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Current services in relation to need

Background papers: Lifestyle and wider determinants :: Sexual health [Update in progress] :: Current services in relation to need

Medway is currently working towards an integrated sexual health model. It is anticipated that the new model will be commissioned and fully operational by October 2016.

Hospital-based genitourinary medicine

Since 2013/14 a slight decrease has been seen in attendance at the hospital-based level 3 genitourinary medicine (GUM) clinic in Medway but it is too early to establish whether this trend is likely to continue in the longer term. Service performance data indicates that there were 10,981 service users attending GUM in 2014/15. Generally these users were representative of the wider population; however, when considering general population not adjusted according to need, black Africans are over represented and Asians are under-represented. The 19 to 35 year old age group make up the majority of service users (63%).

Community-based Contraceptive and Sexual Health Services

Attendance at level 1 and 2 Contraception and Sexual Health (CaSH) clinics has also decreased slightly over the same time period. In 2014/15 there were 10,042 contacts with the level 1 and 2 providers in all settings. Men are significantly underrepresented in level 1 and 2 services with only 5% of attendees in clinics being male.Men-who-have-sex-with-other-men (MSM) are also under represented. Asians are under-represented. Fifty per cent of all clinic attendees are aged 25 or under.

Between all sexual health services level 1-3 there are approximately 27,000 patient contacts per annum, of which approximately 20,000 were in clinical settings.

Young people are supported by a number of community-based CaSH clinics targeted to the under 20s. Some schools and educational establishments host student sexual health clinics. The Student Health Service in Medway operates in 8 educational establishments and provides a range of sexual health services.

Sexual Health Services by other providers

The C-Card condom distribution scheme has over 1,200 young people registered with over 50 individuals trained as registration or distribution points. The scheme is delivered by Medway Public Health and open to 13-20 year olds; the upper age will be increased to 24 as part of the Integrates Sexual Health Service. Venues include schools, youth settings, sexual health clinics and pharmacies. In 2014/15, there were 906 registrations and 1,674 distributions.

Emergency hormonal contraception (EHC) is available to all women aged up to and including 30 through pharmacies via a Patient Group Direction (PGD). In 2014/15 EHC was prescribed on 1,399 occasions.

GPs are commissioned to fit long-acting reversible contraception (LARC), including intrauterine devices (IUDs) or systems (IUS) and subdermal implants (SDIs), by Medway Public Health. In 2014/15 there were 1,981 LARC procedures by GPs. This compares to 2,465 fitted by CaSH clinics (data from the Public Health England LASER report which is not publically available).

HIV point of care testing focussing on the black African community is currently provided by a local charity (Health Action Charity Organisation). The scheme will end 31 March 2016 as the responsibility for community-based HIV screening is taken on by the integrated sexual health service. Campaigns are used to amplify the messages of HIV testing week to MSM and the wider community.

The National Chlamydia Screening Programme (NCSP) is funded and administered locally by Medway Public Health and promotes testing and treatment through GPs, pharmacies, sexual health clinics, outreach, mail out service and other community organisations.

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.