Guidance

Abdominal aortic aneurysm screening programme standards valid for data collected from 1 April 2020

Updated 17 February 2022

Applies to England

AAA-S01: uptake: completeness of the initial screen offer

This document links to a glossary of screening terms for definitions of terms. To see the meaning of an acronym, hover over it with your cursor to see the full definition.

Description

Proportion of eligible men who are offered screening.

Rationale

To maximise the impact of the screening programme all eligible men should be offered a screen. A man should not miss out on the opportunity to make an informed choice to accept screening because he was not invited by the provider.

Definition

Numerator: number of cohort men eligible for the initial screen offered an initial appointment date which occurs within the screening year plus an additional 2 months.

Denominator: number of cohort men eligible for the initial screen in the screening year.

An offer is assumed if a letter for invitation is generated on the Screening Management and Referral Tracking (SMaRT) database. Men whose contact details are inaccurate, resulting in a post office return, are considered eligible but are not counted as being offered an invitation as there is evidence the offer was not received.

An additional 2 months after the end of the screening year is included to allow men who are loaded into the cohort on the last day of the screening year to be invited and screened.

Men who are offered an invitation for screening but are found to be ineligible are removed from the numerator and denominator.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 95.0%

Achievable level: greater than or equal to 99.9%

Caveats

None

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider, clinical commissioning group (CCG) and GP practice

Reporting period

Screening year of the eligible cohort (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S02: uptake: completeness of the annual surveillance offer

Description

Proportion of annual surveillance appointments due where an appointment was offered 6 weeks either side of the due date.

Rationale

To maximise the impact of the screening programme, men with detected small AAAs should be offered a timely annual surveillance scan. This is to ensure they are on the correct surveillance interval and to minimise the risk of rupture. A man should not miss out on the opportunity to accept a surveillance scan because he was not invited by the provider.

Definition

Numerator: number of appointments offered less than or equal to 6 weeks (less than or equal to 42 calendar days) either side of the due date.

Denominator: number of annual surveillance appointment due dates occurring in the reporting period.

The surveillance standard counts appointments not men. For example, if a man has 2 due dates each one will be counted.

An offer is assumed if a letter for invitation is generated on the SMaRT database. Men whose contact details are inaccurate, resulting in a post office return, are considered eligible but are not counted as being offered an invitation as there is evidence the offer was not received.

Appointments for men ineligible for surveillance less than or equal to 6 weeks (less than or equal to 42 calendar days) after their due date and not conclusively scanned are not included in the numerator or denominator.

Ineligible criteria are:

• died

• out of cohort

• surveillance ceased

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 95.0%

Achievable level: greater than or equal to 99.0%

Caveats

None.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme.

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme.

Published by: provider

Reporting period

Screening year in which the appointment was due (1 April to 31 March).

Quarterly data is reported internally; annual data is published.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S03: uptake: completeness of the quarterly surveillance offer

Description

Proportion of quarterly surveillance appointments due where an appointment was offered 4 weeks either side of the due date.

Rationale

To maximise the impact of the screening programme, men with detected medium AAAs should be offered a timely quarterly surveillance scan. This to ensure they are on the correct surveillance interval and minimise the risk of rupture. A man should not miss out on the opportunity to accept a surveillance scan because he was not invited by the provider.

Definition

Numerator: number of appointments offered less than or equal to 4 weeks (less than or equal to 28 calendar days) either side of the due date.

Denominator: number of quarterly surveillance appointment due dates occurring in the reporting period.

The surveillance standard counts appointments not men. For example, if a man has 4 due dates each one will be counted.

An offer is assumed if a letter for invitation is generated on the SMaRT database. Men whose contact details are inaccurate, resulting in a post office return, are considered eligible but are not counted as being offered an invitation as there is evidence the offer was not received.

Appointments for men ineligible for surveillance less than or equal to 4 weeks (less than or equal to 28 calendar days) after their due date and not conclusively scanned are not included in the numerator or denominator.

Ineligible criteria:

• died

• out of cohort

• surveillance ceased

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 95.0%

Achievable level: greater than or equal to 99.0%

Caveats

None.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: local screening service.

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme.

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme.

Published by: provider

Reporting period

Screening year in which the appointment was due (1 April to 31 March).

Quarterly data is reported internally; annual data is published.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S04: coverage: initial screen

Description

Proportion of eligible cohort men who are tested.

Rationale

Coverage is an essential measure for the screening programme as it provides an indication of the accessibility of the service and that men are aware of the importance of screening.

This standard needs to be looked at in conjunction with the proportion of people offered an initial screen.

