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Call for GPs to act as GUM 'safety valve'

The Government has come under pressure to abandon its 'softly softly' approach to chlamydia screening in the UK and speed up the roll-out of its national programme with GPs fully involved.

The recommendation came in the Health Protection Agency's annual report last week on sexually transmitted infections in the UK. It showed an alarming rise in disease rates, including a 20 per cent rise in HIV infection in 2002 and a 14 per cent leap in cases of chlamydia (see table).

The report, produced jointly with the Scottish Centre for Infection and Environmental Health, also highlighted the problem of overflowing GUM clinics. The funding led to calls from an expert overseeing implementation of the Government's sexual health strategy for GPs to act as a safety valve for the service.

But Dr Philip French, who advises the Government on implementing its national sexual health and HIV strategy, said: 'Sexual health is to a great extent a primary care issue but it is a difficult one when GPs are getting pressure from all sides. They are the pressure valve of the NHS.'

The report said GUM waiting times in some areas are more than six weeks, far short of the proposed national target of 48 hours, and were contributing to high levels of disease transmission.

Dr French said GP implementation of the strategy, launched two years ago, had been patchy.

Despite the absence of funding, GPs are earmarked for involvement in the national chlamydia screening programme. The initiative is shortly to enter the second phase of its gradual roll-out with a further 10 sites.

A Department of Health spokesman said it planned to continue its phased introduction of chlamydia screening and had formed a primary care subgroup to look at ways of involving more GPs.

GPs will still be expected to offer the service on a 'cost neutral basis', although the Government will cover the cost of tests and treatment until 2005/6. After this point PCTs must fund it themselves.

Dr Trevor Stammers, a GP in south London and senior tutor at St George's Medical School, warned that some areas were struggling to perform new, more accurate, tests because of a lack of funding. He said: 'I think it is going to be a problem if what we are experiencing here is reflected in other areas.'

Dr Jenny Hopwood, chlamydia co-ordinator for the Wirral pilot and senior clinical medical officer at St Catherine's Hospital, Merseyside, said GPs in her area were willing to continue with screening despite withdrawal of the £10 per test plus capitation fee they were paid during the pilot phase.

Sexually transmitted infections cases

Disease New cases Percentage

in 2002 increase on 2001

HIV - all 5,542 20

Chlamydia 82,206 14

Gonorrhoea 24,958 9

Syphilis 1,232 68

Genital warts 69,449 2

Genital herpes 18,379 2

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