standards Board and a Data-Set Change Notice (DSCN) was issued to all Primary Care and Hospital Trusts. The revised return is being phased in during 2008/09 and is known as the Genitourinary Medicine Clinic Activity Dataset or GUMCAD. The collection of GUMCAD is the first phase of implementation of the Common Dataset for Sexual Health.
By collecting information on patient area of residence, ethnic group and country of birth, GUMCAD will improve the public health utility of the data and will facilitate robust assessment of local service needs. For example, the data can be used to identify (1) emerging syphilis outbreaks in particular localities, (2) increasing gonorrhoea transmission among certain ethnic groups, or (3) HIV or other STI risk in specific immigrant populations. This information will be used to inform the public health response by:
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Improving the planning and management of services.
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Developing, adapting and refining interventions.
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Monitoring the effectiveness of sexual health policies.
Electronic data collection and processing should also improve the timeliness of outputs from the Health Protection Agency.
Approval and implementation
The GUMCAD project's application to the Review of Central Returns (ROCR) to make collection of the dataset mandatory was successful and obtained on 8th October 2007. GUMCAD was successfully piloted and subsequently approved by the NHS Information Standards Board (ISB) as an NHS information standard on the 27th February 2008. A Data-Set Change Notice (DSCN) was issued by ISB in March 2008. GUM clinic software providers must implement GUMCAD at all their sites in England. GUMCAD will replace the KC60 statistical return which will cease to be in use from April 2009.
The GUMCAD project is being directed and overseen by a Steering Group, with representatives from HPA Centre for Infections and Local and Regional Services, the Department of Health, the British Association for Sexual Health and HIV, South West Public Health Observatory, PCT commissioners and academia. The main role of the Steering Group is to:
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Advise on dataset items for inclusion.
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Advise on and co-ordinate dataset approval processes (ROCR & ISB).
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Identify and resolve problems in GUMCAD rollout.
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Review GUMCAD and suggest modifications as required.
In addition, an Implementation Group, with representation from CfI, LRS and GUM clinic software providers, is responsible for co-ordinating the pilot and data extract roll out, and also for identifying and resolving technical problems.
GUMCAD reporting tool
The HPA will upload, store, and collate the data and generate local output reports for monitoring local, regional and national public health priorities in sexual health. Some of the proposed outputs generated will include:
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Reports of STI rates and numbers by area of patient residence and patient demographics (sex, sexual orientation, age group, ethnic group and country of birth).
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Reports of chlamydia test uptake in GUM settings by area of patient residence for collation with National Chlamydia Screening Programme data.
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Reports on STI and HIV testing and hepatitis B vaccination rates in GUM settings by area of patient residence.
In the future, the dataset will also provide the core clinical and demographic information for a range of GUM-based HIV and STI surveillance systems, thus reducing workload within GUM clinics and at the HPA.
A description of the standardised automated reports developed using data from GUMCAD is given in the document below. Reports will be available from August 2009 and will be restricted for use by government and public health organisations only.
GUMCAD Automated Report Specification (Word Document, 798 KB)
GUMCAD data sharing policy
This is a provisional document detailing the strict principles for accessing, storing and sharing GUMCAD data.
GUMCAD Provisional Data Sharing Policy - July 2009 (PDF, 66 KB)
GUMCAD extract specification
The final version of the GUMCAD extract specification is below:
GUMCAD guidance for clinic staff
Comprehensive guidance for clinic staff on the recording, collection and transmission of GUMCAD data to HPA is below. The guidance was developed by HPA and BASHH and is being sent to all GUM clinics in England.
GUMCAD Guidance to clinic staff (Version 9) (PDF, 166 KB)
Updates on GUMCAD roll-out
Information sent to GUM clinics and regions on the progress of the GUMCAD roll-out
GUMCAD update for clinics - 19 November 2009 (PDF, 156 KB)
GUMCAD update for clinics - 07 July 2009 (PDF, 54 KB)
GUMCAD update for clinics - 09 April 2009 (PDF, 57 KB)
GUMCAD update for clinics - 21 November 2008 (PDF, 51 KB)
GUMCAD update for clinics - 08 September 2008 (PDF, 40 KB)
GUMCAD Pilot in Enhanced Sexual Health Services
Work has begun on piloting GUMCAD in non-GUM settings offering Level 2 and above sexual health services (e.g. enhanced general practices, contraceptive and community sexual health services and integrated services). The pilot will examine the feasibility and acceptability of rolling out GUMCAD to these services to improve STI surveillance in order to better estimate the burden of sexual ill health in the population, and the impact of changes in service delivery. Results from the pilot will be available by summer 2009. The project plan can be found below:
Project Plan – GUMCAD 2 (PDF, 310 KB)
Last reviewed: 4 March 2010
