Genitourinary medicine (GUM) is a clinical specialty. In common with other specialties, clinical training alone is insufficient to prepare consultants for life in the modern NHS. Consultants need to have a wide range of skills from other disciplines if they are to provide and manage an effective service. In addition to generic skills needed for all NHS consultants, specialists in GUM need to understand the role of treatment and care services in the control of sexually transmitted infections (STI). The current network of clinics in the United Kingdom dates back to the Royal Commission report on venereal diseases of 1916 that recommended services be “skilled, free… and provided at the earliest possible moment” in order to reduce the impact of infection on the population—that is, these services were developed and maintained to deliver a public health goal.^1,2 Thus the consultant in GUM has always had to address the need of individual patients attending services …