The trend in chlamydia diagnoses is affected by multiple factors. The UK Health Security Agency routinely monitors chlamydia testing and diagnoses through sexually transmitted infection surveillance datasets. In 2022, there were 68,882 chlamydia diagnoses among females aged between 15 and 24 years old, a 22% increase compared to the 2021 figure of 56,562. There were 37,404 diagnoses in males aged between 15 and 24 years old in 2022, a 28% increase compared to the 2021 figure of 29,317.

Local authorities are responsible for commissioning chlamydia screening for their local population as part of their public health responsibilities, funded by the Public Health Grant. The Department publishes annual reports on local authority public health spending.

The following table shows the spend on sexually transmitted infection (STI) testing and treatment via the Public Health Grant, including chlamydia, between 2015/16 and 2021/22:

Source: Office for Health Improvement and Disparities

The aim of England’s National Chlamydia Screening Programme (NCSP) is to reduce the health harms caused by untreated chlamydia infection in women by ensuring all eligible women under the age of 25 years old are offered a chlamydia test.

UK Health Security Agency works with providers and commissioners of sexual and reproductive health services to implement the NCSP, monitor levels of chlamydia testing and diagnoses through our national surveillance systems and evaluate the impact of chlamydia screening on health outcomes.

The forthcoming sexual and reproductive health strategy for England will set out plans to improve sexual and reproductive health outcomes and wellbeing, including tackling sexually transmitted infections (STIs). The strategy will focus on reducing the harms associated with STIs, reducing the incidence and adverse outcomes such as stillbirths or infertility and tackling stigma, morbidity and mortality. As part of the strategy’s development, we are considering various goals including those proposed by the World Health Organization, related to the control of STIs.

We are developing a new Sexual and Reproductive Health Strategy for England, which will be published later this year. The Strategy will set out our plans to improve sexual and reproductive health outcomes and wellbeing, including tackling sexually transmitted infections (STIs). As part of the Strategy’s development process, we are currently considering the control of STIs. The reproduction or ‘R’ numbers for various STIs will not be included in the Strategy, as the R number for a typical STI differs from many other infections and cannot not easily measurable or generalised to the overall population. Factors include the population density of susceptible people, transmission probability per sexual partner and the number of sexual partners during a period of time, as well as the time spent in the infectious state.

The current reproduction number or ‘R’ of chlamydia, gonorrhoea and syphilis is not known, as R number estimates for sexually transmitted infections (STIs) require behavioural information which cannot be easily measured.

The calculation of R for a typical STI differs from many other infections, in that it does not depend only on the population density of susceptible people, but rather the transmission probability per sexual partner and the number of sexual partners during a period of time, as well as the time spent in the infectious state. The value of R differs between different sexual networks and groups at higher risk of STIs as well as over time and cannot be generalised to the overall population.

Increases in rates of syphilis, gonorrhoea and chlamydia are likely to be due to a number of factors. These include increases in both the number of people attending sexual health services and the number of tests for sexually transmitted infections. Other factors include, better detection of infection and behavioural changes such as an increase in partner numbers and condomless anal intercourse, as well as, for some men who have sex with men, ‘chemsex’ and group sex facilitated by geosocial networking applications.

Local authorities will receive £3.1 billion in 2019/20, ring-fenced exclusively for use on public health, including sexual health. We are investing over £16 billion in local authority public health services over the five years of the 2015 Spending Review until 2020/21. It is for individual local authorities to decide their spending priorities based on an assessment of local need, including the need for sexual health services taking account of their statutory duties.

My Rt. hon. Friend the Secretary of State has had numerous discussions with cabinet ministers to discuss a range of topics in advance of the Spending Review. Public health funding for 2020 onwards, including for sexual health services, will be considered carefully in the next Spending Review, in the light of the available evidence.

Local authorities are required by regulations to provide comprehensive open access sexual health services, including provision for sexually transmitted infection testing and treatment and contraception.

The latest statistics show that more people are now accessing sexual health services. Attendances have increased by 7% between 2017 and 2018 (from 3,337,677 to 3,561,548). This continues the trend of increases in attendances seen over the past five years. To help manage the overall increase in demand, local authorities are increasingly commissioning online services to manage lower risk and asymptomatic patients. These services have the potential to reach groups not currently engaged with clinic services.

No discussions have been held with the Royal College of Nursing on the relationship between herpes, chlamydia and Alzheimer’s disease.

Local authorities monitor the performance of local sexual health contracts. This information is not collected by Public Health England (PHE).

It is the responsibility of local authorities to ensure ease of access to chlamydia screening. PHE supports local areas through facilitated chlamydia care pathway workshops. These workshops enable local commissioners and providers to explore and review local chlamydia activities, and create data driven action plans to improve service provision and outcomes.

Local authorities monitor the performance of local sexual health contracts. This information is not collected by Public Health England (PHE).

It is the responsibility of local authorities to ensure ease of access to chlamydia screening. PHE supports local areas through facilitated chlamydia care pathway workshops. These workshops enable local commissioners and providers to explore and review local chlamydia activities, and create data driven action plans to improve service provision and outcomes.

