If patients are not being seen within 48 hours then that has a serious public health implication

Dr Elizabeth Foley, Southampton University

This could be partly due to a huge increase in demand.

Over one million patients were seen at GUM clinics in 1999 - more than twice the number at the start of the decade.

The researchers sent a questionnaire to the lead clinician at each of the 258 GUM clinics in the UK asking how quickly they thought patients with one of two symptom scenarios would be seen.

The symptoms indicated a severe viral or bacterial infection which could be easily transmitted to other people.

Phone requests

Healthcare staff posing as patients with the same set of symptoms also contacted clinics by phone, asking to be seen as quickly as possible.

Almost 80% of the doctors contacted responded. And almost all them said that patients with such symptoms would be seen within 24 hours, and that there were protocols in place for this to happen.

But the telephone survey showed that 22% of patients could not be accommodated within 48 hours. In fact, 49 of them had to wait longer than a week.

Patients for clinics in the North West of England, the West Midlands, and Wales had the longest waits.

Almost all of these patients had their cases assessed only by a receptionist, who the researchers suggest were not adequately trained for the task.

In total, 311 telephone contacts were made with staff at GUM clinics. However, 600 attempts were made.

The researchers suspect that there study probably underestimates the problem because the "patients" who made telephone contact were experienced healthcare staff, who insisted on being seen ad who could talk articulately about their symptoms.

Researcher Dr Elizabeth Foley told BBC News Online: "If patients are not being seen within 48 hours then that has a serious public health implication.

"People's symptoms may improve before they are seen, and they might sleep with somebody else and pass the infection on."

Dr Foley said the only solution was to provide more resources so that GUM clinics were better equipped to meet increased demand.

A spokesperson for the Royal College of Obstetricians and Gynaecologists said: "Patients who are concerned that they may be showing symptoms of sexually transmitted infections should have access to swift advice, diagnosis and treatment if necessary.

"GUM clinics exist to provide this service at what can be a worrying time for the patient. Ideally patients should be seen within 48 hours where possible."

The research is published in the journal Sexually Transmitted Infections.