Evaluating Unity Sexual Health rapid results service
Demand for HIV and sexually transmitted infection testing is on the rise, but local authority budgets for sexual health services are shrinking. Unity Sexual Health provides sexual health services for Bristol, North Somerset and South Gloucestershire. They redesigned their services to improve access and delivery of care, while remaining cost-effective.
Traditionally, patients had to wait over a week for chlamydia and gonorrhoea test results, and then had to return to the clinic for treatment. Unity introduced a new service where patients drop off their samples which are then checked with new rapid testing equipment, so that results, treatment and advice can be given within hours. As most sexual infections don’t cause any symptoms, early detection and treatment can help stop infections spreading and prevent serious disease developing.
Project aims
We collaborated with Unity Sexual Health to evaluate the changes to the Unity Central Health Clinic service. This project had four parts:
- Using computer modelling to analyse the flow of patients
- Interviewing patients and staff to understand their experiences and views
- Looking at data from before and after the changes, to see how the new service affects the cost and delivery of care
- A health economics evaluation to understand if the changes offer good value
What we did
For the computer modelling part of the project, researchers developed a discrete event simulation (DES) model to analyse the flow of patients within Unity Sexual Health and find possible ways to improve the services Unity provides. This identified bottlenecks in the consultation and treatment queues for walk-in patients.
The interview study, data analysis and economics evaluation are still being written up.
What we found and what this means
Computer modelling study
Unity introduced an online self-sampling service for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) in June 2017. Modelling this new service alongside existing services showed that the average waiting time for all patients decreased to 88 minutes from 128 minutes.
Self-sampling also reduced the cost of staff time for managing each patient to £72.64, compared to £88.74 under the same system but without self-sampling.
What next?
Enabling asymptomatic patients to self-sample for STIs and HIV could reduce waiting times at sexual health clinics, according to our modelling. This finding could inform the redesign of sexual health services across the UK, at a time when demand for HIV and sexually transmitted infection testing is rising but local authority budgets for these services are shrinking.
Paper
Modelling patient flows and resource use within a sexual health clinic through discrete event simulation to inform service redesign
Read the paperLead collaborators
- Dr Patrick Horner, Unity Sexual Health
- Dr Suneeta Suni, Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust
ARC West Staff
Joni Jackson
Research Associate, Quantitative Research
Dr Joanna Kesten
Research Fellow, Qualitative Research
Dr Theresa Redaniel
Team Lead and Senior Lecturer in Health Services Research and Epidemiology
Dr Martha Elwenspoek
Research Fellow in Test EvaluationPartners on this project
University Hospitals Bristol and Weston NHS Foundation Trust
University Hospitals Bristol and Weston NHS Foundation Trust is a dynamic group of hospitals in the heart of Bristol and Weston-Super-Mare, with over 100 clinical services across ten sites. They offer care to the people of Bristol, Weston-Super-Mare and the South West, and have an international reputation for cardiac surgery, paediatric services, oncology and bone marrow transplantation. They are the largest centre for medical training and research in the South West.