Supporting the NHS Abdominal Aortic Aneurysm (AAA) Screening Programme in England from 15 years

NHS England and the UK National Screening Committee partnered with NEC Health to develop SMaRT platform to support Abdominal Aortic Aneurysm (AAA) Screening Programme. By the end of the 2024/25 screening year, almost 3.5 million men in England had been offered screening, with over 2.8 million conclusive tests completed. Around 27,000 aneurysms have been detected, more than 8,500 men referred for surgery and over 6,500 AAA repairs undertaken.

An abdominal aortic aneurysm is a potentially life-threatening condition that often presents without symptoms but carries a high risk of death if it ruptures. Early identification through population health screening enables surveillance and planned intervention, significantly reducing the likelihood of emergency treatment and mortality.

The NHS AAA Screening Programme was introduced in 2009 and achieved full population coverage in England by 2013. It aims to reduce mortality from ruptured AAA through systematic, population-based screening for men over 65. The programme is commissioned and assured by NHS England and delivered by local screening services.

For more than 15 years, NEC Health has worked with NHS England and the UK National Screening Committee to provide the software used to deliver the AAA Screening Programme in England.

The national platform behind AAA screening delivery

The AAA Screening Management and Referral Tracking (SMaRT) platform is used by local services to manage the end-to-end delivery of the programme within a centrally hosted system. It provides the operational capability required to run screening clinics, manage surveillance pathways and report activity in line with national standards.

The platform supports:

• Identification and management of annual screening cohorts using national GP registration data

• Standardised call and recall for initial screening and ongoing surveillance

• Clinic and appointment management across community-based settings

• Recording of consent and screening results

• Long-term surveillance for men with small and medium aneurysms

• Referral tracking and outcome recording for men requiring specialist vascular assessment

• Secure storage, retrieval and quality assurance of ultrasound images

• Reporting against nationally defined key performance indicators

By providing a shared national system, SMaRT supports consistent delivery across local services and enables NHS England to oversee programme activity, quality and performance at a national level.

Evidence from the 10-year review

In 2025, the UK National Screening Committee used the NHS AAA Screening Programme as a case study in assessing screening effectiveness, drawing on a 10-year review of outcomes across the UK. The review confirmed that the programme continues to meet its primary objectives to reduce mortality by identifying aneurysms early and ensuring men are managed and referred in line with national clinical standards.

Key findings included:

• A 54% reduction in surgery for ruptured AAA, falling from 975 cases in 2013 to 445 in 2022

• A 40% reduction in AAA-related mortality, decreasing from around 1% in 2012 to 0.6% in 2022

• Confirmation that the programme continues to be cost effective

• Improved screening uptake in more deprived areas, supporting progress in reducing health inequalities

In England, screening activity is captured and reported through the SMaRT platform, supporting NHS England’s oversight of programme delivery and contributing to the evidence used in UK-wide effectiveness reviews. By the end of the 2024/25 screening year, almost 3.5 million men in England had been offered screening, with over 2.8 million conclusive tests completed. Around 27,000 aneurysms have been detected, more than 8,500 men referred for surgery and over 6,500 AAA repairs undertaken.

A long-term partnership for effective AAA screening

The 10-year effectiveness review confirms that the NHS AAA Screening Programme continues to deliver sustained clinical and public health benefit across the UK. Maintaining that position depends on consistent delivery, strong governance and reliable national data.

In England, the AAA SMaRT platform supports local screening services to deliver the pathway consistently and report activity through a single national system. This provides NHS England with a national dataset for oversight, assurance and contribution to UK-wide effectiveness reviews.

NEC Software Solutions is proud to support NHS England as a national screening partner, providing the infrastructure and service continuity required to operate, assure and evolve a population screening programme over the long term.

“Over the 10 years that we looked at, nearly 3.5 million men were offered screening. Around 400 aneurysm ruptures were prevented by screening every year and about 300 deaths from ruptured aneurysm… In the last decade, there’s been an approximate halving of the number of men treated in hospital with a rupture [across the whole population] and in the screened population, those figures have fallen by two‑thirds. We believe that this represents the effects of the screening programme.”
-Jonothan Earnshaw, Former National Clinical Lead, NHS Abdominal Aortic Aneurysm Screening Programme, UK NSC effectiveness review presentation