APPENDIX 44
Memorandum by Dr Graz Luzzi, Genitourinary
Medicine department, South Buckinghamshire NHS Trust (SH71)
Thank you for the opportunity to submit evidence
for the above review of sexual health services and the effectiveness
of the sexual health strategy.
This clinical department was expanded in 1992 when
HIV allocation funding became available to the district health
authorities. We serve a population of approx 300,000 and manage
over 8,000 patient attendances per year; we are an "open
access" service which means that members of the public can
self-refer and request an appointment.
The main points I would like to highlight are:
1.In the last nine years we have received no additional
resources, and in fact have needed to make cuts because of the
trust's overall financial position; this is despite:
2.A large rise in demand for the service, leading
to a gradual increase in waiting times for routine appointments,
which have now reached five weeks. This should be regarded as
unacceptably long for patients who may have transmissible infections.
(Urgent cases are currently seen within 48 hours but this may
not be sustainable).
3.We have seen large rises in numbers of patients
presenting with the major sexually transmitted infections, notably
chlamydia and gonorrhea.
4.At the current level of resourcing, general GU
clinics are not held every day—our constraint, in common
with many other GU departments, is not physical capacity but no
additional funding to employ extra staff, to run more clinical
sessions.
5.There is one consultant for a population of approx
300,000; compared with the Royal College of Physicians GUM liaison
committee recommendation of 1 per 113,000 population.
6.We have seen a dramatic rise in numbers of patients
newly diagnosed with HIV—37 in 2000 and 2001, which is greater
than all previous years combined.
7.For HIV treatment and care, I am the sole consultant
for mid and south Buckinghamshire, a population of c.500,000.
8.Primary Care Trusts (PCTs) are unlikely to give
sexual health services priority in the context of the national
service frameworks (NSFs) and NICE approved developments, which
soak up much of the available funding in the annual round of service
and financial framework (SAFF) funding decisions.
CONCLUSION
In order for the sexual health strategy to be effective,
a mechanism needs to be developed to provide PCTs with major incentives
to invest in sexual health service provision, despite competition
from the NSFs and other priorities for spending.
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