The target, set by the UK government for 2008, will mean that all sexual health clinics will have to provide every patient with an appointment within 48 hours of contacting the service, similar to the target imposed for access to an appointment with a family doctor.

But the experience of a large sexual health clinic in Leeds, for which appointments are booked by phone or in person, known as a closed appointment system, shows that demand for services heavily outstrips supply. And no amount of efficiency savings can possibly hope to address this, suggest the authors.

The authors reviewed all patients' attempts to book an appointment by phone over five working days. The results were then compared with the actual capacity within the clinic over the same period.

The authors calculated that 626 appointment slots would be required to ensure that all patients were seen within 48 hours of the request being received.

In all, over three quarters of appointment requests were made by phone; almost one in five were made in person, and the rest came through referrals from family doctors.

More than eight out of 10 phone requests were for a new appointment, as opposed to follow up. But there were only 181 new appointment slots available with doctors or nurses, despite the fact that the clinic was working to 103 per cent capacity.

As a result, almost three quarters of patients requesting a new appointment could not be seen. To accommodate demand, even during a relatively quiet time of the year (July), the clinic would have to triple or quadruple its current capacity, say the authors.

They conclude that the apparent improvement in waiting times afforded by closed booking systems is superficial. Many callers are simply not able to book an appointmen
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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ Specialty Journals
1-Feb-2006