Abstract
In response to the increasing waiting times for appointments at genitourinary (GU) medicine clinics1,2, the Department of Health has made three targeted funding allocations to improve access consisting of a non-recurrent allocation of £5 million in 2002–03, followed by an £8 million recurrent and a further £5 million non-recurrent allocation in 2003–04.
The British Association for Sexual Health and HIV (BASHH) conducted a survey of lead consultants for GU medicine clinics in March 2004 to determine if they could confirm whether all of the targeted funding had been allocated to their budgets. A total of 122 individuals representing 132 (65%) clinics in England, responded to the questionnaire for either calendar year. Of the first £5 million non-recurrent allocation, made in January 2003, the number and percentage of the 117 respondents who had received their full allocation was 96 (82%) compared to 13 (11%) who received less than the allocated amount and 8 (7%) who were uncertain. These individuals were able to confirm that £3,155,000 (92%) of the £3,424,500 allocation to their clinics had reached its intended target. Of the second £8 million recurrent allocation in financial year 2003–04, 76 (64%) of 119 respondents received their full allocation, 30 (25%) respondents received less than the allocated amount, and 13 (11%) respondents were uncertain. The total amount of the allocation for the clinics represented by these 106 recipients was £4,566,500 of which £3,619,663 (79%) had reached their clinic budgets. Of the final non-recurrent £5 million allocation in financial year 2003–04, 61 (51%) respondents received their full allocation, 49 (41%) respondents received less than their allocated amount, and nine (8%) respondents remained uncertain. The total amount of the allocation for the clinics represented by these 110 recipients was £3,258,000 of which £1,638,000 (50%) had reached their clinic budgets.
Thus, of the total £7,824,500 allocation to the Primary Care Trusts (PCTs) with lead sexual health responsibilities for the GU medicine clinics of recipients in 2003–04, only £5,257,663 (67%) was confirmed to have reached clinic budgets. Overall, only 51 (43%) of 119 respondents could confirm having received all of their recurrent and non-recurrent allocations, 58 (49%) had received either a reduced allocation or none at all and 10 (8%) were uncertain.
This survey suggests that a significant proportion of the additional funding to improve access to GU medicine clinics failed to reach its intended target. The deficit between the amounts allocated and received by clinics was larger in financial year 2003–04, when the funding was given to PCTs with lead roles for sexual health, as compared with the preceding year when it was allocated directly to clinics. Moreover, the late allocation of non-recurrent funding and the inability of many clinics to arrange for this funding to be carried forward at year-end may have further prevented its intended use to increase service capacity and reduce waiting times.