Definition

Numerator: number of cohort men eligible for the initial screen who had a conclusive screen result within the screening year plus an additional 2 months.

Denominator: number of cohort men eligible for the initial screen in the screening year.

An additional 2 months after the end of the screening year is included to allow men who do not attend or cancel at the end of the year to be reinvited and screened.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 75.0%

Achievable level: greater than or equal to 85.0%

Caveats

Some men may choose to defer their initial screen which may lower the number tested within the screening year plus 2 months.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider, CCG, Local Authority and GP practice

This standard is also key performance indicator (KPI) AA2

Reporting period

Screening year of the eligible cohort (1 April to 31 March).

Cumulative data is published quarterly and annually.

Validation deadlines: 30 September (Q1), 31 December (Q2), 31 March (Q3) and 30 June (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S05: coverage: annual surveillance scan

Description

Proportion of annual surveillance appointments due where there is a conclusive scan less than or equal to 6 weeks either side of the due date.

Rationale

Coverage is an essential measure for the screening programme. Timely and conclusive annual surveillance scans provide an indication of the accessibility of the service and shows that men are aware of the importance of surveillance. This standard needs to be looked at in conjunction with the proportion of annual surveillance appointments offered.

Definition

Numerator: number of conclusive scans less than or equal to 6 weeks (less than or equal to 42 calendar days) either side of the due date for annual surveillance men.

Denominator: number of annual surveillance appointment due dates occurring in the reporting period.

The surveillance standard counts appointments not men. For example, if a man has 2 due dates each one will be counted.

Appointments for men ineligible for surveillance less than or equal to 6 weeks (less than or equal to 42 calendar days) after their due date and not conclusively scanned are not included in the numerator or denominator.

Ineligible criteria:

• died

• out of cohort

• surveillance ceased

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 85.0%

Achievable level: greater than or equal to 95.0%

Caveats

If a provider overrides a man’s appointment from annual surveillance to quarterly surveillance SMaRT will still generate another annual surveillance due date which will remain without a conclusive test and artificially increase the denominator.

Additional due dates can be created in SMaRT if a man is deactivated and he is reactivated without reinstating his previous due date. Guidance on reactivation is available within the support section of SMaRT. An additional due date can also be created following recall after quality assurance of an image.

Men who are visualised at medical imaging will not be counted in the numerator as SMaRT does not record an appointment date.

These instances can be exception reported at programme board.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

This standard is also key performance indicator AA3.

Reporting period

Screening year in which the appointment was due (1 April to 31 March).

Data is published quarterly and annually.

Validation deadlines: 30 September (Q1), 31 December (Q2), 31 March (Q3) and 30 June (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S06: coverage: quarterly surveillance scan

Description

Proportion of quarterly surveillance appointments due where there is a conclusive scan less than or equal to 4 weeks either side of the due date.

Rationale

Coverage is an essential measure for the screening programme. Timely and conclusive quarterly surveillance scans provide an indication of the accessibility of the service and shows that men are aware of the importance of surveillance. This standard needs to be looked at in conjunction with the proportion of quarterly surveillance appointments offered.

Definition

Numerator: number of conclusive scans less than or equal to 4 weeks (less than or equal to 28 calendar days) either side of the due date for quarterly surveillance men.

Denominator: number of quarterly surveillance appointment due dates occurring in the reporting period.

The surveillance standard counts appointments not men. For example, if a man has 4 due dates each one will be counted.

Appointments for men ineligible for surveillance less than or equal to 4 weeks (less than or equal to 28 calendar days) after their due date and not conclusively scanned are not included in the numerator or denominator.

Ineligible criteria:

• died

• out of cohort

• surveillance ceased

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

Caveats

If a provider overrides a man’s appointment from quarterly surveillance to annual surveillance SMaRT will still generate another quarterly surveillance due date which will remain without a conclusive test and artificially increase the denominator.

Additional due dates can be created in SMaRT if a man is deactivated and he is reactivated without reinstating his previous due date. Guidance on reactivation is available within the support section of SMaRT. An additional due date can also be created following recall after quality assurance of an image.

Men who are visualised at medical imaging will not be counted in the numerator as SMaRT does not record an appointment date.

These instances can be exception reported at programme board.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

This standard is also key performance indicator AA4.

Reporting period

Screening year in which the appointment was due (1 April to 31 March).

Data is published quarterly and annually.

Validation deadlines: 30 September (Q1), 31 December (Q2), 31 March (Q3) and 30 June (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S07: coverage: initial screen in the most deprived 30% of local areas

Description

Proportion of men in the eligible cohort who were tested and who lived in a lower super output area (LSOA) classed as decile 1 to 3 in the English indices of deprivation 2019.

