Select Committee on Health Written Evidence


APPENDIX 30

Memorandum by William Ford-Young (HA 37)

BACKGROUND

    —  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 contraceptive services.

    —  Holistic nature of sexual health and levels of service provision in National Strategy ignored by GP contract—different 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.

THE WAY AHEAD

    —  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 CHANGE ONE THING TO BE AN EFFECTIVE DRIVER FOR SEXUAL HEALTH IMPROVEMENT AT PCT LEVEL

    —  Concentrate on chlamydia screening programme.

    —  Evidence based

    —  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 sexual health

    —  Acceptable to the patients

    —  Acts as in-road into other STIs and risk-taking behaviour





 
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