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Consultant nurse Claire Tyler considers key government targets in relation to STIs, and their implications for nurses
OVER THE PAST decade there has been a deterioration in the sexual health of the nation.
This is reflected by the increasing rates at which bacterial sexually transmitted infections (STIs) such as Chlamydia are diagnosed, an increasing prevalence of HIV infection and the highest level of teenage pregnancy in western Europe.
To fuel this public health crisis, a doubling in demand for access to services over these ten years has meant that many genitourinary medicine (GUM) clinics are unable to cope.
Some services have reverted from 'walk-in' to booked appointment clinics as a way to manage demand. But this has often resulted in longer waiting times for first appointments.
Health Protection Agency data (HPA 2004) highlight that only 18 per cent of people with routine appointments are seen by GUM service staff within 48 hours of first contact. This means that people with STIs remain untreated for longer, which in turn increases the likelihood that they will transmit infections to other people.
The Department of Health responded to the worsening sexual health of the nation in several ways, one of which being the publication of a national strategy (DH 2001). This strategy sets out to define the roles of different services in delivering sexual health care, and identifies for the first time the growing role that nurses can have in service delivery.
Key targets
The public health white paper, Choosing Health (DH 2004), has made sexual health a new NHS priority.
For the first time, primary care trusts (PCTs) have been asked to develop plans to:
* Increase screening for Chlamydia
* Decrease the prevalence of gonorrhoea
* Ensure that all access to GUM services is within 48 hours of referral.
Resources for investment from April 2006 have been allocated to PCTs to help them meet these targets.
Chlamydia screening
New technology has afforded more sensitive and specific investigations for both Chlamydia and gonorrhoea, which are available either as seperate or combined tests.
This technology makes widespread screening, or case finding, in primary care settings viable, especially because the tests, which are either urine based or rely on patients taking their own swabs, are easily administered by...