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Government recommends GP incentives for taking on sexual health work

GUM clinics told to offload work onto GPs

The Government wants genito-urinary medicine clinics to streamline services and shift work to GPs in order to meet 48-hour access targets.

A new Department of Health report advises GUM clinics to stop 'unnecessary clinical activity' such as some pre-test counselling and patient follow-up.

The report also provides the clearest indication yet that

ministers recognise GPs will need to be incentivised to take on sexual health care.

It recommends 'development of additional STI services through initiatives such as incentivising general practice

and development of the national chlamydia screening programme in primary care'.

But the best practice guidance makes no commitment to extra national funding for sexual health, with PCTs instead expected to fund GPs through local enhanced services.

Sexual health experts welcomed the main thrust of the report, but stressed resources and training would be essential.

Dr Simon Barton, president of the British Association for Sexual Health and HIV, said: 'I would support increasing access by widening availability of services in the community.

For example, asymptomatic

patients need information

but don't necessarily need counselling. Unless that service network is enabled in primary care, the Government won't be getting value for money.'

Dr George Kinghorn, honorary professor of genito-

urinary medicine at Sheffield's Royal Hallamshire hospital, said focusing on specialist services could 'detract from the main objective of maximising patient access'. He added: 'Primary care will have an increased role in sexual health, but many practitioners lack training and confidence in STIs. They need to be incentivised and supported by specialist services.'

Dr William Ford-Young, chair of the RCGP's sex, drugs and HIV task group and a GP in Macclesfield, said if sexual health was resourced through the QOF, GPs could help GUM clinics meet targets.

The guidance, published last week, recommended GUM clinics cut pre-test discussions for low-risk patients, cancel specialist services such as colposcopy that may be offered elsewhere, reduce numbers of follow-up appointments and promote nurse-led care.

It came as the Government's independent advisory group

on sexual health and HIV warned services were at risk

unless PCTs were made to ring-fence funding.

• For sexual health information,

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