Rationale

Men living in more deprived areas are less likely to attend for screening but are more likely to have an aneurysm. It is important for providers to engage with men living in more deprived areas to make sure they can make a personal informed choice.

This standard only focuses on one aspect of inequalities in access to AAA screening. It is acknowledged that there are many sources of inequalities and providers should work with commissioners to identify and reduce drivers of inequalities relevant to their local area. AAA inequalities guidance has further information.

Definition

Numerator: number of cohort men eligible for the initial screen in deciles 1 to 3 who had a conclusive screen result within the screening year plus an additional 2 months (in the event of non-attendance and cancellations at the end of the year this allows men to be reinvited and screened).

Denominator: number of cohort men eligible for the initial screen in the screening year who lived in a LSOA classed as decile 1 to 3 in the index of multiple deprivation 2019.

LSOA is assigned based on the man’s postcode at time of discharge from the screening programme if he was screen clear, declined, did not attend or was an incomplete screening episode. If the man has an aneurysm detected it will be based on the postcode at the time the data was extracted from SMaRT.

An additional 2 months after the end of the screening year is included to allow men who do not attend or cancel at the end of the year to be reinvited and screened.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 75.0%

Achievable level: greater than or equal to 85.0%

Caveats

Some men may choose to defer their initial screen which may lower the number tested within the screening year plus 2 months.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year of the eligible cohort (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2020

Date standard last updated: N/A

AAA-S08: uptake: initial screen

Description

Proportion of eligible cohort men offered screening who are tested.

Rationale

This standard gives an indication of the acceptance of the screening test in those offered the screen.

Uptake should be looked at in conjunction with coverage of the initial screen and the proportion of eligible cohort men offered the initial screen.

Definition

Numerator: number of cohort men eligible for the initial screen who have had a conclusive screen result within the screening year plus an additional 2 months.

Denominator: number of cohort men eligible for the initial screen offered an initial appointment date which occurs within the screening year plus an additional 2 months.

An offer is assumed if a letter for invitation is generated on the SMaRT database. Men whose contact details are inaccurate, resulting in a post office return, are considered eligible but are not counted as being offered an invitation as there is evidence the offer was not received.

An additional 2 months after the end of the screening year is included to allow men who do not attend or cancel at the end of the year to be reinvited and screened.

Men who are offered an invitation for screening but are found to be ineligible are removed from the numerator and denominator.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 75.0%

Achievable level: greater than or equal to 85.0%

Caveats

Some men may choose to defer their initial screen which may lower the number tested within the screening year plus 2 months.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider, CCG and GP practice

Reporting period

Screening year of the eligible cohort (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S09: uptake: annual surveillance scan

Description

Proportion of annual surveillance appointments offered less than or equal to 6 weeks either side of the due date where there is a conclusive scan less than or equal to 6 weeks either side of the due date.

Rationale

This standard gives an indication of the acceptance of surveillance in those offered.

Uptake should be looked at in conjunction with coverage of the annual surveillance scan and the annual surveillance appointments offered.

Definition

Numerator: number of conclusive scans less than or equal to 6 weeks (less than or equal to 42 calendar days) either side of the due date for annual surveillance men.

Denominator: number of appointments offered less than or equal to 6 weeks (less than or equal to 42 calendar days) of the due date for annual surveillance men, where the due date occurs in the reporting period.

The surveillance standard counts appointments not men. For example, if a man has 2 due dates each one will be counted.

An offer is assumed if a letter for invitation is generated on the SMaRT database. Men whose contact details are inaccurate, resulting in a post office return, are considered eligible but are not counted as being offered an invitation as there is evidence the offer was not received.

Appointments for men ineligible for surveillance less than or equal to 6 weeks (42 days) after their due date and not conclusively scanned are not included in the numerator or denominator.

Ineligible criteria:

• died

• out of cohort

• surveillance ceased

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

Caveats

If a provider overrides a man from annual surveillance to quarterly surveillance SMaRT will still generate another annual surveillance due date which will remain without a conclusive test and artificially increase the denominator.

Additional due dates can be created in SMaRT if a man is deactivated and he is reactivated without reinstating his previous due date. Guidance on reactivation is available within the support section of SMaRT. An additional due date can also be created following recall after quality assurance of an image.

Men who are visualised at medical imaging will not be counted in the numerator as SMaRT does not record an appointment date.

These instances can be exception reported at programme board.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year in which the appointment was due (1 April to 31 March).

