Background/introduction The National Chlamydia Screening Programme (NCSP) recommends opportunistically screening sexually active 15 to 24 year olds annually and on change of partner. Through a number of changes to the delivery of screening, Leeds has maintained a higher than average detection rate indicator (DRI) despite declining spend. We describe these changes and corresponding DRIs.

Aim(s)/objectives To review and re-structure chlamydia control activity to provide greater value for money.

Methods A multi-professional steering group was established and a strategic approach taken to commission chlamydia within sexual health services. Our approach included: screening, treatment and partner notification embedded within contraception and sexual health services; commissioning of online testing and an enhanced pharmacy scheme; signposting website developed; phasing out financial incentives for General Practitioners (GP); reducing outreach testing, marketing and staff.

Results In 2014 £371k was spent on screening activities (£538k 2010/11). 2014 Q1-Q2 DRI was 3,104 (2,168 England; 2,325 Yorkshire and Humber) and 2,511 (1,888 England; 2,128 Y&H), respectively compared to 2,698 (2,093 England; 2,367 Y&H) and 2,355 (1,947 England; 2,068 Y&H) for equivalent time periods in 2013. In 2013 most tests were performed in GP (30%) followed by GUM (26.6%), Internet (26.8%) and CASH (13.5%). Positivity across all settings in 2013 was 9.5%.

Discussion/conclusion By concentrating activity in venues with higher positivity, in line with guidance from the NCSP, it has been possible to achieve the DRI target whilst working within tighter economic constraints. In particular, outreach screening was costly and produced low volumes of tests with low positivity.