The reduction in the chlamydia detection rate has been reviewed by the National Chlamydia Screening Programme (NCSP) team of Public Health England (PHE) and it is apparent that the proportion of tests that are positive has remained stable. Therefore the chlamydia detection rate reduction is probably due to an overall reduction in testing.

PHE recently conducted a survey of sexual health commissioning across England and the NCSP team is collecting further data from local authorities on the retendering of sexual health services. Once these data are analysed, the results will inform future PHE actions to support commissioners to deliver the best services for their populations. PHE intends to add to the routine data collected whether or not chlamydia testing has been “offered’. This will enable PHE to monitor changes in young peoples’ acceptance of the offer of a chlamydia test.

The current National Chlamydia Screening Programme (NCSP) advice is that health service based screening may be supplemented by high quality internet-based testing. This is highlighted in the NCSP Standards for Chlamydia Screening, Equity of Access Report and Guide on Involving Young Men in Chlamydia Screening. The Public Health England (PHE) sexual health facilitator team advocate this to local commissioners and providers. Internet testing is attractive to some population sections, especially men.

Currently PHE does not collect information specifically on remote testing delivered through postal kits. Therefore the current number of such providers cannot be ascertained. PHE has applied to the Standardisation Committee for Care Information to introduce data collection on postal testing commissioned by local authorities.

The remote testing data for five years collected prior to 2012 by the NCSP is shown in the following table:

The National Chlamydia Screening Programme (NCSP) recommends in its guidance that Chlamydia screening should be integrated within wider sexual health provisions for young adults, and offered at every opportunity (for example, consultations such as emergency hormonal contraception and abortion referrals). National guidance on integrated care models has been produced by the NCSP.

In addition to screening offered via postal test kits, general practitioner surgeries and genitourinary medicine clinics, commissioners are advised to ensure that screening is available in contraceptive health services, pharmacies and where appropriate, through outreach programmes. The NCSP provides guidance on when and how to best deliver outreach programmes with the aim of ensuring services are based on need, are good value for money and are sustainable.

The information is not available in the requested format.

The proportion of 15 to 24-year-olds, the target age group of the National Chlamydia Screening Programme, who had a Chlamydia test in each upper tier local authority in England for the most recent year for which data are available (2013) has been placed in the Library.

The proportion of 15 to 24-year-olds, the target age group of the National Chlamydia Screening Programme, who had a Chlamydia test in each upper tier local authority in England for 2012 has been placed in the Library.

In August 2013, following an evidence review and professional and public consultation, the National Chlamydia Screening Programme (NCSP) updated recommended case management for those testing positive for Chlamydia to include the routine offering of re-testing, around three months after treatment. A position statement was published which summarises the consultation

process and key feedback received, sets out considerations for local implementation and outlines resources to be developed by the NCSP:

www.chlamydiascreening.nhs.uk/ps/resources/re-testing/NCSP%20Position%20Statement_Re-testing%20of%20Positiv e%20Chlamydia%20Cases_August%202013_FINAL.pdf

Local authorities are responsible for the commissioning of Chlamydia screening and the NCSP provides the following resources to support commissioners to encourage re-testing after a Chlamydia diagnosis:

Discussion guide for healthcare professionals:

http://www.chlamydiascreening.nhs.uk/ps/resources/re-testing/Chlamydia%20re-testing%20discussion%20guide%20March%202014.pdf

Models of existing practice:

http://www.chlamydiascreening.nhs.uk/ps/resources/re-testing/Chlamydia%20re-testing%20guidance%20-%20Models%20of%20Practice%20March%202014.pdf

A local audit tool is also in development.

Public Health England monitors re-testing rates at seven to 14 weeks following a diagnosis using data from the genitourinary medicine clinic activity dataset (GUMCAD) and the Chlamydia testing activity dataset. Rates of re-testing following a Chlamydia diagnosis are calculated quarterly. The most recently available data are for diagnoses made between July and September 2013. Re-testing rates are reported separately for GUM and tests in other settings, as individuals cannot be identified between systems due to the anonymous nature of GUM clinic attendances.

Re-testing rate at seven to 14 weeks after a diagnosis, among 15 to 24-year-olds, for those diagnosed between July and September 2013:

GUM clinics: 11.8%

Other settings: 13.1%.

The information is not available in the requested format.

The number of Chlamydia tests and diagnosis in each upper tier local authority in England, 15 to 24-year-olds, for the most recent year for which data are available (2013) has been placed in the Library.

The number of Chlamydia tests and diagnosis in each upper tier local authority in England, 15 to 24-year-olds for 2012 has been placed in the Library.

The number of Chlamydia tests by testing service type and upper tier local authority, 15 to 24-year-olds, in England for the most recent year for which data are available (2013) has been placed in the Library.

The number of Chlamydia tests by testing service type and upper tier local authority, 15 to 24-year-olds, in England for 2012 has been placed in the Library.

Tests done through online services cannot be specifically identified in the dataset and are reported to the Chlamydia Testing Activity Dataset as “other”.