STI testing cheaper at GP surgeries

Practice-based STI treatment can undercut GUM clinics by £475 per patient.

GPs can treat STIs more cheaply than GUM clinics, an analysis of a local enhanced service (LES) suggests.

Study of the impact of a LES for treating STIs in City and Hackney PCT in East London has shown that treating chlamydia and gonorrhoea costs £930 per positive case in the primary care setting. The comparative price for GUM clinics in the borough was £1,405.

When treatment of all types of STIs was considered, GUM clinics cost £630 per case. An equivalent figure was not available for GP practices, although a full range of STIs was managed in both settings.

The LES was introduced by the PCT in April 2004 and was joined by 32 of 51 practices in the area. According to the data for 2004/5, LES practices made eight times as many positive chlamydia diagnoses as non-LES practices.

Training, a local STI treatment booklet, fast-track referral to GUM clinic and a sexual health GPSI were provided under the LES. The PCT paid practices a £2,000 retainer fee and £150 per positive diagnosis.

But the GUM clinic was paid £182 per first visit by a patient and £104 per follow-up. The cost of testing one chlamydia sample and one gonorrhoea sample was £14.98 at both venues.

But experts from Homerton Hospital in Hackney who carried out the research said direct comparison of costs between GP practices and GUM clinics was difficult because both provided services unavailable in the other.

An exclusive survey published by GP (5 October 2007) showed that funding may not be the only barrier to testing. Of the 226 GPs questioned, 52 per cent said they would carry out the tests if they had the time.

Dr Ewen Stewart, chairman of the RCGP Sex, Drugs and HIV Group, said: 'Any intervention that increases STI testing in primary care should be welcomed.

'Rewarding practices that offer quality STI testing within an agreed framework for diagnosis and management is entirely appropriate and appears to be cost-effective.'

STI Online 2008, live links at

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