Inequalities in access to genitourinary medicine clinics in the UK: Results from a mystery shopper survey

Elizabeth Foley*, Martina Furegato, Gwenda Hughes, Christopher Board, Vanessa Hayden, Timothy Prescott, Eleanor Shone, Rajul Patel

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)

Abstract

Study design This study investigated whether access to genitourinary medicine (GUM) clinics meets UK-recommended standards. Methods In January 2014 and 2015, postal questionnaires about appointment and service characteristics were sent to lead clinicians of UK GUM clinics. In February 2014 and 2015, researchers posing as symptomatic and asymptomatic â patients' contacted clinics by telephone, requesting to be seen. Clinic and patient characteristics associated with the offer of an appointment within 48â ...hours were examined using unadjusted and UK country and patient gender adjusted multivariable logistic regression analyses. In March 2015, a convenience sample (one in four) of clinics was visited by researchers with the same clinical symptoms. Ability to achieve a same-day consultation and waiting time were assessed. Results In 2015, 90.8% of clinics offered symptomatic â patients' an appointment within 48â ...hours when contacted by telephone, compared with 95.5% in 2014 (aOR=0.46 (0.26 to 0.83); p<0.01). The decline was greatest in women (96.0% to 90.1%; p<0.05), and clinics in England (96.2% to 90.7%; p<0.01). For asymptomatic patients, the proportion offered an appointment within 48â ...hours increased from 50.7% in 2014 to 74.5% in 2015 (aOR=3.06 (2.23 to 4.22); p<0.001), and in both men (58.2% to 90.8%; p<0.001) and women (49.0% to 59.6%; p<0.01). In adjusted analysis, asymptomatic women were significantly less likely to be offered an appointment than asymptomatic men (aOR=0.33 (0.23 to 0.45); p value<0.001). 95% of clinics were able to see symptomatic patients attending in person. Conclusions Access to GUM services has worsened for those with symptoms suggestive of an acute STI and is significantly poorer for asymptomatic women. This evidence may support the reintroduction of process targets.

Original languageEnglish
Pages (from-to)472-475
Number of pages4
JournalSexually Transmitted Infections
Volume93
Issue number7
DOIs
Publication statusPublished - Nov 2017

Bibliographical note

Funding Information:
Funding This service evaluation was supported by an education grant from BASHH to perform clinic visits.

Publisher Copyright:
© 2017 Published by the BMJ Publishing Group Limited.

Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.

Keywords

  • CLINICAL STI CARE
  • GENITOURINARY MEDICINE SERVICES
  • INFECTION CONTROL

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