STI services in the United Kingdom: a way forward.

T he crisis in our sexual health services has recently received wide publicity, firstly, with the publication of the National Strategy for Sexual Health and HIV and, subsequently, with the report of the House of Commons Health Select Committee. The issue of how to cope with a seemingly impossible workload faces many clinics. Anecdotally, the solutions employed are many and varied (ranging from the use of a security guard to keep out the crowds to changes leading to a wide variety in clinical practice). Some of the ideas raised by Bradbeer and Mears will already have been adopted by a number of clinics (including my own). Some are most certainly controversial. There is little hard evidence to inform this debate. The views that I express are based on over 20 years’ experience of working full time in genitourinary medicine (GUM) clinics, both teaching and non-teaching, in and outside of London.