Guidance on the calculation of AAA screening programme standards
Updated 13 May 2026
Applies to England
© Crown copyright 2026
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1. Introduction
Quality assurance standards were established in 2009 for abdominal aortic aneurysm (AAA) screening. These standards were developed by the NHS AAA Screening Programme to ensure providers are delivering high quality services for their local populations and achieving the NHS AAA Screening Programme objectives. In 2014, the quality assurance (QA) standards were revised and republished as pathway standards. They underwent a second major review in 2018 to 2019 and were published as screening programme standards applied to data collected from 1 April 2019, with a minor modification to standard 14 and 15 occurring in 2022, to include rapid growth referrals. The operational delivery plan for 2025 to 2026 included a priority review of standards. Subsequent changes to the definition and thresholds of standards, including the retirement of 2 pathway standards were applied to data collected from 1 April 2026.
A full history of updates to the standards can be found here.
The definitions for the standards have been agreed by NHS England and are described in the metadata section below.
Bespoke reports to extract the relevant data from the screening management and referral tracking (SMaRT) IT system have been developed. The standards reports are created from several queries that extract data from SMaRT and apply various inclusion and exclusion criteria. It is not possible for providers to calculate the figures for certain standards. Where providers can calculate all or part of the figures for the standard, record level data are included as supplementary tabs within the programme standard reports to show how the aggregated numbers are calculated.
2. How to use the screening standards metadata
Metadata provides a description of a piece of information. In this case, the piece of information is a screening standard. Metadata describes the programme standards so that the details of how they are defined, what they measure and how they are calculated can be understood. Metadata provides clarity and transparency around each standard for those creating the data and those using it. The metadata tables below provide the definitions for each standard and the calculations used for the report.
For each standard in the programme screening standard reports, which is calculated from SMaRT, a metadata table has been created that includes:
- Standard title
- Code
- Description
- Detail – published information for further detail on the standard
- Numerator
- Denominator
- Calculation
- Conditions – criteria used to calculate the standard
- Reporting period – period that each standard is measured to / within
- Notes – any supplementary information for consideration for each standard
Providers are encouraged to familiarise themselves with the tables below.
3. Screening standards metadata
Screening standards are not presented in numerical order but are grouped together according to their similarity and the report format.
- Initial screening standards (AAA-S01, AAA-S02, AAA-S03 and AAA-S04)
- Surveillance standards (AAA-S05, AAA-S06, AAA-S07, AAA-S08)
- Image QA and nurse assessment (AAA-S09, AAA-S10 and AAA-S11)
- Referrals (AAA-S12 and AAA-S13)
4. Cohort initial screen uptake and coverage
Standard AAA-S01: initial screen offer
Read published information for further detail on this standard.
Standard AAA-S02: initial screen coverage
Read published information for further detail on this standard.
Standard AAA-S03: initial screen coverage in the most deprived 30% of local areas
Read published information for further detail on this standard.
Standard AAA-S04: initial screen uptake
Read published information for further detail on this standard.
5. Surveillance screen uptake and coverage
Standard AAA-S05: annual surveillance coverage
Read published information for further detail on this standard.
Standard AAA-S06: annual surveillance uptake
Read published information for further detail on this standard.
Standard AAA-S07: quarterly surveillance coverage
Read published information for further detail on this standard.
Standard AAA-S08: quarterly surveillance uptake
Read published information for further detail on this standard.
6. Image QA and nurse assessment
Standard AAA-S09: visualised initial screens
Read published information for further detail on this standard.
Standard AAA-S10: time to internal quality assurance
Read published information for further detail on this standard.
Standard AAA-S11: time to nurse assessment
Read published information for further detail on this standard.
7. Referrals
Standard AAA-S12: time to first vascular surgeon assessment
Read published information for further detail on this standard.
Standard AAA-S13: time to vascular surgery
Read published information for further detail on this assessment.