Official Statistics

Quality and methodology information and development plan for official statistics in development on sexually transmitted infections

Updated 3 June 2025

About the statistics

This quality and methodology information (QMI) report covers the following data from sexual health services (SHSs) in England:

• the gender identity of service users
• the number of recent sex partners reported by people being tested for sexually transmitted infections (STIs) or diagnosed with selected STIs (gonorrhoea and syphilis)
• whether people being tested for STIs at SHSs are symptomatic

These have been published as Official Statistics in Development with our existing Official Statistics on sexually transmitted infections and screening for chlamydia in England.

Change log

3 June 2025: QMI report updated to include data on symptomatic status of people testing at sexual health services.

17 July 2024: QMI and development plan for official statistics in development first published.

Quality summary

Accuracy and reliability

Accuracy is the proximity between an estimate and the unknown true value. Reliability is the closeness of early estimates to subsequent estimated values.

The accuracy of the statistics is largely dependent on the accuracy of the source data submitted by SHSs. As this is the second publication of the statistics on gender identity and recent sex partners and the first publication of the statistics on symptomatic status, we are publishing them as provisional estimates to more widely engage with stakeholders to assess and, where necessary, improve the quality of the data.

The data used for these statistics is reported using the GUMCAD STI Surveillance System. GUMCAD is a pseudonymised and depersonalised data set of all face-to-face attendances, and remote (telephone and online) consultations at SHSs 바카라 사이트“ this means that the data is depersonalised so it is not possible to identify individual people. STIs are not notifiable diseases, but reporting of GUMCAD is mandatory as specified in the Department of Health and Social Care바카라 사이트™s SHS service specification.

The source data is based on the GUMCAD specification published in 2019 (commonly referred to as 바카라 사이트˜GUMCADv3바카라 사이트™) which included, for the first time, data items that help contextualise STI diagnoses by understanding risk behaviours, including the number of recent sex partners (in the 3 months prior to the SHS attendance) whether people attending SHSs and testing for STIs have symptoms, and gender identity. The implementation of GUMCADv3 at SHSs was paused due to disruptions to clinical service provision during the first year of the COVID-19 pandemic in 2020 to 2021. Implementation resumed in 2022, and 2023 is the first calendar year for which most SHSs in England reported data on gender identity and recent sex partners to UKHSA (Tables 1 and 2). Further details on the piloting and implementation of GUMCADv3 are available in .

Table 1. The number and geographical distribution of sexual health services (SHSs) reporting the GUMCADv3 specification [note 1] in England and regions, 2024

Area	Number of SHSs	v3 implemented (n) [note 2]	v3 implemented (%) [note 2]
North East	13	13	100
North West	43	40	93
Yorkshire and the Humber	24	24	100
East Midlands	17	17	100
West Midlands	23	23	100
East of England	32	32	100
London	42	38	90.5
South East	35	34	97.1
South West	18	18	100
England	247	239	96.8

Table 2. The number of sexual health services (SHSs) reporting the GUMCADv3 specification [note 1] in England, 2019 to 2024

Year	Number of SHSs	v3 implemented (n) [note 2]	v3 implemented (%) [note 2]
2019	291	7	2.4
2020	264	46	17.4
2021	263	133	50.6
2022	245	214	87.3
2023	242	225	93
2024	247	239	96.8

Source: Data from routine returns to the GUMCAD STI Surveillance System. The number of SHSs is based on the number that are registered to report GUMCAD to UKHSA 바카라 사이트“ which may not reflect the total number of services that people can go to (some services may combine their data and make a single (grouped) GUMCAD submission).

Note 1: GUMCADv3 is the current (April 2019) specification of the GUMCAD STI Surveillance System.

Note 2: 바카라 사이트˜implemented바카라 사이트™ is defined as the ability to record and report GUMCADv3 data to UKHSA.

We have assessed the source data on gender identity to be reasonably accurate based on comparisons to the proportions of transgender and gender diverse (a person whose gender identity is non-binary or identifies in any other way) people , but we recognise the high degree of uncertainty of these Census estimates. The Office for National Statistics (ONS) acknowledged that respondents to the Census , but this is based on self-completed data outside of a clinical setting. As the source data for these statistics is obtained from SHSs and is reported by sexual healthcare practitioners with , there is a greater likelihood that the gender identity data in GUMCAD is reported as intended.

