This document provides a summary of the national abdominal aortic aneurysm (AAA) screening programme in the UK, including key statistics and performance indicators for 2017/2018. It discusses several initiatives to improve the programme, such as adopting a new demographic data source, developing an inequalities toolkit, updating training resources, and establishing image quality standards. The document outlines plans to test a proposed 10-point image scoring system to help standardize the assessment of ultrasound image quality across the screening programme.

1. Introduction and national update
Lisa Summers, National Programme Manager,
AAAScreening Programme, Public Health England

2. Headline figures
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Headline figures 2009/10 to date 2016/17 2017/2018
Number men eligible for screening 1,612,104 282,357 285,966
Number of men offered screening 1,588,036 281,965 282,583
Number of men screened 1,254,187 228,563 222,887
Number of men with aorta ≥3.0 cm 15,846 2,473 2,232
Coverage (percentage) 77.8 80.9 77.9
Uptake (percentage) 79.0 81.1 78.9
Aneurysms detected (percentage) 1.26 1.08 1.01
Referred for surgery 3652 789 813

3. KPIs 2017/18
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Latest data published Q3 (October 2017 – December 2017).
AA2 (coverage of initial screen)
• Performance 62.1% (above acceptable threshold of 56%)
• 24.4% of providers (10/41) did not meet acceptable threshold
AA3 (coverage of annual surveillance screen)
• Performance 92.5% (the same as Q2 and above acceptable threshold
85%)
• 4.9% of providers (2/41) did not meet acceptable threshold
• AA4 (coverage of quarterly surveillance screen)
• Performance 93.5% (similar to Q2 and above acceptable threshold 85%)
• 2.4% of providers (1/41) did not meet acceptable threshold
https://www.gov.uk/government/collections/nhs-screening-programmes-national-data-
reporting under the ‘Reports’ section

4. Standards, reporting & guidance
• Reporting requirements
• Revision of pathway standards 2018/19
• Review of policies and guidance, including SOPs
• GDPR – business as usual
NB: No Patient information in free text field around referrals
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5. IT & equipment
• IT specialist
• SMaRT:-
• Training for Co-ordinators/Admin
• User Group
• Version 9.6
• Northgate contract
• Equipment specification re-evaluation
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6. Demographic Feed
• NHAIS due to be decommissioned towards the end of 2018
• SPINE Demographics will be the sole authoritative source (for England &
DMS) for identifying subjects who become newly eligible for AAA screening
and for providing notifications of subsequent changes to their
demographic/registration details
• AAA first programme to transfer over in September 2018
• Will receive all men registered AND resident in England as opposed to just
registered in England
• Will receive men registered with the Defence Medical Services (DMS)
• Accessible Information Standard
• Business as usual
• Future – health & justice system
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7. Inequalities toolkit
Four nations approach
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8. Training & Education
Introducing the ‘new’ Paddy…
Tsitsi Muchayingeyi
National Training & Education Manager, AAA & DES
IEPP
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9. Image Quality
Accurate measurement of the abdominal aorta with ultrasound is a central
activity of the National AAA screening programme
PS5 The percentage of assessed images of acceptable quality
PS6 The percentage inaccurate calliper placement determined by review
of static images
Cannot reliably assess compliance with standards 5 and 6 due to:-
• The characteristics of an acceptable image are not sufficiently defined
• The current terminology is subjective
• There is no external quality assurance of image quality (the current
system is reliant upon self-reported data)
In current practice pathway standards 5 and 6 are seldom discussed

10. Image Quality
Currently the image characteristics assessed at QA and recorded on SMaRT
comprise:-
• Depth
• Focus
• Gain
• Calliper placement
Should we add anatomical landmarks? lumbar spine on both the
longitudinal (LS) and transverse (TS) images and the inferior vena cava (IVC)
on TS images
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11. Image Quality Workshop 2017
It was agreed that any
scoring system should be:
Simple
Practical
Able to achieve
reproducible results
Applicable to all AAA
screening images
These factors were collated
into a 10 point scoring
system

12. What happens now?
NAAASP research committee approval
Recruit:-
20+ CSTs/QA leads
Score an image set of 50 cases (anonymised) comparing (in 2hours)
Reliability
Time efficiency and user comments

13. Diary Dates
• Nursing Day – 19 September 2018, London
• Directors’ meeting – 27 November 2018, Glasgow
• VSGBI – 28-30 November 2018, Glasgow
• National Research & Audit Day - 7 February 2019, Newcastle
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14. Thank You!
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