MRC/CSO SPHSU, University of Glasgow Occasional Paper
NaSH (National Sexual Health System) is a clinical management IT system in use across all sexual health settings in Scotland. The system is designed to be a full electronic patient record, and includes information on sexual risk factors such as recent and lifetime sexual history, clinical conditions, test results, prescribing, and demographics (e.g. ethnicity, postcode/area).
NaSH has a sophisticated reporting database, for which an anonymised data view has been created, similar to that in use for research in primary care systems. This could be a useful resource for future sexual health research, subject to appropriate ethical review, and would enable research to make better use of existing data, be cheaper than initiating large-scale surveys, give access to high-risk populations, and provide the means to respond to immediate research questions.
We conducted a scoping review to assess the issues involved in accessing and using NaSH for sexual health research. The report on the review is potentially of interest to you and a copy is available on the SPHSU website
In brief, NaSH offers a comprehensive data set of potential use in sexual health research, with over 700,000 patients and more than 300,000 attendances recorded annually. Data include medical, family and sexual history, reproductive health and contraception, social and lifestyle factors, test requests/results, patient actions/recalls, prescriptions, symptoms, physical examination details, partner notification, and referrals. NaSH allows patient-centred choice of whether to use an anonymous identifier or NHS number, which could facilitate record linkage.
Key issues in the use of the data are: data collection and completeness; storage and retrieval; and research governance. Use of NaSH in real time has been problematic and there is a need to address conflict between the requirements of comprehensive and complete data for research purposes and the need for a routine clinical system to function in a routine way. We conclude that concerns over data collection, storage and retention should be considered within the context of the wider public health and research benefit.
If you provided information or contributed to our review, we are grateful for your input. We hope that you find the review of interest and would be happy to hear from you if you have questions or comments.
Lisa McDaid MPhil PhD
Programme Leader – Sexual Health
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Dr Andrew Winter PhD FRCP (Glasg) FRCP (Edin)
Hon Senior Lecturer, University of Glasgow &
Consultant in Sexual Heath & HIV, NHS Greater Glasgow & Clyde