Describing his relationship with society, Oscar Wilde said: “The only thing worse than being talked about is not being talked about”. This quote could be applied to the way sexual health professionals in the UK feel about the Department of Health (DH). After years of neglect, sexual health was “talked about” so much in the DH corridors of power that it became one of six national health priorities. As a result, much-needed money was invested in the specialty.1 But with this extra investment came the dreaded outcome targets. Of course targets can be useful, but there are many examples within the NHS over the years of unintended consequences and perverse incentives being engendered by targets that were seemingly inadequately thought through.

One of the DH sexual health targets is that all patients wanting a sexually transmitted infection (STI) screen should be offered an appointment within 48 h.1 A more recent subsidiary aim is that 95% of patients should actually be seen within this time frame.2 This makes sense epidemiologically speaking, in that the longer a patient has to wait the more the likelihood that there will be undesirable consequences such as onward …