Effects of a change from an appointment service to a walk-in triage service at a sexual health centre

A walk-in triage system (WITS) was introduced at Melbourne Sexual Health Centre in August 2001 as a result of the perceived need to increase access to the clinic for clients requiring immediate assessment. An audit of this alteration to clinic operation resulted in a significant increase in the number of new clients attending the clinic who were younger and less likely to report using condoms, substantial increases in the number of investigations ordered for bacterial sexually transmitted infections (STIs) and an increase in the detection of genital herpes and chlamydia. There are a number of possible explanations for these changes other than the change to clinic operation but these are less likely causes for the observed changes. Our findings should complement the other reasons to adopt a WITS system, such as improving access for those most in need and vital to reach if STI rates are to fall.