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Restructuring a GUM service to include nurse-led clinics

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Hartlepool?s genitourinary medicine service has been restructured, with the introduction of nurse-led clinics to help deliver service improvements and 48-hour access in screening of sexually transmitted infections.

The background

The demand for the service was clearly identified by the local population, as there was a 13-week waiting list in situ for patients requesting screening, and the size of the list was increasing ominously.

The latest government strategy identifies that GUM services throughout the UK need to reduce waiting times to within 48 hours before 2008. This clearly states that a much-needed reformation was required for the Hartlepool service - and this was needed promptly.

Restructuring the service

The restructuring of the service identified three immediate strategies to determine the lack of resources within the existing structure.

These were: to assess capacity and demand; to develop extra clinics and to initiate nurse-led clinics. Without doubt the present structure was inadequate and the amount of clinics was insufficient for the number of people trying to access the service.

It was also proposed to increase the size of the existing clinics by 50%. This allowed the department to focus on and generate further 'new patient? appointments. Allocated clinics were implemented in the two days of every week were previously none were in place.

Nurse-led clinics

The nurse-led clinic was a further initiative to allow ongoing treatment to be maintained independently from the clinician service.

This considerably reduced the review appointments ordinarily taken up in regular clinics and again made available 'new patient? appointments.

Future developments of the nurse-led clinics are being discussed to allow for an increase in access to the service and further develop the skills of the specialist nurses.

The impact

This strategy has provided a much-needed improvement in the screening of sexually transmitted infections. The provision can now be considered as being in concordance with the demand of its population and meeting service delivery.

The extra clinics have increased patient accessibility and waiting times are now sustained at 48 hours.

However, these initiatives must not be considered as a quick-fix solution. The provisions that have been put in place need to be prolonged and sustained indefinitely with money that is directed towards or ringfenced for GUM supporting this.

Susan Crinion, health advisor working for Hartlepool GUM services; Jane Collins, nurse specialist; Janet Bradley, staff nurse.

Contact: susan.crinion@nth.nhs.uk

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