Integrated Sexual Health Report

One of the guiding principles in implementing the Integrated Sexual Health Tariff was to promote integrated services. To do this effectively it was important to collate together both datasets (GUMCAD and SRHAD) for both types of care, GU and Sexual and Reproductive Health. However, GUMCAD has been developed for epidemiological purposes to monitor prevalence of disease and is therefore episode based while SRHAD is designed to monitor care activity and is contact based. In a GUMCAD report the patient’s test date is used as the central record for an episode and the diagnosis is ‘attached’ to the test – there is actually no reportable record of care delivered (apart from a few anomalous care codes). Where as the SRHAD records the care activity delivered in each visit.

It was therefore decided by the Data Management Working Group that a patient visit would be uniquely identified in both GUMCAD and SRHAD by the Clinic ID, Patient ID and Attendance Date. That means it would be assumed any patient attending the same clinic on the same date would have had only one visit. It also assumes that both data collection systems in an integrated clinic use the same Patient ID and Clinic ID, which they are required to do anyway. By making these assumptions we have been able to create an Integrated Sexual Health Tariff Dataset which is based entirely on SRHAD and GUMCAD. It does require an additional field to identify Level 1 and 2 GUM clinics, this needs to be done because they use a slightly different set of diagnosis codes with the suffix ‘M’ to denote ‘medication given’.

By adopting this integrated dataset approach, double accounting of tariffs triggered in different reporting systems for the same care is prevented and a truly integrated Tariff supports integrated care delivery.