Effective role redesign: an audit of outcomes following the introduction of a new nurse-led service.

Genitourinary medicine services have had to modernize to try to meet the growth in demand. Changes should be audited to ensure standards remain high. We introduced a 'comprehensive care nurse-led service' for patients presenting for asymptomatic screening and as asymptomatic contacts (partners of known positive patients). Following implementation we audited outcomes and patient satisfaction. During the audit period (01/07/2005 to 30/11/2005), 446 patients were seen. A sexual health screen was performed in 433 (216 females: 217 males). Forty-one patients (9.5%) were chlamydia-positive by enzyme-linked immunosorbent assay testing (background clinic rate 8.5%). Forty-six (10.6%) were treated epidemiologically as chlamydia-negative contacts of chlamydia-positive index patients and 18 (4.1%) were treated as chlamydia-negative urethritis/cervicitis. Uptake of HIV testing was 71.2% (311/433). Average wait-to-appointment was three days (background clinic wait 2-3 weeks). Nurse-led clinics were judged successful in terms of outcomes, improving access and patient satisfaction.