Select Committee on Health Written Evidence


Memorandum by the Faculty of Family Planning and Reproductive Health Care (HA 10)


  The Faculty of Family Planning and Reproductive Health Care of the Royal College of Obstetricians and Gynecologists (FFPRHC) oversees Postgraduate Medical and Specialist training in the field of Sexual and Reproductive Health Care. The Faculty has over 11,000 members which represents a significant proportion of doctors providing contraceptive care in the UK in both Primary Care and Specialist Services.


Recommendation 8—Lack of consultant training positions

  We note there does not appear to have been any substantial investment in consultant posts either in Family Planning/Contraceptive or Genitourinary Medicine (GUM). There have only been an additional four National Training Numbers awarded to Family Planning in the last two years. This is not adequate even to maintain the current workforce, let alone train doctors to lead services where there is no medical need. Without specialist leadership, innovative approaches, prevention and treatment of sexually transmitted infections (STIs), abortion and contraceptive services within the community will not be possible. Family Planning/Community Sexual and Reproductive Health Services have the capacity to train more consultants, but not the resources or National Training Numbers. It should be noted that the majority of consultants leading Family Planning/Contraceptive services are single-handed. This is far from ideal. They need to work alongside consultant colleagues in Family Planning/Contraception or a GUM consultant.

Recommendation 9—Lack of resource

  The Faculty welcomes the additional resources recently released to support Sexual and Reproductive Health. We believe however, better value for money would be obtained by distributing a much greater proportion of the extra funding to community Family Planning and Sexual Health services who would be able to most effectively relieve pressure on GUM services by diagnosing, treating and supporting a large proportion of patients who would otherwise need to travel to a central GUM clinic. By working in partnership in this way with specialist GUM clinics, Family Planning and other community services would encourage innovation which should improve access for "hard to reach groups" and help address inequalities seen within Sexual Health. For those still needing or choosing access to GUM clinics, waiting times would fall dramatically.

Recommendation 10—Lack of development of nurse role and long distance learning initiatives

  The Faculty strongly supports the important role of nurses in the provision of Sexual Health. Nurses have traditionally played a major role in the provision of contraception and amply demonstrated their ability to screen, diagnose and treat sexually transmitted infection. Specific targeting of resources to allow more nurses who work in the community to access prescribing of courses and further develop their role, would greatly improve sexual health service capacity. To date, this has not occurred in a systematic manner and there has been no clear demonstration to Primary Care Trusts of potential development of nurses working within community services.

  The Faculty however is most supportive of the intention by the Department of Health to develop long distance learning initiatives for all clinicians.

Recommendation 12—Clinical networks

  The further development of clinical networks would be supported by the Faculty, but in order for this to happen, a greater proportion of funding must be directed at training community specialists and improving the infrastructure in community based contraceptive services.

  The Faculty welcomes the Department of Health intended survey of contraceptive provision within Primary Care Trusts—but notes funding must be set aside to help address deficiencies as they are identified.

Recommendation 13—Waiting times

  The Faculty welcomes improved access to Genitourinary Medicine that should be achieved through increased investment. We note however the tradition within contraceptive clinics that provide walk-in services, means the pressure of increased demand cannot be monitored this way.

Recommendation 14—Infrastructure

  We welcome the Department of Health initiative to visit GUM premises within England—we are concerned this has not been extended to other specialist contraceptive and sexual health clinics.

Recommendation 15—Chlamydia screening

  The Faculty notes with approval, substantial progress being made to introduce systematic chlamydia screening for the under 25 year olds.

Recommendation 29—Contraceptive services

  The Committee recommended the Government took "immediate steps to rectify priority in balance" (Para 211) regarding the investment in contraceptive services. This has not happened. It is vital funding is secured to act on deficiencies identified in a survey performed by the Faculty of Family Planning and Reproductive Health Care in November 2004.

Recommendation 32—Abortion services

  No progress made to date in re-modeling services to improve choice and access.

Recommendation 49—National service framework

  Progress has been made within the last 18 months, but it is patchy. A national service framework does not appear to have been seriously considered. The Faculty is in complete agreement with the Committee, that it is required to ensure a systematic approach to improving Sexual Health through sexual relationships, education and Health Promotion as well as clinical services.

  The Faculty welcomes the work of the House of Commons Health Committee on Sexual Health and believes it is essential to ensuring continued focused efforts of the National Health Service on Sexual Health. Excellent Service Standards have recently been developed by MEDFASH. Standards alone however, will not improve sexual health. It is essential that all Primary Care Trusts focus on monitoring and improving their services against these national standards.

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