Sexual health

1
Sexual health

• Being a Clinical Lead In It

2
Difficulties as sexual health clinical lead

• No definition of sexual health
• No job description
• No champion in PCT management
• No lead practice nurse
• No clear lines of accountability
• Meetings frequently cancelled
• My many competing commitments

3
Scope of sexual health

• Sexually transmitted diseases
• HIV/AIDS - and others
• Prevention - mostly not a clinical area
• Treatment - primary care or GUM?
• Contraception
• Teenage pregnancy strategy?
• Termination of pregnancy services?
• Psychosexual problems/erectile dysfunction etc???

4
National guidance, targets, strategies
Look at good practice elsewhere
Bradford-wide strategies
How to improve sexual health in NBPCT?
Liaison, with Public Health, F/P, GUM
Training for Primary Care Staff
Liaison with PCT groups with overlapping remit eg
young people
Map existing provision in PCT
5
National guidance, targets, strategies

• National Strategy for Sexual Health and HIV 2001
• Provisions of new GMS contract for levels of
  service in Sexual Health
• Teenage pregnancy strategy

6
Sexual Health Implementation Group (Bradford wide)

• All PCTs
• Health Promotion
• Social Services
• Voluntary Sector
• Education

7
Liaison with Public Health, FP services, GUM,
microbiology(Bradford wide)

• GUM monitoring group (no longer meeting)
• Proposed clinical sexual health group (not met
  yet)

8
Existing PCT provision

• Most contraception now practice based
• Much FP work by practice nurses
• TOP contract with Lilac clinic inadequate
• Shipley Young Peoples Health project
• STDs - partly primary care, partly GUM clinic
• Variation between practices and probably within
  practices

9
Overlap with other PCT activities

• Young peoples health group
• Cervical smear targets
• Commissioning for TOPs
• ? Mental health (psychosexual)
• ? Urology (erectile dysfunction)

10
Training for primary care staff

• Identify needs of each group of staff
• Identify areas of training needed
• E g organising user friendly services, diagnosis
  of STDs, referral, treatment, contact tracing
• Provide training, e g at PLTs

11
Look at good practice elsewhere

• Why reinvent the wheel?

12
What we need now

• GP lead with time, energy and commitment
• Practice nurse lead with time, energy and
  commitment
• PCT manager with clear remit to support clinical
  leads