Background Before 2008 GUM provision in BFG comprised one central and two satellite GUM clinics. Run by a F/T consultant and 3 or 4 nurses, it covered an area the size of Scotland with little primary care input. Since 2008 Guy's and St. Thomas' [GSTT] and SSAFA Forces Help have held the contract to provide GUM services to the BFG population. The contract was for a nurse-led service with consultant cover provided remotely and through monthly visits from the UK.
Aim To increase provision of screening and management of STIs across BFG by the new [reduced] staff.
Objectives To modernise the GUM service; to develop the 15 primary care medical centres across the region to provide level 1 and 2 GUM service, and to offer out-reach screening to soldiers and school children.
Methods The labs replaced routine cultures and chlamydia PCR with dual NAATs making it cost neutral. We modernised the GUM service and encouraged testing, especially for HIV. Training for primary care providers included STIF courses. Once trained, GPs supported their nurses to deliver screens. The GUM nurses visited medical centres to encourage and support provision. We also instituted young peoples' services for schools and targeted screening to soldiers at Health Fairs.
Results 60 multi-professionals have attended our STIF courses, mean evaluation score is 4.4/5. We used figures from the lab servicing the majority of BFG. Despite a steep decline in the community [soldiers, their dependants and contractors] from 46k in 2008 to 36k in 2011, there has been a marked improvement in all measures of SH provision. The GUM workload has also risen and HIV tests have doubled.
Conclusions We describe a successful, innovative, cost effective model for a nurse-led GUM service which could be used elsewhere. There is now a vastly increased availability of STI screening for our scattered, high-risk population. We will present data for 2008–2011 by age and gender (see abstract P131 table 1).