New study shows worrying deterioration in access to sexual health services for patients

Findings from a new study published in the British Medical Journal Sexually Transmitted Infections have demonstrated that access to genitourinary medicine (GUM) services for symptomatic patients has deteriorated in recent years.

The two-year study ‘Inequalities in access to genitourinary medicine clinics in the UK: results from a mystery shopper exercise’ was carried out to better identify how successfully patients were able to access sexual health services across the United Kingdom, following the removal of the Department of Health’s mandatory 48 hour-access targets in 2010.

The study involved the dissemination of postal questionnaires on appointment and service characteristics to all GUM clinic lead clinicians across the United Kingdom in January 2014 and 2015. These were followed up with telephone calls to the clinics by researchers the following month posing as symptomatic and asymptomatic ‘patients’ to request appointments.

Results demonstrated that in 2014, 95.5% of patients with symptoms suggestive of an acute sexually transmitted infection (STI) were offered an appointment within 48 hours. In 2015 however, this figure dropped to 90.8%, well below the 98% level that was previously recommended. Analysis revealed that the most marked declines in access were amongst clinics in England, and that women were less likely to be offered an appointment than men.

Whilst there was an increase in the proportion of patients without symptoms offered an appointment within 48 hours (51% in 2014 to 74.5% in 2015), half of these were an invitation to attend a walk-in session, and nearly a fifth of patients (18%) were unable to book any fixed appointment whatsoever. Again, women fared worse than men with only 59.6% of asymptomatic women in 2015 being offered an appointment within 48 hours.

Commenting on the findings, Dr Elizabeth Carlin, BASHH President said:

The results from this study are especially concerning given the wider context of year-on-year increases in gonorrhoea and syphilis diagnoses, and the emergence of antibiotic-resistant gonorrhoea.

It is essential that patients are able to access GUM services as quickly as possible and the study’s findings strongly support the case for the re-introduction of a mandatory 48 hour access target.

The full study is available online here.