The study’s objectives were to understand issues of using the general rule as a setting for chlamydia screening and explore ways to implement a successful screening strategy.

Based on the literature review findings, a semi-structured schedule was constructed to interview a purposive sample of policymakers, consultants in sexual and reproductive health, and primary care professionals. A thematic framework was used for qualitative analysis.

Twenty-two themes were identified and were ranked in order of word count. The topic that generated the most discussion was heterogeneity of knowledge, attitudes, and general practice skills. When broken down by professional group, this topic ranked the highest for practice nurses and consultants in sexual health; GPs and the chlamydia screening coordinator spoke most about financial incentives, while the public health consultant spoke most about access.

Most believed screening can and should be done, and general practice can offer better population coverage. It needs to have little impact on clinicians’ workload, for example, by using urine tests and self-taken vaginal swabs. Financial recognition needs to reflect the administrative costs and the implications for reception staff, but this and the innovative tests might add to the screening program’s cost. Incentives have to be handled sensitively to reduce inequity among GPs and other services offering screening.