Genito Urinary Medicine GUM and the 48 hour access target Kirsty Ellis

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Genito- Urinary Medicine (GUM) and the 48 hour
access target.
Kirsty Ellis Acting Matron
Department of GUM Sheffield
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Introduction

• National Picture
• Why is access important?
• Where are we now?
• What developments have been made?
• Challenges ahead
• Summary

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National Picture

• The past decade has witnessed a deterioration in
  the UKs sexual health.
• Growing waiting times to access GUM have been a
  contributing factor to worsening sexual health.
• In 2004 ,18 of people were offered routine
  appointments and only 72 emergency appointments
  were seen within 48 hours.

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Target

• 100 of patients attending GUM services are
  offered an appointment to be seen within 48
  hours by March 2008
• Choosing Health
• Department of Health 2004.

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Why is 48 hr access important?

• Rapid relief of symptoms
• Reduced risk of complications
• Decreases onward transmission
• Reduces incidence of STIs and HIV.
• Reduces overall healthcare costs

Gonorrhoea
Genital Herpes
Congenital Syphilis
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GUM Workload in Sheffield
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Where are we now?
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How was this achieved?

• Expanding the roles of nursing staff
• Reducing follow ups
• Changing clinical practice
• Rebuilding clinic

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Reducing follow-ups

• Flexible working patterns
• Home treatment
• No news is good news
• Text message or telephone results line
• Streamlining services i.e. Youth Clinic

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Changing Clinical Practice

• Firewall clinics
• x2 Weekly
• Semi- urgent symptomatic

• Rapid screening clinics
• Limited to asymptomatic only
• Clear protocol, agreed exclusion, screening
  pathway, no routine examination, no microscopy.
• No follow ups

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Expanding the roles of Nursing staff

• Nurse Practitioners
• Developing and training senior nurses
• Underpinning of nursing service by health care
  assistants
• Health Advisors, targeting the hard to reach
  populations, with Nurse-led outreach services

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Expanding the roles of Nursing staff

• Supporting the release of senior medical staff/
  consultants to
• Care for complex patients
• Provide training and teaching
• Research
• Service development
• Clinical leadership

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Capital build
Vacant space located adjacent to GUM
offices Access only through toilet cubicle wall !
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Capital build

• 3M Development that has created a new male,
  female clinic, a dedicated HIV facility,
  reception and waiting area.
• These facilities have allowed the service to move
  forward and improve access for patients.

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Challenges ahead

• Sustaining 100 and increasing the 80 attendance
  
• Media campaigns that will increase the demand
• Improve access to other aspects of sexual health,
  working in collaboration with other services.
• Support the excellent work already done in the
  city.

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Challenges ahead

• Promote transferability of specialist services
  into the community
• Maintaining staff motivation and morale.

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Summary

• Optimising the use of the team
• Adapting to patient need
• Constant service evaluation

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Thank you