Outcomes in genitourinary medicine: whose priority?

Abstract

The primary role of genitourinary medicine (GUM) services in the UK is the treatment and control of sexually transmitted diseases (STDs). The origins of the service lie in its public health function, yet measuring outcomes locally and nationally is not straightforward. Difficulties arise from the complex interactions between sexual behaviour, the biology of STDs and the role of clinical services; from the potential consequences of the National Health Service (NHS) internal market on national STD control; and from the limitations of information and surveillance systems. This paper considers each of these areas in turn and concludes with some proposals for measuring GUM outcomes locally and nationally which might potentially satisfy the concerns of commissioners and providers.