APPENDIX 8
Memorandum by the Faculty of Family Planning
and Reproductive Health Care (HA 10)
INTRODUCTION
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.
PROGRESS TO
DATE IN
IMPLEMENTING RECOMMENDATION
OF COMMITTEES
ENQUIRIES INTO
SEXUAL HEALTH
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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