KCI Sexual Health
Statistical Publication Notice
27 October 2009
Key Clinical Indicators for Sexual Health: ‘Population Based’ KCIs: Data for 2008.
INTRODUCTION
KEY POINTS
Female Sterilisation: 12.3 women per 10,000 (aged 15 – 49) had a sterilisation procedure in 2008, compared to 12.6 in 2007.
Vasectomy: A total of 41.3 per 10,000 men (aged 15 – 59) in Scotland had a vasectomy in 2008, compared with 40.1 in 2007.
It should be noted that it is not currently possible to quality assure the vasectomy data provided by NHS boards to the same extent as the ISD national data returns.
Termination of Pregnancy: The proportion of early terminations has been rising steadily in more recent years, with 56.8% of all terminations performed at less than 9 completed weeks gestation in 2008. This figure has risen by 2.6 percentage points from 2007.
Long acting reversible methods of contraception (LARC): The uptake of LARC continues to increase.
The uptake of very long acting methods (Implanon (the implant), IUDs (the coil) and Mirena (IUS)) increased from 40.6 per 1000 women aged 15 – 49 in 2007/2008 to 59.1 in 2007/2008. All of NHS boards have increased their uptake of these very long acting or ‘lasting’ methods.
INTERPRETATION
Due to the impact of H1N1 on the work priorities and resources at Health Protection Scotland (HPS) over recent months, it has not been possible to include the chlamydia KCI in this issue of the report, despite best efforts. HPS are currently finalising the KCI for chlamydia data for 2008 and these will be published in November 2009.
The recording of waiting times data has moved from SMR01 to New Ways. Figures for 2008 show a significant under recording of procedures in New Ways when compared to the numbers from SMR01. Therefore whilst it is possible to use the SMR01 data to obtain numbers of procedures carried out in 2008, it is not possible to examine the waiting times data for these procedures so these are not reported for 2008.
The indicator for termination of pregnancy has changed to reflect the QIS sexual health standards. In previous years the KCI for termination of pregnancy reported on terminations at ‘under 10 weeks' where this was taken to be procedures carried out up to and including 69 days gestation (9 weeks and 6 days gestation i.e. less than 10 completed weeks). This has been modified to procedures carried out under 9 completed weeks (less than 63 days) gestation, therefore comparison with the previous years’ reports on the website is not possible.
Unlike the other indicators on this report, the LARC data are reported by financial year 2008/2009 rather than calendar year 2008
DETAILED FINDINGS
“Respect and Responsibility: Strategy and Action Plan for Improving Sexual Health” highlighted the need to monitor sexual health service development both nationally and at an NHS board level. A set of Key Clinical Indicators (KCIs) has been developed for this purpose.
This document reports on the sterilisation, termination of pregnancy and long acting reversible methods of contraception (LARC) indicators.
Due to the impact of H1N1 on the work priorities and resources at Health Protection Scotland (HPS) over recent months, it has not been possible to include the chlamydia KCI in the October 2009 publication despite best efforts. HPS are currently finalising the KCI for chlamydia data for 2008 and these will be published in November 2009.
After the data quality issues around the Hepatitis B vaccination indicator from last year’s report it was decided not to report on this indicator until local audit data are available or until the National Sexual Health System (NaSH) is able to supply these data.
These indicators, in addition to that on HIV therapy, represent the ‘Population Based Indicators’.
The Key Clinical Indicators for sexual health were developed on behalf of the National Sexual Health Advisory Committee (NSHAC).
The Key Clinical Indicators are part of the wider quality framework for sexual health. The indicators helped to inform the development of the Quality Improvement Scotland (NHS QIS) Sexual Health Service Standards and also the National Sexual Health System (NaSH).
Male and female sterilisation:
Female sterilisation
12.3 women per 10,000 (aged 15 - 49) had a sterilisation procedure in 2008, compared to 12.6 in 2007.
Vasectomy
2008 data shows a slight decrease in the numbers of vasectomies performed inhospital since 2007 (2,363 v 2,835). However the total number performed show an increase (6,413 v 6,217). This is explained by the increase in the numbers that are reported as performed outwith inpatient/daycase settings e.g. community and family planning clinics or by a GP.
Termination of Pregnancy
The proportion of early terminations has been rising steadily in more recent years, with 56.8% of all terminations performed at less than 9 completed weeks gestation in 2008. This figure has risen by 2.6 percentage points from 2007.
The rate of abortions in SIMD5 (most deprived) for 2008 is 18.1 per 1000 women compared to 9.0 for SIMD1 (least deprived). This indicates that women in the most deprived areas are more likely to use termination services than those in the least deprived areas.
Long acting reversible methods of contraception (LARC): In typical use, the ‘long-acting’ or ‘lasting’ methods of contraception have a lower failure rate than alternative reversible methods (for example, contraceptive pill, condoms).
The uptake of very long acting methods (Implanon (the implant), IUDs and Mirena (IUS)) has increased from 40.6 in 2007/2008 to 59.1 in 2008/2009.
CONCLUSIONS
The key clinical indicators for sexual health highlight priority areas in sexual health services and provide a benchmark against which NHS boards can measure some aspects of their performance and allow them to use the data for performance monitoring and comparison with others - leading to improved services and the sharing of best practice.
This year NHS QIS published the Sexual Health Services standards. It is hoped that these data will help NHS boards to monitor their progress against these standards.
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MAIN CONTACTS:
Zareena Rafiq (submitting form)
DASH Project Manager
0131 275 7164
Zareena.rafiq@nhs.net
GLOSSARY:
IUD – Intrauterine device
IUS – Intrauterine System
PRE-RELEASE ACCESS:
NHS Board Chief Executives
NHS Board Communication leads
ScotPHN
Lead clinicaians for Sexual Health in Scotland
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).
HISTORY OF THIS PUBLICATION:
Last Published: September 2008
Next Due: August 2010
Data Available Since: 2005
Zareena Rafiq 
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