Table of contents

Unmet needs and service gaps

Background papers: Lifestyle and wider determinants :: Sexual health [Update in progress] :: Unmet needs and service gaps

HIV testing and diagnosis:

Significant numbers of HIV cases remain undiagnosed and access to HIV testing and treatment and care for the positives requires further improvement. HIV knowledge and skills within primary care (GPs and nurse practitioners) and other health providers in related fields in Medway PCT do not appear to be sufficiently strong. Professionals at these touch points in the health system are not familiar with the many presentations of HIV and not confident in testing and care pathways.[1]

Chlamydia screening:

Increased screening through core services and targeted outreach is required to reach the proposed Public Health Outcome diagnosis range of 2,400 positives per 100,000 15-24 year old population.

Community focused STI screening services:

Limited understanding and delivery of sexual health services (such as screening, information and advice) through primary care. Improved management of the pathways between providers to ensure patients are accessing appropriate services efficiently.

Targeted Outreach:

CASH services need to develop a clear outreach strategy to engage those more at risk of sexual ill health including MSM, Black African Populations.

Young peoples sexual health services:

Access has improved and onsite services available in educational establishments. However need to ensure provision of services in Chatham area is maintained. Need to continue to work towards Your Welcome accreditation.

Local termination of pregnancy services:

Access has improved and women are presenting at earlier gestations (ytd in 2011 80% before 10 weeks). Referral pathway developed to local CASH services but need to monitor the effectiveness of this pathway. Levels of contraception provided has increased significantly but repeat abortions high so need to target LARC activity.

Provision of Long Acting Reversible Contraception (LARC):

Promotion and uptake of LARC will require improvement.

Sexual Assault Referral Centre (SARC)

Whilst there is a sexual assault referral service located at Darent Valley Hospital, the wrap around services are currently grant-funded.


[1]   Design Options. Rapid Sexual Health Needs Assessment 2007; Medway Primary Care Trust.