Similarly, we have assessed the source data on sexual behaviour to be accurate based on comparisons to produced by University College London on the number of recent sex partners. While the source data is reported by all publicly commissioned SHSs in England, most services providing an exclusively online service did not report any data on recent sex partners. Therefore, the data on number of recent sex partners published in these statistical products is restricted to SHSs providing face-to-face care 바카라 사이트“ these represent 97% (232 of 239) of SHSs reporting GUMCADv3. Please refer to Table 9 of the accompanying data tables. In 2024, data on the number of recent (prior 3 months) sex partners was reported for 31% (753,152 of 2,398,259) of face-to-face attendances in 2024, but this data was not commonly reported for people being tested for STIs using online postal self-sampling kits.

As many providers prioritise face-to-face consultations for people at greater risk of STIs or HIV, this means that the distribution of recent sex partners may be skewed towards those reporting more partners. Some SHSs offering face-to-face consultations in London did not report GUMCADv3 data 바카라 사이트“ this would, in turn, skew the distribution of recent sex partners towards those reporting fewer partners. We therefore cannot say with certainty whether the data published in this statistical product over or under estimates the number of people being tested or diagnosed with STIs reporting multiple recent sex partners.

The collection of data on whether people attending SHSs were symptomatic was implemented with GUMCADv3 to better assess service use and the number of service users testing for STIs in line with national guidelines for asymptomatic screening (such as (BASHH)). In 2025, the first data on the proportions of STI tests (any one or a combination of tests for chlamydia, gonorrhoea, syphilis, HIV, hepatitis A, hepatitis B, hepatitis C, Mycoplasma genitalium, mpox, or trichomoniasis) in people attending SHSs in England by whether they were symptomatic or asymptomatic (without symptoms) has been published.

The number of STI tests uses a different unit of analysis than the number of sexual health screens published in our statistic products, because STI tests considers tests for each STI separately, while sexual health screens is a composite measure of 4 tests routinely offered at SHSs (for chlamydia, gonorrhoea, syphilis and HIV). Data on whether people testing for STIs at SHSs were symptomatic or not is broken down by gender identity and sexual orientation. Of the total number of SHSs reporting GUMCADv3, 97.9% (234 out of 239 SHSs) reported data on symptomatic status (symptomatic: yes or no) in 2024.

Based on the commissioning arrangements for online and face to face SHSs in England, we believe the data on symptomatic status to be reasonably accurate 바카라 사이트“ this is because online SHSs are primarily for asymptomatic people while people with symptoms of an STI are primarily treated at face-to-face SHSs. This is the pattern reflected in the GUMCAD data.

Relevance

Relevance is the degree to which the statistics meet user needs in both coverage and content.

There is a clear need for timely, high-quality gender identity data from SHSs 바카라 사이트“ this will help us assess the equity of sexual health provision in England for people of all gender identities. The data on the number of recent sex partners will provide essential information to understand patterns of sexual risk behaviour among people attending SHSs, and how these vary between and within population sub-groups and by STI. Data on whether people attending SHSs and testing for STIs have symptoms will provide information about service use and contribute to service planning and delivery. People with STI needs should have access to STI care regardless of their symptomatic status. The collection of this information will provide data on patterns of sexual healthcare seeking and whether these align with national guidelines for asymptomatic screening.

We aim to publish these statistics annually. England has experienced rising rates of STIs since the early 2000s, with the largest annual number of diagnoses of gonorrhoea reported in 2023. However, there is a lack of national data on STI diagnoses by gender identity, whether people attending SHSs and testing for STIs have symptoms, or on the distribution of recent sex partners for people being tested for or diagnosed with STIs.

The target audience for these official statistics includes people in local public health teams and the providers and commissioners of SHSs in local authorities, as well as academic collaborators and third sector partners. We have used external stakeholder feedback to design the data collection, and the format of these statistical products.

Timeliness and punctuality

The statistics are published as provisional estimates. Provisional estimates are early estimates that we publish as soon as possible, allowing for production and . This is because we want people to have the most up-to-date data available.

Provisional estimates may be revised in later publications, as the source data is updated and improved. This means that if you compare across publications, you may see that some figures have changed slightly from one publication to the next.

