Continuation rates did not differ much between the two counselling styles and approaches were compatible with high continuation rates. Lowering the barriers to SDI use can benefit patients and reduce costs to the health economy.

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Background and methodology Lengthy waiting times can be a major problem in walk-in sexual health clinics. They are stressful for both patients and staff and may lead to clients with significant health issues leaving the department before being seen by a clinician. A self-triage system may help reduce waiting times and duplication of work, improve patient pathways and decrease wasted visits. This paper describes implementation of a self-triage system in two busy sexual and reproductive health clinics. Patients were asked to complete a self-assessment form on registration to determine the reason for attendance. This then enabled patients to be directed to the most appropriate specialist or clinical service. The benefits of this approach were determined by measuring patient waiting times, reduction in unnecessary specialist review together with patient acceptability as tested by a patient satisfaction survey. The ease of comprehension of the triage form was also assessed by an independent readers' panel. Results IntroductionSexual health care is deemed by the Department of Health to be a key priority for the National Health Service (NHS). In November 2004, the Public Health White Paper 'Choosing Health' stressed the importance of modernising NHS sexual health services with an emphasis on easy access to testing and treatment of sexually transmitted infections (STIs). 1 Southwark, in South London, is an area with one of the highest prevalences of STIs, teenage pregnancy and abortion in the UK. 2 In 2004, when this study was initiated, the age-standardised abortion rate in Southwark was 46 per 1000 women, compared with 17.8 per 1000 for England and Wales. 2 In order to improve access to STI health care, family planning clinics in Southwark also began testing and treatment of common genital infections. This has led to a significant increase in workload, creating a challenge in managing these patients without reducing the quality of care received by those attending clinics for contraception. During 2003During -2004, the total number of clinical consultations increased by 24% (from 15 370 to 19 051).For many years these clinics had been operating a walkin, open-access system, which was thought to best meet the needs of the local population. The increasing demand, however, had an impact on the waiting time in the clinics, with increasing patient dissatisfaction. assigned to the 'traditional treatment' arm, with patients at subsequent clinics being assigned to the 'self-triage' system. Waiting times were collected by the receptionist and clinic staff. Ninety six patients followed the traditional route, 97 the new self-triage system. Sixty-nine (35.8%) patients completed the satisfaction survey. The self-triage system significantly reduced waiting time from 40 (22, 60) to 23 (10, 40) minutes [results expressed as median (interquartile range)]. There was a non-significant reduction in the proportion of patients seeing two clinicians from 21% to 13% (p = 0.17). Satisfaction levels were not significantly altered (...

IntroductionContract tendering and service integration has resulted in great uncertainty for sexual health staff. Our service has recently integrated with sexual and reproductive health (SRH) and is currently under tender. We aimed to review and address the satisfaction of our staff.MethodsAn online survey was disseminated to staff at our sexual health service.Results73% of staff responded: 13 doctors, 9 nurses, 6 technicians, 15 health advisors/psychologists, 8 receptionists, 8 administrators, 3 anonymous. On a scale of 1–10, staff rated: feeling valued 5.9; enjoying work 6.4; day-to-day support 5.7. Scores were lower among receptionists (4, 4.1, 3.6 respectively). 61% felt day-to-day issues were dealt with in a timely manner. Cascade of information from management to staff was deemed ‘too little’ by 53%. 34% stated they did not have the opportunity to contribute to decisions affecting them. Staff found it easier to raise concerns with their line manager (6.7/10) than with management (5.7/10). These scores were lower among receptionists (3.6/10, 4/10 respectively).DiscussionImprovement work is addressing the issues raised by our staff. Initiatives include: Staff Member of the Month Award; Daily team huddle actively including receptionists, addressing day-to-day issues; Psychology session with receptionists to better understand their concerns; Clinic has relocated to be next to reception (rather than on a different floor); A buddying system for incoming SRH staff; Regular integration emails from management and whole team briefings.DiscussionOur survey demonstrates the need to actively ask, listen and respond to staff’s satisfaction, especially during such uncertain times.