Health care costs are rising faster than inflation in almost all developed countries. Improving the efficiency of health care will go some way to address this issue. There has been a significant improvement in the delivery of sexual health care with a particular focus on innovation. In this issue, Baraitser et al. evaluate their services, that uses computer-assisted interviewing combined with self-collected samples in London. This editorial discusses this service in the context of the control of sexually transmissible infections and other recent health care innovations.