Utilisation of genitourinary medicine services by general practitioners: effect of geographic location, fundholding status, and potential effect of total fundholding.

Objectives: To determine the current utilisation of genitourinary medicine (GUM) services by general practitioners (GPs) and any changes likely to occur with moves towards a primary care led NHS.

Methods: A questionnaire survey of practising GPs appearing in the Medical Directory in England and Wales to determine the effect of geographical location, fundholding status, and potential effect of total fundholding on referrals to GUM clinics.

Results: Referral patterns for STDs varied according to the genital infection concerned, being highest for gonorrhoea and lowest for Trichomonas vaginalis infection. Referral patterns were little affected by geographic location of the practice or fundholding status. The reported intention on becoming total fundholding was a modest shift towards more STDs being treated in the community which varied according to the genital infection concerned.

Conclusions: Although some GPs elect to always treat some STDs in the community most refer patients to GUM clinics. There appears to be little enthusiasm among GPs, should they become total fundholders, to extend their range of services to include STD provision.