Quarterly data is reported internally; annual data is published.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S10: uptake: quarterly surveillance scan

Description

Proportion of quarterly surveillance appointments offered less than or equal to 4 weeks either side of the due date where there is a conclusive scan less than or equal to 4 weeks either side of the due date.

Rationale

This standard gives an indication of the acceptance of surveillance in those offered.

Uptake should be looked at in conjunction with coverage of the quarterly surveillance scan and the quarterly surveillance appointments offered.

Definition

Numerator: number of conclusive scans less than or equal to 4 weeks (less than or equal to 28 calendar days) either side of the due date for quarterly surveillance men.

Denominator: number of appointments offered less than or equal to 4 weeks (less than or equal to 28 calendar days) of the due date for quarterly surveillance men, where the due date occurs in the reporting period.

The surveillance standard counts appointments not men. For example, if a man has 4 due dates each one will be counted.

An offer is assumed if a letter for invitation is generated on the SMaRT database. Men whose contact details are inaccurate, resulting in a post office return, are considered eligible but are not counted as being offered an invitation as there is evidence the offer was not received.

Appointments for men ineligible for surveillance less than or equal to 4 weeks (28 days) after their due date and not conclusively scanned are not included in the numerator or denominator.

Ineligible criteria:

• died

• out of cohort

• surveillance ceased

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

Caveats

If a provider overrides a man from quarterly surveillance to annual surveillance SMaRT will still generate another quarterly surveillance due date which will remain without a conclusive test and artificially increase the denominator.

Additional due dates can be created in SMaRT if a man is deactivated and he is reactivated without reinstating his previous due date. Guidance on reactivation is available within the support section of SMaRT. An additional due date can also be created following recall after quality assurance of an image.

Men who are visualised at medical imaging will not be counted in the numerator as SMaRT does not record an appointment date.

These instances can be exception reported at programme board.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year in which the appointment was due (1 April to 31 March).

Quarterly data is reported internally; annual data is published.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S11: test: non-visualised initial screens

Description

Proportion of initial screens where the aorta could not be visualised.

Rationale

In order to maintain quality of the screening test, it is important to monitor the number of inconclusive scans. Technical faults and patient factors will impact on the number of inconclusive scans.

Definition

Numerator: number of initial screens recorded as non-visualised (including technical failure).

Denominator: total number of initial screens in the screening year.

This will include initial screens from cohort and self-referral men.

The standard counts the number of screens not the number of men screened.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: less than or equal to 3.0%

Achievable level: less than or equal to 1.0%

Caveats

None.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year in which the screen occurred (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

AAA-S12: test: time to internal quality assurance

Description

Proportion of abnormal screens (aorta greater than or equal to 3.0 to less than 5.5cm) reviewed less than or equal to 21 calendar days of the initial screen date.

Rationale

Ongoing internal quality assurance aims to identify omissions and inconsistencies in technique and training. This is to make sure quality and standards are maintained in line with the national standard operating procedures and the screening technician’s scope of practice. Where a screen indicates a small or medium aneurysm, the images should be reviewed by the clinical skills trainer or quality assurance lead less than or equal to 21 calendar days. This is so that a man can be moved into surveillance and referred for nurse assessment if he has a small or medium sized aneurysm (aorta greater than or equal to 3.0 to less than 5.5cm) or be reassured if no aneurysm is found (aorta less than 3.0cm).

Definition

Numerator: number of abnormal screens reviewed by a clinical skills trainer or quality assurance lead less than or equal to 21 days of the initial screen date.

Denominator: number of initial screens identified as abnormal (aorta greater than or equal to 3.0 to less than 5.5cm) sent for internal quality assurance during the reporting period.

This will include initial screens from cohort and self referral men.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 60.0%

Achievable level: greater than or equal to 95.0%

Caveats

None.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year in which the initial screen occurred (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2020

Date standard last updated: N/A

AAA-S13: diagnosis / intervention: time to nurse assessment

Description

Proportion of men who had a small or medium aneurysm detected (aorta greater than or equal to 3.0cm to less than 5.5cm) at initial screen and the number of men who had a medium aneurysm detected (greater than or equal to 4.5cm to less than 5.5cm) at the annual surveillance scan who had a nurse assessment less than or equal to12 weeks of their conclusive scan.

Rationale

Men with aneurysms require close monitoring, support and secondary prevention to help reduce their overall vascular risk and improve outcomes. The nurse assessment appointment should occur shortly after finding the small or medium aneurysm to reduce anxiety. Nurse specialists assess men for vascular risk factors and give advice about health and lifestyle to reduce their risk. It also provides the man with an opportunity to ask questions about the condition.