Because these are early estimates, there is a trade-off against timeliness and accuracy. GUMCADv3 data was reported by 97% of SHSs in England in 2024 바카라 사이트“ we did not wait for all SHSs to report this data before we produced the statistics (please see Table 1 in the 바카라 사이트˜Accuracy and reliability바카라 사이트™ section) as doing so would mean that we would have needed to delay their publication.

Accessibility and clarity

Accessibility is the ease with which users can access the data, also reflecting the format in which the data is available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.

We currently publish these statistical products as part of this statistical release:

1. STIs and screening for chlamydia in England 2024 report.
2. STIs annual data.
3. STI in England slide set.
4. STIs in England infographic.
5. Quality and methodology information report.

The official statistics are made available in a range of media (such as HTML and OpenDocument Spreadsheet format) which optimise accessibility across different devices (such as desktop computers and smart phones) and different operating systems (such as Microsoft and Apple). The content has also been designed in a way that it is accessible for users with visual impairments. For example, the data and data notes are presented in a way that is compatible with a data reader, and graphics are designed in a way that is accessible to people who are colour-blind (such as using sufficient contrast between colour gradients).

Please also review the 바카라 사이트 accessibility statement.

Comparability and coherence

Coherence is the degree to which data that is derived from different sources or methods, but refers to the same topic, is similar. Comparability is the degree to which data can be compared over time and domain.

Data included in the official STI and NCSP statistics has been collected in a consistent manner over time using surveillance data sets with approved Information Standards Notices from NHS England (formerly NHS Digital). GUMCAD data has been reported to UKHSA since 2008, and the first submissions of gender identity, whether people attending SHSs and testing for STIs have symptoms, and recent sex partner data with routine surveillance returns were submitted in 2019.

The data items used to assess gender identity were developed with external stakeholder input, and are also used for the HIV official statistics published by UKHSA. Similarly, the data used to monitor the number of recent sex partners and whether people attending SHSs and testing for STIs have symptoms is collected using data items developed after at some SHSs and with external stakeholder input. The number of recent partners uses a 3-month lookback interval in keeping with for SHSs.

The publication of this data as official statistics in development will help us further assess the quality of the data reported, and to prospectively assess its comparability over time.

Official statistics in development

These statistics are labelled as (previously termed 바카라 사이트˜experimental statistics바카라 사이트™). Official statistics in development are developed under the guidance of the Head of Profession for Statistics. The goal is to develop statistics that can, in due course, be produced to the standards of the . This statement provides further detail on the nature of the development and how we are continuing to assess these statistics against the Code of Practice.

These stats are published as official statistics in development because we know that some SHSs have not reported data on gender identity, whether people attending SHSs and testing for STIs have symptoms and recent sex partners.

Context and user need

These statistics report on the number of sex partners people report having in the past 3 months, the self-reported gender identity of people accessing SHSs in England, as well as whether people attending SHSs were symptomatic.

We already publish official statistics on STIs (tests and diagnoses) and sexual health services in England. The new data (in these official statistics in development) will improve the public health utility of the source data by improving our ability to assess equity of sexual health service provision, and trends in risk behaviours in people diagnosed with STIs. The statistics will help us better understand who is accessing SHSs and how to meet their needs.

Development plan

As covered above we have identified a need for the statistics to be published, but these are the reasons that we are not publishing as official statistics immediately.

We have identified some quality issues with the data. Firstly, all SHSs are not reporting GUMCADv3 data so the data on gender identity, sexual behaviour and whether people attending SHSs and testing for STIs have symptoms is incomplete. We are engaging with SHSs and SHS commissioners in local authorities to encourage the remaining 3% of SHSs to start submitting GUMCADv3 data to UKHSA. We conduct regular data quality meetings and webinars for both SHSs and commissioners to ensure they are aware of the necessity for reporting this data.

Secondly, data on the number of recent sex partners is currently not being reported by most online services. Therefore, the data on recent sex partners published in these statistical products is restricted to SHSs providing face-to-face care 바카라 사이트“ these represent 97% (232 of 239) of SHSs reporting GUMCADv3. Please refer to Table 3 of the accompanying data tables.

