Modernization in GUM/HIV services: what does it mean?

2003 ◽  
Vol 14 (2) ◽  
pp. 89-98 ◽  
Author(s):  
Angela J Robinson ◽  
Karen Rogstad

Genitourinary medicine services are expected to modernize in order to meet the needs of the NHS in the 21st century. Although increased funding is essential, there is a need for services to look at new ways of delivering care in order to deal with the increasing rate of sexually transmitted infections (STIs) including HIV in the community. This must include a review of skill-mix and roles. Some changes may appear to lower the quality of service. There must be auditing of changes to ensure that standards are not lowered. A short-lived working group was put together at the request of the RCP joint speciality committee for GUM consisting of representatives from diverse GUM clinics which have all been involved in extensive modernization of their service in order to meet demand. This report does not hold all the answers but provides suggestions for clinics wishing to initiate change. Changes must be appropriate to the local population and access pressures. More extreme measures may only be appropriate in the most severely stretched clinics and with consideration of measuring outcomes.

1998 ◽  
Vol 9 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Anne M Johnson

Summary: The primary role of genitourinary medicine (GUM) services in the UK is the treatment and control of sexually transmitted diseases (STDs). The origins of the service lie in its public health function, yet measuring outcomes locally and nationally is not straightforward. Difficulties arise from the complex interactions between sexual behaviour, the biology of STDs and the role of clinical services; from the potential consequences of the National Health Service (NHS) internal market on national STD control; and from the limitations of information and surveillance systems. This paper considers each of these areas in turn and concludes with some proposals for measuring GUM outcomes locally and nationally which might potentially satisfy the concerns of commissioners and providers.


2002 ◽  
Vol 13 (12) ◽  
pp. 847-849
Author(s):  
A R Markos

A retrospective casenote study was conducted to examine the risk factors for patients who were diagnosed as hepatitis C (HCV)-positive (between 1999 and 2001) in a semi-rural genitourinary medicine (GUM) setting in Staffordshire, UK. There was a remarkable escalation in the number of reported HCV-positive cases, year on year, in our study. The majority of the positive cases (20/21) gave a history of previous intravenous drug use (IVDU). The incidence of other sexually transmitted infections were reportedly high in our HCV-positive patients. The increasing number of reported HCV-positive cases in the GUM clinic of the semirural Staffordshire setting, may reflect a national pattern that needs further investigations. We advise that HCV serology should be offered to GUM clients (who have a history of IVDU), and to their sex partners. They should also be advised to take tests to exclude other STDs. The case for offering HCV serology as a routine test for patients who request 'the exclusion of STDs' is still undecided.


2014 ◽  
Vol 19 (48) ◽  
Author(s):  
E J Savage ◽  
H Mohammed ◽  
G Leong ◽  
S Duffell ◽  
G Hughes

A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.


2018 ◽  
Vol 11 (7) ◽  
pp. 366-370
Author(s):  
Rabia Aftab

Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life, adding economic burden and causing serious morbidity. Chlamydia infection is the most common bacterial STI, making up a large proportion of the over 1 000 000 STIs acquired every day. Although easily cured with antibiotics, untreated chlamydial infection can have serious consequences affecting reproductive health and the unborn child. Since chlamydia infection is typically asymptomatic, screening provides an opportunity to prevent complications and reduce transmission. With long waits for genitourinary medicine appointments and busy sexual health clinics, screening in primary care can help to improve chlamydia detection and treatment rates.


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