Background/introduction On-going procurement exercises in Sexual Health inevitably require that efficiencies are sought whilst maintaining high quality and equity of access.
Aim(s)/objectives This test of change aimed to inform a streamlining of a city centre walk-in service and to test the feasibility of delivering an integrated service using staff with mixed skill sets. Means were sought to reduce re-attendances to the co-located Contraception and GU Medicine services.
Methods For two weeks in January 2016 patients attending the walk-in service were triaged by a senior dual trained clinician. Triage notes were made and patients were subsequently seen by another clinician who could meet all of their needs. Data was collected regarding staff skillsets, waiting times, patient-perceived versus clinician-assessed needs as well as services actually delivered and staff feedback.
Results 324 patients were seen (236 females, 88 male). Approximately 40% of women had mixed (GU and contraception) needs, whilst of those believing themselves to have a solely contraception need, half were identified as also having a GU need. A third of patients were symptomatic Two thirds had a sexual health screen. Nursing staff saw 66% of patients. 80% of staff reported similar or increased job satisfaction (qualitative data are available).
Discussion/conclusion Service users perceived needs are often less than those assessed by experienced clinicians. Delivering an integrated walk-in service whilst maintaining specialist skills is feasible if triage is effective; missed opportunities are minimised. Work to assess the utility and cost-effectiveness of different types of triage is required
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