APPENDIX 22
Memorandum by Dr E Carlin and Dr D Kellock
(SH 37)
Dr E Carlin is Head of Service of Genitourinary
Medicine and a Consultant in Genitourinary Medicine at King's
Mill Hospital, Mansfield Rd, Sutton-in-Ashfield, Nottinghamshire.
Dr D Kellock is a Consultant in Genitourinary
Medicine at King's Mill Hospital.
SUMMARY
The Genitourinary (GU) Medicine service at King's
Mill Hospital is increasingly under pressure due to increased
patient numbers, limited staffing, size of the accommodation,
and increasing drug costs. At Newark there is no GU Medicine service
and this needs to be urgently addressed.
BACKGROUND
The Genitourinary (GU) Medicine clinic at King's
Mill Hospital serves a population of approximately 300,000, comprising
a mixture of urban and rural communities. There are numerous areas
of deprivation and high health needs. In the market town of Newark,
in the south-east of the region there are no GU Medicine services
and potential patients in this area must travel significant distances
to access specialist GU Medicine care.
ISSUES WHICH
NEED TO
BE ADDRESSED
AT KING'S
MILL HOSPITAL
1. Limited space for the existing service
and expansion would be impossible within the confines of the current
premises.
2. Limited training facilities with no room
available within the department for staff education.
3. Difficulty in recruiting both medical
and nursing staff in GU Medicine, which is a reflection of National
trends and may not be seen as a high priority for additional funding.
4. Low staff numbers resulting in low morale,
difficulty in expansion and limited opportunities for staff development,
particularly amongst nursing staff.
5. Long waiting times for the next available
appointment and overbooked existing clinic lists. Access has been
a National issue and we have submitted data towards surveying
this:
http://www.agum.org.uk/filingcab/accesssurvey0302.htm
http://www.agum.org.uk/filingcab/accessgpep130701.doc
6. Increased numbers of HIV infected patients
requiring care and treatment are now attending the GU Medicine
clinic.
7. Increased numbers of patients are attending
the GU Medicine clinic with sexually transmitted infections and
genital infections.
8. Increased numbers of complex problems
are occurring amongst the case mix of patients attending the GU
Medicine clinic.
9. Testing for Chlamydia trachomatis is
by enzyme linked immunoassay rather than the more sensitive but
more expensive nucleic acid amplification techniques, due to lack
of funding and laboratory support.
10. Drug costs for both GU Medicine but
also HIV care are rising and evidence based medicine requires
us to offer those treatments, which are most efficacious although
they may be more expensive.
11. The Sexual Health Strategy is still
only in draft form and there has been difficulty locally in identifying
the Sexual Health Lead at the PCTs.
12. Education in the community is integral
to the Sexual Health Strategy but requires manpower and funding,
both of which are extremely limited.
ISSUES WHICH
NEED TO
BE ADDRESSED
AT NEWARK
1. A GU Medicine service which is locally
accessible for the residents of the Newark district needs to be
developed. This needs to be highlighted as a priority, and since
it is difficult for local residents to pursue this for reason
of self-identification, it is important that this is championed
by the healthcare providers.
June 2002
| 
