Workload in the GUM clinic setting
Overall workload, presented as all counts of diagnoses, screens and conditions seen, increased by 16% across Scotland between 2007 and 2008. This compares with a 13% increase in each of the previous two years.
This workload increased in all NHS board areas except NHS Fife and NHS Forth Valley.
Figure 1.1: All aspects of care (diagnosis and/or screening and/or treatment) recorded in GUM clinic settings, by gender, 1999-2008.
180000 160000 140000 120000 100000 80000 60000 40000
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Men Data source: STISS
In 2008, there was an almost four-fold variation in rates of episodes of care (diagnosis and/or treatment) by NHS board of residence of patients.
The highest episode rate was observed among the residents of NHS Lothian; this is a similar observation to that in the previous two years.
The variation in these rates is partly due to the lack of provision of local genitourinary medicine (GUM) clinic services in some NHS board areas. It is clear that some patients cross NHS boundaries to access services.
Scotland’s Sexual Health Information
Figure 1.2: All episodes of care (diagnosis and/or treatment) in GUM clinic settings by NHS board of residence and by NHS board of treatment, 2008.
Lothian Glsgw & Clyde Tayside SCOTLAND Borders Fife Grampian Forth Valley Ayr & Arran Highland Lanarkshire Dmfr & Gall
NHS board of residence
Rate per 100,000 NHS board of treatment
The denominator is the population aged 15-64 Mid-year population data for 2008 available from GROS5 Data source: STISS
Workload in the primary care setting
These data are based on estimates of the number of consultations with general practitioners (GPs) and practice nurses using the Practice Team Information (PTI) sample of practices (see Appendix 1 for further details on how these estimates are calculated).
The estimates indicate an increase in primary care workload for genital chlamydia, genital herpes and genital warts in Scotland between 2006/2007 and 2007/2008.
There appears to be a two-fold increase in female consultation rates for genital warts. However, the confidence intervals around these rates are large because of the relatively small numbers of consultations involved, and these data are compatible with a much smaller rise in consultation rates. Furthermore, this rise is not seen in GUM clinic attendance.
Overall workload for men decreased between 2003/2004 and 2007/2008, while that for women increased.
Although some of the apparent rise in female consultation rates for genital warts may be an artefact of random fluctuation because of relatively small numbers of consultations, it is possible that there has been an effect of the publicity regarding the introduction of a human papilloma virus (HPV) vaccine in September 2008. The vaccine, available to young girls aged 12-18, aims to prevent up to 70% of cervical cancers. Around 30-40 types of the human papilloma virus infect the genital tract; types 6 & 11 can cause genital warts while types 16 & 18, among others can cause cervical cancer. (See Chapter 2 for further information).