Guidance

Abdominal aortic aneurysm screening programme standards valid for data collected from 1 April 2026

Updated 9 April 2026

Applies to England

1. AAA-S01: 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.

1.1 Description

Proportion of eligible men who are offered screening.

1.2 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.

1.3 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.

1.4 Performance thresholds

Acceptable level: greater than or equal to 98.0%

Achievable level: greater than or equal to 99.9%

1.5 Caveats

None

1.6 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, integrated care boards (ICBs) and GP practice

1.7 Reporting period

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

Cumulative data is reported internally quarterly and published annually.

1.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2026

2. AAA-S02: initial screen coverage

2.1 Description

Proportion of eligible cohort men who are tested.

A supplementary indicator shows coverage of the initial screen by each IMD decile.

2.2 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.

The presentation of coverage by each IMD decile enables services to use this information for targeted and continuous improvement in accessibility of the service provided.

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

2.3 Definition

2.4 Coverage of initial screen

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.

2.5 Coverage of initial screen for the eligible cohort by each IMD decile of participants’ residence

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.

2.6 Performance thresholds

Acceptable level: greater than or equal to 75.0%

Achievable level: greater than or equal to 85.0%

2.7 Caveats

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

The aggregated coverage figures by IMD may be less than the overall figures. In some circumstances it has not been possible to attribute an IMD decile to a participant.

2.8 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, ICB, local authority and GP practice

This standard is also key performance indicator (KPI) AA2

2.9 Reporting period

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

Cumulative data is published quarterly and annually.

2.10 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

3. AAA-S03: initial screen coverage in the most deprived 30% of local areas

3.1 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.

3.2 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.

3.3 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.

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.

3.4 Performance thresholds

Acceptable level: greater than or equal to 75.0%

Achievable level: greater than or equal to 85.0%

3.5 Caveats

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

3.6 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, ICB and GP practice

3.7 Reporting period

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

Cumulative data is reported internally quarterly and published annually.

3.8 Review dates

Date standard introduced: April 2020

Date standard last updated: N/A

4. AAA-S04: initial screen uptake

4.1 Description

Proportion of eligible cohort men offered screening who are tested.

4.2 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.

4.3 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.

4.4 Performance thresholds

Acceptable level: greater than or equal to 77.0%

Achievable level: greater than or equal to 85.0%

4.5 Caveats

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

4.6 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, ICB and GP practice

4.7 Reporting period

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

Cumulative data is reported internally quarterly and published annually.

4.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2026

5. AAA-S05: annual surveillance coverage

5.1 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.

5.2 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.

5.3 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.

5.4 Performance thresholds

Acceptable level: greater than or equal to 87.0%

Achievable level: greater than or equal to 95.0%

5.5 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.

5.6 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.

5.7 Reporting period

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

Data is published quarterly and annually.

5.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2026

6. AAA-S06: annual surveillance uptake

6.1 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.

6.2 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.

6.3 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.

6.4 Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

6.5 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.

6.6 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

6.7 Reporting period

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

Quarterly data is reported internally; annual data is published.

6.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

7. AAA-S07: quarterly surveillance coverage

7.1 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.

7.2 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.

7.3 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.

7.4 Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

7.5 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.

7.6 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.

7.7 Reporting period

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

Data is published quarterly and annually.

7.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

8. AAA-S08: quarterly surveillance uptake

8.1 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.

8.2 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.

8.3 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.

8.4 Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

8.5 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.

8.6 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

8.7 Reporting period

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

Quarterly data is reported internally; annual data is published.

8.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2020

9. AAA-S09: visualised initial screens

9.1 Description

Proportion of initial screens where the aorta could be visualised.

9.2 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.

9.3 Definition

Numerator: number of initial screens recorded as visualised (not 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.

9.4 Performance thresholds

Acceptable level: greater than or equal to 98.0%

9.5 Caveats

Services are not expected to have a visualisation rate of 100% due to individuals with a habitus that prevents a satisfactory image using portable ultrasound equipment.

9.6 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

9.7 Reporting period

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

Cumulative data is reported internally quarterly and published annually.

9.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2026

10. AAA-S10: time to internal quality assurance

10.1 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.

10.2 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).

10.3 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.

10.4 Performance thresholds

Acceptable level: greater than or equal to 80.0%

Achievable level: greater than or equal to 95.0%

10.5 Caveats

None.

10.6 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

10.7 Reporting period

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

Cumulative data is reported internally quarterly and published annually.

10.8 Review dates

Date standard introduced: April 2020

Date standard last updated: April 2026

11. AAA-S11: time to nurse assessment

11.1 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 to 12 weeks of their conclusive scan.

11.2 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.

11.3 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.

11.4 Performance thresholds

Acceptable level: greater than or equal to 70.0%

Achievable level: greater than or equal to 85.0%

11.5 Caveats

Where additional nurse assessments are provided (i.e. at individual’s request) these should be recorded in SMaRT but are not included in reporting against this standard.

11.6 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

11.7 Reporting period

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

Cumulative data is reported internally quarterly and published annually.

11.8 Review dates

Date standard introduced: April 2020

Date standard last updated: April 2026

12. AAA-S12: time to first vascular surgeon assessment

12.1 Description

Proportion of men with an aorta greater than or equal to 5.5cm appropriately referred, or an aorta greater than or equal to 4.0cm that has grown 1cm or more in 1 year, seen by vascular surgeon less than or equal to 2 weeks of their last conclusive ultrasound scan.

12.2 Rationale

Men with a large aneurysm, or an aneurysm greater than or equal to 4.0cm that has grown 1cm or more in 1 year, 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.

12.3 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, or where the aorta was greater than or equal to 4.0cm and has grown 1cm or more in 1 year, 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, or where their aorta was greater than or equal to 4.0cm and has grown 1cm or more in 1 year, within the screening year.

Men are deemed appropriately referred if their aorta measures greater than or equal to 5.5cm as confirmed by computerised 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.

12.4 Performance thresholds

Acceptable level: greater than or equal to 90.0%

Achievable level: greater than or equal to 95.0%

12.5 Caveats

None.

12.6 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

12.7 Reporting period

Screening year of referral (1 April to 31 March). Quarterly data is reported internally; annual data is published.

12.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2026

13. AAA-S13: time to vascular surgery

13.1 Description

Proportion of men with an aorta greater than or equal to 5.5cm appropriately referred, or an aorta greater than or equal to 4.0cm that has grown 1cm or more in 1 year, deemed fit for intervention and not declining, and operated on by a vascular surgeon less than or equal to 8 weeks of their last conclusive ultrasound scan.

13.2 Rationale

The screening pathway up to and including the time to treatment is commissioned by NHS England. Men with a large aneurysm, or with an aneurysm greater than or equal to 4.0cm that has grown 1cm or more in 1 year, 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.

13.3 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, or where the aorta was greater than or equal to 4.0cm and has grown 1cm or more in 1 year, 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 or where the aorta was greater than or equal to 4.0cm and has grown 1cm or more in 1 year, and suitable for intervention and not declining in the screening year.

Men are deemed appropriate for referral if their aorta measures greater than or equal to 5.5cm as confirmed 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.

13.4 Performance thresholds

Acceptable level: greater than or equal to 60.0%

Achievable level: greater than or equal to 80.0%

13.5 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.

13.6 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

13.7 Reporting period

Screening year of referral (1 April to 31 March). Quarterly data is reported internally; annual data is published.

13.8 Review dates

Date standard introduced: April 2009

Date standard last updated: April 2026