Local enhanced services for sexual health (LESSH) are meeting standards relating to accessibility, staff training and competencies but failing to produce audit data so that clinical outcomes can be evaluated, a study has concluded.

Five PCTs were identified in Surrey and Sussex that commissioned LESSH from their general practices. National standards were identified by discussion with local experts including commissioners, service leads and professional organisations.

These standards were then evaluated across dimensions of structure, process and outcome using interviews with local GU medicine consultants, PCT commissioners and key personnel.

Six different service specifications for LESSH were identified, four of which targeted young people. However, two specifications did not include partner notification. Standards relating to accessibility of services were largely met, as were those for staff training and competencies. Poorly met standards related to service networks (e.g. GUM support), shared protocols and clear referral pathways. Clinical outcome standards such as treatment of diagnosed infections could not be ascertained because of poor data collection.

The authors note that there is a general lack of data collection for audit despite the investment in LESSH. Commissioners should include some audits that practices should do as part of their enhanced service specification for sexual health. It is important to realise that audits for enhanced services aren't about just going through a process of counting up numbers and ticking boxes, but can provide valuable evidence that they are value for money and hence worth investing in.

Dr Richard Ma