A shrinking service: can it mislead people into thinking there is less disease?

This study looks at the impact of reduced clinical services on infection rates in a small suburban genitourinary medicine clinic, and compares the rates with the national trends. Data were gathered from the KC60 reports and compared with national data on the Health Protection Association Website. Between 1996 and 2001, waiting time for appointments increased along with the number of patients not attending appointments. There was an apparent drop in the number of cases of chlamydial infection in contrast to a national increase; however, when the figures were adjusted for the fall in clinic size, a small rise was seen. The incidence of gonorrhoea, in contrast, rose in excess of national trends, and new HIV/AIDS diagnoses tripled. A disproportionate number of wart virus infections were seen. It seems that long waits for appointments and high DNA rates are skewing diagnosis rates for the clinic, and the shrinking service appears not to be meeting the community's needs.