Evaluating a model of nurse-led care in a genitourinary medicine clinic

The development of advanced practice roles for nurses working in the speciality of genitourinary medicine (GUM) is part of a wider process of change in nursing and the National Health Service. Despite the paucity of evidence of their effectiveness, there has been a steady growth of nurse-led GUM clinics over the past decade. This thesis explores the impact of nurse-led GUM clinics for women in a central London GUM service. A process and outcome evaluation was conducted to demonstrate the effectiveness, acceptability and cost of nurse-led GUM clinics. 880 women were randomised to nurse-led or doctor-led clinics of whom 224 had their clinical records audited. A further (non-randomised) sample of 282 women completed a satisfaction survey, 20 completed an exit interview and 18 had their consultation observed. Staff completed 586 waiting time surveys. Staff interviews and focus group discussions identified the issues associated with the nurse-led clinic intervention. A cost analysis determined the average, incremental and marginal costs of nurse-led clinics. The median documentation audit scores for specialist nurses (n=103) and senior house officers (SHOs) (n=121) were 92% and 85% respectively (p