Article Text
Abstract
Background/introduction Demand exceeds capacity in many sexual health services. In response to this, our GUM department developed a triage policy based on agreed clinical priorities. When we integrated with the local Sexual and Reproductive Health (SRH) service, which had its own more loosely defined priorities, an essential part of the process was to agree shared clinical priorities.
Aim(s)/objectives To create a single, agreed set of priorities across an integrated sexual health service.
Methods We reviewed the existing GUM priorities, and agreed they were still applicable. We created a formal set of SRH priorities. We merged the two into an integrated set of clinical priorities that would apply across the whole service.
Results The existing GUM priorities were patients with or at significant risk of HIV, followed by patients with or at significant risk of syphilis, then gonorrhoea¸ then chlamydia. The SRH priorities were widespread provision of long-acting reversible contraception (LARC), followed by emergency contraception (especially IUD), high quality abortion service, services for young people and services in more deprived areas. The single, agreed set of priorities for the integrated service were HIV-positive patients, women with unplanned pregnancy and under 16’s; followed by patients at high risk of HIV, high risk of unplanned pregnancy, and/or people living in areas of high deprivation.
Discussion/conclusion Creating shared priorities has proved invaluable when pressure on the service builds up. Both services had to shed priorities that might have hitherto been regarded as “sacrosanct”.