title: The impact of establishing a local-enhanced service for treating sexually transmitted infections in primary care.
abstract: OBJECTIVE
  To consider whether a local-enhanced service in sexual health in City and Hackney, London, added to the services already provided within the borough and to compare the cost to the Primary Care Trust of diagnosing sexually transmitted infections (STI) in general practice and in the genitourinary medicine clinic.
  
  
  METHODS
  An observational study describing the local-enhanced service in primary care, including a quantitative analysis of swabs taken for chlamydial and gonorrhoeal infections at different venues before and after the introduction of the local-enhanced service.
  
  
  RESULTS
  32 out of 51 general practices (63%) within City and Hackney joined the local-enhanced service. An upward trend in the proportion of chlamydial infection swabs taken in general practice compared with other venues predated the introduction of the local-enhanced service. Practices participating in the local-enhanced service accounted for over 99% of the STI diagnosed in primary care and for 8% of the cases of chlamydial infection diagnosed in the borough. The cost per STI diagnosed within the local-enhanced service was pound930.
  
  
  CONCLUSIONS
  The local-enhanced service provided a supportive and incentivised framework for STI testing within primary care. An inequity in service provision within general practice predating the local-enhanced service continued at the same level after the introduction of the local-enhanced service.
authors.affiliation: Department of Sexual Health, Homerton Hospital, Homerton Row, London E9 5SL, UK.
authors.forename: H
authors.initials: H
authors.lastname: Sohal
authors.forename: S
authors.initials: S
authors.lastname: Creighton
authors.forename: J
authors.initials: J
authors.lastname: Figueroa
authors.forename: A
authors.initials: A
authors.lastname: Gibb
mesh_terms: D002690:Chlamydia Infections / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D006069:Gonorrhea / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D006801:Humans; D008131:London; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D014686:Venereology / Q000191:economics / Q000458:organization & administration*