Sexual Health Checkup

Programmes like BBC3's Unsafe Sex in the City, which last series focussed on Birmingham's sexual health clinics, highlight the rising numbers of infections and need to address public health.  The responsibility for commissioning most Sexual Health Services has recently moved from the NHS to Public Health in Local Authorities and Birmingham's City Council has launched a public consultation to get views as part of a redesign and recommissioning process.

Director of Public Health, Dr Adrian Phillips, added: “Taking care of your sexual health means more than being free from sexually transmitted infections, or not having to face unplanned pregnancy as a result of ineffective contraception or no contraception at all. It means taking care of your health, your partner’s health, and your decisions about relationships.

http://birminghamnewsroom.com/2013/10/birmingham-sexual-health-services-under-review/

The consultation runs from 9 October until 9 December and can be accessed at:
https://www.birminghambeheard.org.uk/adults-communities/sexual-health-consultation

Why do we need a sexual health commissioning strategy for Birmingham?It is needed to ensure that future spending on sexual health achieves the following:

• Securing services that meet current and future demand

• Securing services that are value for money and of the right quality

• Prioritising the types of services that are required to make a difference for Birmingham citizens and especially the most vulnerable.

It will help decide how to balance the budget between those services we have to buy (statutory) and those we would like to buy (non-statutory) on behalf of Birmingham residents.

http://www.bhamsouthcentralccg.nhs.uk/2012-02-13-08-29-02/news/538-sexual-health-consultation

This all matters because while the UK faces increasing sexual health issues, Birmingham has specific challenges in being a young diverse city with an increasing population, https://www.birminghambeheard.org.uk/adults-communities/sexual-health-consultation/supporting_documents/SH%20Needs%20Assessment%20Summary%20v1.7.pdf.  Birmingham's population has increased by almost 90,000 since 2001 with 45.6% of it's residents under 30.  In 2011 the largest ethnic group was White British at 53.1% of residents alongside 13.5% Pakistani, 6.0% Indian, and Black Caribbean 4.4% amongst residents from Eastern Europe, Africa and the Middle East and from all over the world.  Some 238,313 residents were born outside of the UK.

The latest data for Birmingham shows:

Birmingham has the second largest concentration of people living with HIV (outside London). Of these, 50% had a late diagnosis, leading to avoidable ill health and potential transmission

Over the last five years, the number of STIs diagnosed has risen by nearly 30%.

Last year, 8,820 new STIs were diagnosed

Young people, black minority ethnic communities and men who have sex with men (MSM) are disproportionately affected

http://birminghamnewsroom.com/2013/10/birmingham-sexual-health-services-under-review/

A few of the questions the survey is asking are listed below:

• Do you agree with our proposal to create a joined up, managed, sexual health system rather than separate services?

• We propose that family Doctors (GPs) and community pharmacies should be providing more sexual health services. Do you agree this is a good idea?

• We propose a significant role for voluntary organisations in the sexual health system, especially to support vulnerable groups. Do you agree with this approach?

• We propose three satellite clinics, one in the city centre, one just north of the city centre and one somewhere towards the south edge of the city. These will provide both contraception and testing and treatment. What should we think about when choosing where to put services?

So why should I blog about this when I tend to talk about regeneration and Birmingham more generally?  Well for me a healthy city as much as a skilled and well educated city will reach it's potential and transform people's lives alongside the physical environment by looking after the welfare of it's residents.  The city's founding fathers in the age of grand civic municipal governance sought to protect residents through public health, gas, water and electricity, education and sewerage ownership.  The transfer of the sexual health services from the NHS to the city offers a chance for the city to focus on it's residents and seek to improve their welfare to improve the city overall. 

For me in response to the questions the survey asks I feel that sexual health shouldn't be seen solely as dealt with by the sexual health GUM clinic's so that it doesn't become something shameful or hidden that isn't considered as routine as a visit to the opticians or dentist.  It should be that your looking after your sexual health and accessing it at the most convenient place for you knowing all care will be same and that it is routine and not something that might have stigma or humour attached to. It should be accessible for all so that can accommodate younger people and their accessibility with school/college and for those working adults who may be restricted by working hours.   

A coherent system should help to reduce stigma and provide increased accessibility to sexual health.  Accessibility and openness must be matched by enabling the network of access routes to sexual health to be seen to be there through social media, physical presence and phone call so that whatever time and whatever day there is a way to access support or to find a way to access a care or support at the first opportunity. Engaging GP surgeries and other health centres to be first points of contact and a wide publicity campaign to highlight it's not just confined to the GUM clinic to access sexual health should all help to increase access to sexual health.

The success of such improvements might initially seem the opposite if increased testing creates increased detection rates but this initial peak should see people receiving treatment, care and support and prevent reinfection and help to reduce the overall need for services.