Table 5 Reflexive Monitoring: assessing impact of the work and making adjustments

Testing data from the NCSP helps them to reflect on their testing rates and efforts:

“(Name of CSW) certainly comes, and if our rates start dropping off, she starts sending us little emails “don’t forget chlamydia screens!”. (General Practitioner 04250)

The more tests you do the easier it becomes:

“You know it’s a bit like getting a wheel turning, you know as I said, you get more confident, you get more aware and it just becomes part of your daily work.” (Nurse 04543)

By doing tests staff realise patients welcome being asked:

“So it’s not… a taboo subject… this is what we do in the surgery, it’s standard practice “would you like a pack?” (As) Opposed… to the nurses being uncomfortable about it, (or) the young person feeling uncomfortable about it. It’s … built in, very much this is what we do, this is what we offer, are you interested and we haven’t had any negative feedback from that at all.” (Nurse 04353)

Offering the test was quick:

“I think it you can do it… within a minute, it doesn’t take a lot of time” (Nurse 04254)

“It’s just a question of being organised really and keeping some (kits) available” (General Practitioner 03029)

Value of putting a specific patient prompt for the next consultation:

“I try and I do it as often as possible… if I do forget, if I know I’m bringing them back in, I’ll put a little alert on for myself to try and remember to do it the next time” (Nurse 04346)

“even without the kind of financial incentive, I think if we recognise that it was a valid thing to do. I think given the initial potential training with regard to helping us to acknowledge that as an important thing to do. The logistics of this is, how you can do it, then I think we could have kind of just gone and flown with it as a result” (General Practitioner 04387)

Barrier, time

“It’s a ten minute appointment, its sometimes just not possible to even go there; we don’t even bother raising it because there’s just not enough time, because you’re running twenty minute late already” (General Practitioner 04380)

“It does lengthen the consultation because you’ve got to be prepared” (General Practitioner 03730)

Barrier, other priorities:

“Because … when we discussed it and I mentioned that about reaching the targets and things and everyone just said we can’t do everything, and just you know do what you can, but we weren’t going (to) have a massive drive on this.” (Nurse 3177)