D2b or not D2b: a regional multicentre survey in level 3 GUM clinics of ‘other conditions requiring treatment’ 

Introduction:
Diagnoses in patients attending GUM clinics are coded using SHHAPT codes. D3 is used for conditions not requiring treatment. It is often taken to mean a negative STI screen; however the code may not reflect the time or expertise required for a consultation with a high risk or anxious individual. The D2b code is used for “other conditions requiring treatment” for which there is no other appropriate SHHAPT code. D2b codes did not attract funding in the SRH tariff.  
This survey aimed to identify the range of complex consultations and non-STI work seen in GUM clinics that were not captured by the coding.
 
Methods:
A retrospective case notes review of patients with a D3 or D2b code attending GUM clinics in 2011.  Data was gathered on socio-demographic details, SHHAPT codes and other diagnoses, and outcome. The data was analysed using Excel.  

Results:
594 patients were included (339 D2b, 255 D3). The commonest diagnoses were genital dermatoses 129(22%). Other diagnoses included chronic pelvic and vulval pain (27), other gynaecological and urological conditions (23), prophylaxis of recurrent infections (33), psychosexual and complex consultations including high risk sexual behaviour, sexual assault, and safeguarding referrals (65).

Discussion:
Following this survey, a list of D2b sub-codes was developed for use in all the regional GUM clinics. Since then, SRHAD codes have been introduced for complex dermatology, urology, and gynaecology conditions. However the continued use of the D2B sub-codes for high risk patients and complex consultations provides valuable data to support commissioning.

D2b or not D2b: a regional multicentre survey in level 3 GUM clinics of ‘other conditions requiring treatment'

The Joint Annual Conference of the British Association for Sexual Health and HIV & the Society for the Study of Sexually Transmitted Diseases in Ireland