Public and patient engagement in genito-urinary and HIV services in Coventry has included a comic turn and simpler branding, reports Lynne Greenwood

A comedy night at a gay nightclub took a different twist when a female stand-up used her spot to promote awareness of a city’s sexual health services.

It was one of the more high profile means of raising awareness and seeking public opinion about the services used by NHS Coventry. The primary care trust’s sexual health and HIV strategy has identified public and patient engagement as an important driver for quality improvement.

28,957 - New episodes of herpes in the UK in 2008

2,524 - New episodes of syphilis in the UK in 2008

It commissioned consultants to carry out an audit of existing engagement in sexual health and HIV services and to determine how it feeds into service development.

PCT sexual health and HIV commissioner Vivienne Parish says: “The principal purpose of the project was to consult local people on the strategy, eliciting their views, preferences and experiences.

“Using a comedian was a fun way to get across our messages to a group of people who are often hard to engage with - the comedy approach in a gay venue was greatly appreciated.”

The government’s strategy for sexual health and HIV aims to reduce the spread of sexually transmitted infections through more rapid detection and treatment. It is supported by the Health Protection Agency, which is helping to improve diagnostic, treatment and prevention services and identifying areas for intensive action.

In Coventry, the consultants also set up a series of listening exercises with several groups, including students, people with learning disabilities, asylum seekers, refugees, homeless people and people with HIV. An incentive to take part gave those who completed a detailed questionnaire the chance to win an iPod Nano.

The results have been used to further develop the strategy and the engagement work is now influencing the development of an integrated sexual health service hub and spoke model.

The hub will deliver genito-urinary medicine, contraception and sexual health services and the spokes - community providers, including primary care and pharmacists - will concentrate on levels one and two sexual health services.

Expanded access

The main outcomes from the engagement exercises were that sexual health services need to expand opening times to include evenings and weekends, offer drop-in appointments, a choice of gender of doctor and confidentiality. Some of those questioned suggested that both positive and negative results should be notified and others said sexual awareness training and free condoms should be available.

Also highlighted was the need for a simple “overarching brand” which brought together all existing sexual health services and could be easily understood by people whose first language is not English and by people with learning disabilities and low literacy levels.

Drop-in opportunities

PCTs are also looking for ways to achieve and maintain the Department of Health’s 48 hour access targets.

Central Manchester University Hospital Foundation Trust, which recorded a rise of almost 2,700 new or reregistered patients for genito-urinary medicine in the three years to 2008, now operates a drop-in clinic with one day dedicated to pre-booked appointments.

Genito-urinary and HIV specialist registrar Darren Cousins used his first year as a trainee on the North West Deanery medical leadership programme to establish a service improvement group of doctors, nurse practitioners and admin workers.

“I wanted it to be led by staff who work in the clinic and I encouraged them to be candid about the problems around patient flow and service,” he says. “The plan was to continually improve and carry out regular service audits to check whether we were making a difference.”

The group used the Productive Ward initiative - developed by the NHS Institute for Innovation and Improvement to help nurses release more time for patient care by improving ward processes - after adapting it to the clinic’s needs.

Changes to the genito-urinary clinic, situated in a city with an ethnically diverse population including around 80,000 students, included a simplified process of compiling patients’ notes - which previously caused delays - and the installation of a drinks machine and electronic signage displaying accurate waiting times to make waiting more palatable.