Table of contents

Current services in relation to need

Background papers: Lifestyle and wider determinants :: Sexual health :: Current services in relation to need

Medway moved to an integrated model of service delivery in October 2017. This included the introduction of an online STI self-sampling scheme. Services are delivered by Hub and Spoke clinics; the hub is at 4 Clover Street Chatham and the spokes include GP Practices, Healthy Living Centres and other community settings. In the first year there were approximately 22,000 contacts in clinical settings and home sampling has proved popular with 1,657 users during the first year.

The service consists of the following elements:

1. Hub and Spoke clinics offering a full level 1-3 service and Self-managed care

The aim is to:

• Provide integrated clinics for contraceptive and genitourinary medicine.
• Improve accessibility through extended opening hours.
• Develop a range of self-managed care interventions, including online self sampling.

2. Outreach

The aim of the outreach element is to:

• Provide immediate and necessary support to prevent sexual ill-health for those not accessing universal services.
• Identify and remove barriers to them accessing universal or targeted services.
• Promote universal services and encourage their use.

3. Psychosexual therapies

• Provide help for patients presenting with sexual health aspects of psychosexual/sexual dysfunction for short to medium term therapy.

4. National Chlamydia Screening Programme

The aim of the Chlamydia screening element is to target 15-24 year olds to:

• Prevent and control chlamydia through early detection and treatment of asymptomatic infection.
• Reduce where possible onward transmission to sexual partners.
• Prevent the consequences of untreated infection.
• Raise awareness and skills of health professionals to screen for chlamydia and provide the information young adults need to reduce the risk of infection and transmission.
• The scheme gives rapid access to chlamydia screening through a range of settings including GP, Pharmacy, online, grab-bins, educational establishments and clinical settings.

5. Get It condom scheme

The aim of the condom distribution scheme is to target 13-24 to:

• Reduce STI transmission and HIV in young people.
• Reduce teenage pregnancy, especially among those identified as being most at risk and vulnerable.
• Achieve an increase in the percentage of the population screened for chlamydia and an increase in chlamydia detection.

Young people can register online or through a number of other venues such as clinics, pharmacies and educational establishments.

6. LARC fitting and removal in primary care

The aim of the Long Acting Reversible Contraception (LARC) fitting and removal in primary care scheme is to:

• Provide women with a choice of where to have LARC fitted to increase availability and uptake.
• Reduce unplanned pregnancy among all women of child-bearing age.
• Reduce teenage conceptions.
• Reduce abortions.
• Provide value for money contraception.
• Increase average LARC usage times so that it is comparable between GPs and Sexual Health Clinics.

7. EHC in Pharmacies

The aim of the EHC in Pharmacies scheme is to:

• Reduce unplanned pregnancy among women aged under 30.
• Reduce abortions especially repeat abortions.
• Reduce teenage conceptions.

8. Community based Targeted HIV screening

The aim of Community based targeted HIV screening is to target identified high risk groups, currently men who have sex with men (MSM) and Black Africans, to:

• Reduce the number of those infected with HIV who are undiagnosed and not on treatment.
• Reduce late diagnosis of HIV.
• Contribute to the reduction of stigma surrounding HIV.

9. HIV Adult services

The HIV adult services provides treatment and support for people living with HIV and is commissioned by NHS England but delivered through the Integrated Sexual Health Service.

Relationships and Sex Education

Medway Public Health supports Relationships and Sex Education (RSE) as part of Personal Health and Social Education (PHSE) by partnering with schools to ensure high quality delivery. RSE is operating in 12 of 18 secondary schools in Medway.