Identifying hidden capacity through modernization of genitourinary medicine services

Rates of sexually transmitted infections have continued to rise in recent years throughout the UK. Poor access to genitourinary medicine clinics has been highlighted as a major factor contributing to this increase. Despite a lack of investment in sexual health services, capacity for new patients has almost doubled over the past decade. However, a significant amount of unreleased capacity is still available within the service. This 'Six Sigma' study group was formed in 2003 to explore whether capacity could be enhanced by further reducing the ratio of follow-up to new-case patient visits. Following implementation of recommended changes, the mean follow-up to new-case ratio reduced from 0.82 (range 0.29-1.69) to 0.62 (range: 0.19-1.40). Crucially, this increase in capacity was achieved without adversely affecting quality of care. The Six Sigma group have developed the tools to release capacity in a controlled and validated way and are keen to help other clinics achieve similar results.