We are working with SHSs to improve the reporting of these data. We will use stakeholder feedback to update our GUMCAD clinical coding guidance to improve its clarity and utility. We anticipate that data will become more complete and reliable over time, as more services capture and submit this data. While UKHSA publishes clinical coding guidance to facilitate and standardise the reporting of GUMCAD data, guidelines on the provision of sexual healthcare including , , and are published by BASHH.

There is a lack of national data on STI diagnoses by gender identity, on the distribution of recent sex partners for people being tested for or diagnosed with STIs or whether people attending SHSs and testing for STIs have symptoms.

To improve GUMCADv3 data quality reported by SHSs, we will incorporate behavioural, testing and gender identity data into existing data reports (as standard) and we have developed a data quality scorecard to highlight data content and allow SHSs to easily monitor the quality of their own data submissions. We will continue to work closely with UKHSA바카라 사이트™s regional network of sexual health facilitators (SHFs) to support the SHSs in their respective regions to improve data quality. In addition, we will also continue to hold data quality workshops with SHFs each autumn.

We anticipate that with an increase in the number of SHSs submitting the required information, the data will be of sufficient quality to be used in a more meaningful way and so be published with the STI and NCSP official statistics.

Data sources

Data on STI tests and diagnoses are submitted by all local authority commissioned sexual health services (SHSs) in England to UKHSA through the GUMCAD STI Surveillance System. GUMCAD was established in 2008 as an electronic surveillance system to collect pseudonymised, individual service user-level data from SHSs. The data set includes:

• STI tests and diagnoses
• demographic data including ethnicity, gender identity and sexual orientation
• sexual behaviour
• outcomes of partner notification and management
• provision of HIV pre-exposure prophylaxis (PrEP)

Services reporting to GUMCAD

The following SHSs report GUMCAD data to UKHSA each quarter:

• SHSs providing specialist (Level 3) and non-specialist (Level 2) STI-related care 바카라 사이트“ these services may also provide SRH care as an integrated service
• online services providing non-specialist (Level 2) STI-related care

Details on the levels of sexual health service provision are provided in .

The following strengths of the data have been identified:

• GUMCADv3 data reporting to UKHSA is mandatory
• data validation rules (applied at the point of submission) ensure that all fields are completed properly
• additional data reviews, enhancement and quality assurance checks are carried out on a quarterly basis and for each annual official statistics release of STI and NCSP data

The following limitations of the data have been identified:

• GUMCAD data is only reported by SHSs 바카라 사이트“
• GUMCAD data is depersonalised so it is not possible to identify individual people 바카라 사이트“ it is therefore not possible to link people바카라 사이트™s records between different services within the data set, or to link people바카라 사이트™s records between different data sets
• this data set does not collect data from private providers of sexual healthcare

Methods

These official statistics in development are produced using automated calculations in standard software packages (such as Stata, SQL, MS Access and MS Excel) which reduces the risk of human error via manual calculations. All calculations are independently verified via multiple quality assurance checks.

GUMCAD data goes through a rigorous data validation and evaluation process. The initial data submissions have automated data validation rules applied at point of submission (enforcing coding and formatting requirements) and are also subject to quarterly data enhancement routines and quality assurance checks (such as ensuring consistency in data trends).

The official statistics in development (the report, data tables, and slide set) are produced using automated calculations which are prepared and tested in advance. Additionally, the statistics are produced by a member of the GUMCAD team and are then independently validated by another member of the team to ensure the accuracy of calculations and the written text in the report. Any data queries that are raised via review are investigated and actioned appropriately 바카라 사이트“ where data may be confirmed as correct or may require the addition of specific data notes or caveats to explain the data content. These quality assurance checks ensure that outputs are robust and reliable.

Related statistics

To our knowledge, there is no other national data on the number of transgender and non-binary people accessing SHSs in England for STI testing and treatment. However, UKSHA already publishes data on the number of transgender and gender diverse people attending HIV services in England. The Netherlands also publishes with breakdowns by gender identity.

ONS has also published as official statistics in development on the number of people in England and Wales whose gender identity differs from the sex registered at birth.

We are not aware of national data on the distribution of recent sex partners among people attending SHSs in England, but data on recent sex partners is regularly captured in surveys of the general population such as , or of specific populations such as the .

Similarly, while there are periodic surveys looking at service use and whether people have had symptoms, this is the first publication of national STI surveillance data on whether people attending SHSs and testing for STIs have symptoms in England.