Open Access Study protocol

Rationale and development of a survey tool for describing and auditing the composition of, and flows between, specialist and community clinical services for sexually transmitted infections

Catherine RH Aicken1, Jackie A Cassell12, Claudia S Estcourt34, Frances Keane5, Gary Brook6, Greta Rait7, Peter J White89 and Catherine H Mercer1*

Author Affiliations

1 Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, Mortimer Market Centre, off Capper Street, London WC1E 6JB, UK

2 Brighton and Sussex Medical School, Mayfield House, University of Sussex, Falmer, Brighton BN1 9PH, UK

3 Centre for Infectious Disease: Sexual Health and HIV Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Barts Sexual Health Centre, St Bartholomew's Hospital, London EC1A 7BE, UK

4 Infection and Immunity, Barts and the London NHS Trust, London UK

5 Department of Genito-urinary Medicine, Royal Cornwall Hospitals NHS Trust, The Hub, Royal Cornwall Hospital (Treliske), Truro, Cornwall TR1 3LJ, UK

6 Patrick Clements Clinic, Central Middlesex Hospital, North West London Hospitals NHS Trust, Acton Lane, London NW10 7NS, UK

7 Research Department of Primary Care and Population Health, University College London Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK

8 MRC Centre for Outbreak Analysis & Modelling, Department of Infectious Disease Epidemiology, Imperial College Faculty of Medicine, London W2 1PG, UK

9 Modelling & Economics Unit, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK

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BMC Health Services Research 2011, 11:30  doi:10.1186/1472-6963-11-30

Published: 9 February 2011



National health strategies have called for an expansion of the role of primary care in England to increase access to sexual health services. However, there is little guidance for service planners and commissioners as to the public health impact of different combinations of specialist genitourinary medicine (GUM) clinics and primary care based services for local populations. Service planning for infectious diseases like sexually transmitted infections (STI) is further complicated because the goal of early detection and treatment is not only to improve the health of the individual, but to benefit the wider population and reduce future treatment costs by preventing onward transmission. Therefore, we are developing a survey tool that will enable service planners to better understand the needs of their local STI care-seeking population and which will help inform evidence-based decision-making about current and future service configurations. Here we describe the rationale and development of this survey tool.


A pen-and-paper questionnaire asking about sociodemographics, reasons for attendance, care pathways, and recent sexual risk behaviours, is being developed for patients to complete in waiting rooms of diverse clinical services, including GUM clinics and primary-care based services in sociodemographically- and geographically-contrasting populations in England. The questionnaire was cognitively tested before being piloted. In the pilot, 67% of patients participated, of whom 84% consented to our linking their questionnaire to data on STI testing and diagnosis and partner notification outcomes from their clinical records.


The pilot study suggests that both the questionnaire and its linkage to routinely-collected clinical data are likely to be acceptable to patients. By supplementing existing surveillance, data gathered by the survey tool will inform service planners' and providers' understanding of the needs and care-pathways of their patients, facilitating improved services and greater public health benefit.