Introduction Online sexual health services could shift demand for asymptomatic testing from clinics to relieve pressure and reduce cost. An online service collaborated with clinicians in two London boroughs to facilitate this through new service pathways.

One clinic developed a triage system directing asymptomatic attenders to order directly via the online service using tablets in the clinic with self-sampling packs prepared immediately to take away. Two clinics offered a ‘weblink’ card signposting those attending during busy periods to the online service. This study describes and evaluates these new pathways to re-direct demand.

Methods We used routinely collected testing data to analyse uptake. We compared the populations who used new pathways (weblink, ‘tablet-in-clinic’) with those resident in the same area accessing the online service without signposting or triage (organic users).

Results In a 6-month period, there were 8,987 orders from organic users, 1,280 orders through ‘weblink’ and 1,555 orders from ‘tablet-in-clinic’ users. Weblink users had a lower kit return rate (62.7%) compared with ‘tablet-in-clinic’ and organic users (71.4%; 71.9%). Positivity rates for any infection were higher among weblink (8.6%) and ‘tablet-in-clinic’ users (8.2%) compared with organic users (6.1%). In this period, 157 service users ordering through weblink or ‘tablet-in-clinic’ ordered their next test through the organic route.

Discussion Collaborative strategies to increase uptake of online services can be effective. These can increase capacity but may reduce user choice. Further work on predictive triage and targeted support for users switching service modality could enhance this offer.