Memorandum by William Ford-Young (HA 37)
GP contract does not marry with National
Strategy for Sexual Health & HIV or NSF for Children &
Young people (which also contains much policy re sexual health)
yet GPs see vast numbers of at risk patients and provide 80% of
Holistic nature of sexual health
and levels of service provision in National Strategy ignored by
GP contractdifferent elements of service in the Strategy
are segregated and placed in various separate "add-on"
elements of the contract or are not included at all.
Enthusiastic GPs will include sexual
health provision at the basic level of "essential services"
but with out reward or performance/quality management, BMA negotiators
will state that sexual health (apart from patients with symptoms)
does not fall into "essential services".
The comprehensive "National
Enhanced Service for More Specialised Sexual Health" is beyond
most practices skills & capabilities at present and very few
PCTs are commissioning such services.
The National Chlamydia Screening
Programme at present is not supported by the contract, yet is
porbably the most important element of the National Strategy,
now further supported by "Choosing Health", that could
be a main driver to improve the sexual health of the nation.
No nationally provided or recognised
education & training programme to support and skill-up GPs
& Practice Nurses.
Evolutionary change of contract to
provide incentive and quality/performance management for sexual
health at basic levels (eg level 1 of Strategy)
Support good coverage of chlamydia
screening programme in general practice by overcoming barriers
financial, resource & time, training & skills.
Support national GP led (eg RCGP)
validated course for holistic sexual health (perhaps along similar
lines to very successful course for managing substance misusers
in general practice).
IF I COULD
AT PCT LEVEL
Concentrate on chlamydia screening
Tackles the most common STI
Can be delivered in large variety
of health care (& non health care settings) thus giving patients
choice, skilling up generic workers, tackling attitudes and normailising
Acceptable to the patients
Acts as in-road into other STIs and