Sexual Health Developing the role of Primary Care using PBC

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Sexual HealthDeveloping the role of Primary
Careusing PBC
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Health Needs Analysis - Key Points

• Ten wards in Birmingham have high levels of
  sexual health problems eight in HoB
• High levels of unwanted and teenage pregnancy and
  repeat terminations
• High levels of all STIs
• Problems meeting chlamydia screening targets
• Over reliance on specialist services for routine
  contraception and STI
• Young people not accessing services
• Long acting reversible methods of contraception
  (LARC) not widely available
• Late presentation of HIV in Soho and Ladywood

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Local Issues

• Small single handed practices few female GPs
• Cultural sensitivities (especially for women)
• Good local training schemes but difficult for
  primary care staff to find time to attend
• Limited engagement with the chlamydia screening
  programme
• Community providers swamped by routine work
• No integration between GUM and RSH

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Approach

• Radical change of approach needed to tackle major
  issues with existing system
• Pan Birmingham Strategy in line with national
  guidance
• Consultation with local community through
  specially designed campaign and events
• In HoB - PBC is leading on developing services in
  primary care consultation through local GP
  meetings

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City Wide Strategy

• Plurality of providers and services available for
  uncomplicated needs (primary and community care)
• Holistic integrated services at all levels
  ideally one stop consultation
• Improve accessibility especially for young
  people times and venues
• Strengthen role of specialist services in
  supporting Levels 1 and 2

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Level 1 Funded through PBC

• Local Enhanced Service to support practices to
• engage with SHIP training
• adopt Youre Welcome quality standards
• routinely risk assess patients and treat
  accordingly
• increase targeted chlamydia testing
• normalise HIV testing
• improve recording
• LES for contraceptive implants (and improved
  training provision) to help improve access to
  long acting reversible contraception (LARC)

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Level 2 Locality Centres

• Integrated (not just co-located) services from
  any willing provider (GP, HoB provider or third
  sector)
• Each centre sited in accessible community
  location to provide Level 2 services with
  failsafe for Level 1
• Shared Community Health Advisors to support
  contact tracing
• Specification to cover range of services, staff
  competencies, and accessibility (particularly for
  young people)

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Training

• Increase the skills of people working in primary
  care and in the community to deliver integrated
  sexual health services
• Co-ordination between SHIP and BRASH to cover
  primary and community care staff risk
  assessment approach
• Establish training database to allow monitoring
  of workforce development
• Increase access to practical training for both
  GUM (STIF) and contraception (DFRSH)
• Create clinical network and community of practice
  for local healthcare professionals

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Level 3 (specialist)

• Reorganise and rationalise existing family
  planning services to move towards integrated
  provision of specialist services discharge of
  Level 1 to primary care
• Concentrate services at City Centre Hub (build on
  success at Boots) with outreach where appropriate
  for vulnerable groups
• Build role for both GUM and RSH in signposting to
  and supporting Level 1 and 2 providers (training
  and advice)

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• Any questions?
• nuala.woodman_at_nhs.net