Definition

Numerator: the number of men in the denominator who had a nurse assessment less than or equal to 12 weeks (less than or equal to 84 calendar days) of their conclusive scan.

Denominator: number of men in the screening year with a

• small or medium aneurysm detected (aorta greater than or equal to 3.0cm to less than 5.5cm) at initial screen

• medium aneurysm detected (greater than or equal to 4.5cm to less than 5.5cm) at the annual surveillance scan

This standard counts scans from cohort and self referral men.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Assessments can be face to face or via the telephone. Further information is available in the nurse assessment guidance.

Performance thresholds

Acceptable level: greater than or equal to 50.0%

Achievable level: greater than or equal to 80.0%

Caveats

None.

Data collection and reporting

Data source: SMaRT

Responsible for data quality and completeness: provider

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year in which the initial screen occurred (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2020

Date standard last updated: N/A

AAA-S14: diagnosis / intervention: time to first vascular surgeon assessment

Description

Proportion of men with an aorta greater than or equal to 5.5cm seen by vascular surgeon less than or equal to 2 weeks of their last conclusive ultrasound scan.

Rationale

Men with a large aneurysm are at risk of rupture and should be seen by a vascular surgeon and operated on (if suitable for surgery) within an 8-week (less than or equal to 56 calendar days) time frame. Men should be assessed for their suitability for surgery less than or equal to 2 weeks (less than or equal to 14 calendar days) of their last conclusive screen so that there are no unnecessary delays in treatment or patient care.

Definition

Numerator: number of men appropriately referred for surgery where the number of days between the date of the last conclusive ultrasound scan, where the aorta was measured as greater than or equal to 5.5cm, and date of the first attended vascular surgeon appointment is less than or equal to 14 calendar days. The last conclusive ultrasound scan date is day 0.

Denominator: number of men appropriately referred for surgery within the screening year.

Men are deemed appropriately referred if their aorta is confirmed to measure greater than or equal to 5.5cm by computerized tomography (CT) or magnetic resonance imaging (MRI) scan.

This includes cohort and self-referral men from the initial screen and surveillance.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Men not meeting the standard should be exception reported via the AAA tracker.

Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

Caveats

None.

Data collection and reporting

Data source: National vascular registry via SMaRT

Responsible for data quality and completeness: provider and vascular service

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year of referral (1 April to 31 March).

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2015

AAA-S15: diagnosis / intervention: time to vascular surgery

Description

Proportion of men with aorta greater than or equal to 5.5cm appropriately referred, deemed fit for intervention and not declining, operated on by a vascular surgeon less than or equal to 8 weeks of their last conclusive ultrasound scan.

Rationale

The screening pathway up to and including the time to treatment is commissioned by NHS England. Men with a large aneurysm are at risk of a rupture and should be seen by a vascular surgeon and operated on (if suitable for surgery) within an 8-week (less than or equal to 56 calendar days) time frame.

Definition

Numerator: number of men appropriately referred, suitable for intervention and not declining where the number of days between last conclusive ultrasound scan at greater than or equal to 5.5cm and date of surgery is less than or equal to 56 calendar days. The last conclusive ultrasound scan date is day 0.

Denominator: number of men appropriately referred for surgery and suitable for intervention and not declining in the screening year.

Men are deemed appropriate for referral if their aorta is confirmed to measure greater than or equal to 5.5cm by CT or MRI scan.

This includes cohort and self-referral men from the initial screen and surveillance.

We calculate performance by dividing numerator by denominator and multiplying by 100 to give a percentage.

Performance thresholds

Acceptable level: greater than or equal to 60.0%

Achievable level: greater than or equal to 80.0%

Caveats

Assessment for suitability for surgery is undertaken by the responsible vascular surgeon. This is based on professional clinical judgement.

Men not meeting the standard should be exception reported via the AAA tracker and discussed on a case by case basis at the local programme board. Further guidance is available in the NAAASP guidance on waiting times standards.

Data collection and reporting

Data source: National vascular registry via SMaRT

Responsible for data quality and completeness: provider and vascular service

Responsible for submission: not applicable as extracted from SMaRT by the national AAA screening programme

Reported by: not applicable as extracted from SMaRT by the national AAA screening programme

Published by: provider

Reporting period

Screening year of referral (1 April to 31 March)

Cumulative data is reported internally quarterly and published annually.

Validation period: July (Q1), October (Q2), January (Q3) and April (Q4)

Review dates

Date standard introduced: April 2009

Date standard last updated: April 2015