What: A sexual health service for the population of Barnsley, Wakefield and Wigan
Who: Belinda Loftus – Head of Integrated Sexual Health Services – Spectrum Community Health (CIC)
Background: Belinda commenced nurse training with Queen Alexandra’s Royal Army Nursing Corps in 1996 after she had completed my army basic training. Her nurse training was based at Royal Naval Hospital Haslar, specializing in sexual health at the main naval base in Portsmouth.
After qualifying she was posted to Catterick and worked in the Military Defence Hospital Unit (MDHU) Northallerton, in general surgery, urology and orthopaedic trauma. It was here where she spent time in the Army Genito-urinary service, before heading off to MDHU Frimley Park in Surrey for further training Following completion of this she was posted to Germany for two years and then Northern Ireland for another two years. During my ten years in the Army she did 4 operational tours; Kosovo, Bosnia, Iraq and Northern Ireland, after Northern Ireland she left Army.
Her first NHS job was as a Nurse Practitioner in Rotherham, spent three years in Rotherham before taking the position of Trinity Centre Manager (at the time Bradford’s GUM service). She was then appointed to her current position as Clinical Service Manager for Bradford’s Integrated Sexual Health services. She then moved on to Spectrum Health Community Interest Company and remains committed to sexual health services.
Spectrum Health CIC focuses their healthcare delivery on 3 specific areas; sexual health, substance misuse services, Health and Justice services. They have services across the North of England.
Approach: Prevention, Resilience, Promotion and Protection
Location: Wakefield, West Yorkshire
Specialty: Sexual health, including management of sexually transmitted infections (STIs) and related conditions, contraception, relationships and sex education to young people.
What initiative or project are you involved in?
All sexual health services aim to provide open and accessible sexual health services that meet the needs of the local population, working closely with the local authorities who commission sexual health services.
The medical teams are led by consultants; specialists in genitourinary medicine (GUM) and contraception, the medical staff also acts as the Clinical Lead. Nursing staff work at bands six and seven and are all independent practitioners. The health advisors are all trained nurses with the skills to deal with partner notification, adjustment to diagnosis, HIV testing of high-risk groups, and complex cases of safeguarding.
Our highly trained staff aim to ensure that patients only have to tell their often embarrassing or distressing story once.
We care for patients with a range of sexual health needs, including:
- concerns about acquiring an infection through recent behaviour
- sexually transmitted infections (STIs) that have significant public health implications, for example HIV, syphilis, chlamydia and gonorrhoea
- other infections such as herpes, warts and trichomonas
- non-infectious conditions, for example vaginal and vulval candidiasis, bacterial vagninosis (BV) and genital skin conditions.
Our services include:
- contraceptive methods
- pregnancy testing
- HIV point-of-care testing
- motivational interviewing
- harm reduction strategies.
We play a key role in safeguarding children, young people and adults, which includes dealing with issues such as child sexual exploitation (CSE), female genital mutilation (FGM) and domestic/intimate partner violence. We also have a strong belief that relationships, and sex education play a key role in ensuring that young people are resilient, able to negotiate safe relationships and develop in to adults who are able to have sexually healthy relationships.
The workload for safeguarding continues to increase; the teams work co-operatively with other service providers to ensure that issues are dealt with swiftly and appropriately.
What prompted the work?
Embarrassment and stigma are major barriers to the use of sexual health services. It is hoped that the merging of contraception and genitourinary medicine (GUM) services will help to tackle this stigma and reduce barriers to treatment seeking. For example, patients attending a contraception appointment, once in a private setting, may feel comfortable enough to disclose other sexual health needs.
How did you initiate the work?
Under the 2012 Health and Social Care Act, responsibility for the commissioning of sexual health services transitioned from NHS Primary Care Trusts to designated receiver organisations.
The merger of contraceptive and GUM nursing has introduced a disparity in competencies. In order to provide an integrated service, significant training has been required to ensure that all clinical staff have the skills to deliver both services. The nursing team use the British Association of Sexual Health and HIV (BASHH) Intermediate Competency Framework, and the Faculty of Sexual and Reproductive Health (FSRH) Competency Package for contraception, which enables knowledge and clinical skills to be gained whilst remaining in practice. This was presented in a poster at the BASHH Spring Meeting 2016.
GPs have a key role to play in enabling good access to sexual health services for the whole community, including pregnancy testing, cervical smear testing, STI screening and referral to specialist sexual health services.
What difference has the project or initiative made?
Patients have new facilities in the centre of towns, located near to travel links, instead of them being located in hospitals or dilapidated buildings. Access has improved to contraception as we have moved away from the traditional sessional approach to the more modern open access with long opening hours.