1. Triage review: Should they stay, or should they go? Dr Susanna Currie ST4 Genitourinary Medicine Central Manchester University Hospitals NHS Foundation Trust

2. BASHH Guidance: – 48 hour access for all – On the day review for emergencies Manchester Centre for Sexual Health: – Triage forms since 2010 Background

3. Review the diagnoses of patients who fill in triage forms And in turn, determine whether triage is effective Aim

4. A retrospective review of all triage forms completed between 5/1/15 – 24/3/15 and the diagnoses of those patients Method

5. January – March 2015 ? patients leave 698 fill in triage forms 210 accepted 488 turned away 224 never returned 264 returned Results

6. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

7. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

8. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

9. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

10. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

11. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

12. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

13. Results - diagnoses n =% accepted% initially turned away PEPSE71000 UTI41000 Herpes377822 PID/Epididymo-orchitis266535 Contact of infection226436 Gonorrhoea195842 STI diagnosed elsewhere125842 Non-specific GU infection375446 Chlamydia335149 HIV250 Primary syphilis250 Hepatitis B250 Candidiasis or BV644258 Molluscum or Warts651585 Late syphilis20100

14. Percentage accepted & rejected

16. January – March 2015 When clinic is full ? patients leave 698 fill in triage forms 210 accepted 488 turned away 224 never return 264 returned Limitations

17. Triage is effective for some conditions – Acute needs such as PEPSE – Common, non-acute conditions such as warts and candidiasis Triage is less effective for patients with chlamydia & gonorrhoea BASHH concerns are justified Conclusions

18. Asymptomatic screen for all patients – Nearly 10% of those who returned had CT or GC – Saving clinic visits – Would this capture those who leave before triage? Closer links between clinics in a region with central booking systems Possible strategies

19. Recommendations for core service provision in genitourinary medicine. British Association for Sexual Health & HIV, 2005. www.bashh.org References