Abstract

Objectives: To consider whether a local enhanced service (LES) in sexual health in City and Hackney, London added to the services already provided within the borough; and to compare the cost to the PCT of diagnosing STIs in general practice and in the GUM clinic.

Method: Observational study describing the LES in primary care, including quantitative analysis of swabs taken for chlamydial and gonorrhoea infections at different venues before and after the LES's introduction.

Results: Thirty-two out of fifty-one general practices (63%) within City and Hackney joined the LES. An upward trend in the proportion of chlamydial infection swabs taken in general practice compared to other venues predated the introduction of the LES. Practices participating in the LES accounted for >99% of the sexually transmitted infections diagnosed in primary care and for 8% of the cases of chlamydial infection diagnosed in the borough. The cost per sexually transmitted infection diagnosed within the LES was £930.

Conclusion: The LES provided a supportive and incentivised framework for STI testing within primary care. An inequity in service provision within general practice predating the local enhanced service continued at the same level after the introduction of the LES.