Welcome
Tuesday 15 September 2020 (Issue 61)
Welcome to the September issue of the Sexual Health, Reproductive Health & HIV Policy eBulletin. Last month the Government announced that Public Health England (PHE) is to be replaced by a new organisation – the National Institute for Health Protection (NIHP). The NIHP will start work immediately and will focus on public health protection and dealing with the next phase of the country’s response to the COVID-19 pandemic. The announcement of major changes to the English public health system has been met across the sector with a degree of incredulity (at the timing, mid-pandemic) and concern (at the implications for system accountability for health improvement and health inequalities). Leading sector organisations have called on the Government to ensure that the vital HIV, sexual health and reproductive health surveillance, policy and prevention work driven by PHE continues so that progress to date in reversing inequalities in sexual health, reproductive health and HIV care is not lost. See how key organisations have responded in the policy section below.
Last week the All-Party Parliamentary Group on Sexual and Reproductive Health (APPGSRH) published the findings of its Inquiry into Access to Contraception in England. In this month’s eFeature Dame Diana Johnson, MP and Co-Chair of the APPGSRH, discusses the Inquiry’s report - Women’s Lives, Women’s Rights: Strengthening Access to Contraception Beyond the Covid-19 Pandemic - and the key recommendations the cross-party group of Parliamentarians have made to rebuild and reshape contraceptive services to ensure women can fulfil their reproductive choices and look after their reproductive health.
Other items to look out for in the round-up this month include: recently published annual data from PHE showing a 5% increase in the number of STI diagnoses in 2019, and much steeper rises in diagnoses of gonorrhoea and syphilis; a new National Framework for e-Sexual and Reproductive Healthcare to support local commissioning and development of testing and contraceptive services; the launch of NAT’s new Community HIV Testing Toolkits to support the implementation and evaluation of community-based testing as we move back towards face-to-face services and Brook’s Inside Out report examining the disproportionate impact of the pandemic on young people including in accessing sexual health and reproductive health services.
***reminder*****
Brook’s Sexual Health Week started yesterday and will run until 20 September. The focus is supporting schools to deliver inspiring, inclusive RSE with a range of new resources and a live nationwide virtual RSE lesson for schools and colleges. See more below.
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eFeature
The Inquiry report released by the All-Party Parliamentary Group on Sexual and Reproductive Health last week puts the spotlight on how women in England are facing increasing difficulty in accessing contraceptive care, due to a combination of funding cuts and a fragmented commissioning system which creates silos between contraception and other areas of sexual and reproductive health. These access issues have been compounded during the COVID-19 pandemic, with marginalised groups likely to be worst affected. In this month’s eFeature, Dame Diana Johnson DBE, MP for Hull North and Co-Chair of the APPGSRH, discusses the report, outlining some of the challenges to contraception provision before and during the pandemic and highlighting the opportunity to ‘build back better’ to ensure women have access to this essential form of healthcare.
>Read Dame Diana Johnson eFeature
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Policy development and guidance
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National Institute for Health Protection
The Government has created a new organisation to focus on public health protection and to deal with the challenges of COVID-19. The health protection functions of PHE will merge with NHS Test and Trace and the Joint Biosecurity Centre (JBC) to create the National Institute for Health Protection (NIHP), under the interim leadership of Baroness Dido Harding. The NIHP will start work immediately but will be formalised and operational by Spring 2021. PHE’s work will continue as the NIHP is formed and the Department for Health and Social Care (DHSC) has indicated it will be publishing a policy paper in September setting out the next steps on PHE’s non-health protection functions. Sexual and reproductive health organisations have called on government to engage with the sector and to clarify how PHE’s other vital health surveillance, prevention and improvement responsibilities will be delivered across government and how they will be adequately funded.
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National Framework for e-Sexual and Reproductive Healthcare
PHE has developed and procured the National Framework for e-Sexual and Reproductive Healthcare as a response to the COVID-19 pandemic to support local commissioning and development of services. The Framework offers local authorities and the NHS a convenient, efficient and cost-effective method for contracting with suppliers of e-sexual and reproductive health services. Brook, Preventx, and SH:24 have been appointed as providers on the Framework and will deliver self-sampling for HIV and STIs and contraception services to a pre-agreed specification, terms and conditions and published price list.
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Access to Contraception Inquiry report
The All-Party Parliamentary Group on Sexual and Reproductive Health (APPGSRH) has published its inquiry report on access to contraception in England. Women’s Lives, Women’s Rights: Strengthening Access to Contraception Beyond the Covid-19 Pandemic illustrates the significant barriers that exist for women and girls when accessing contraception. The APPGSRH calls for a rebuilding of services after the pandemic and makes a series of recommendations including renewed funding for contraceptive services to meet population need, a re-evaluation of the current fragmented commissioning system, proper funding of LARC provision in Primary Care and the collection of data to understand women’s needs and experiences when they access contraception.
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Workforce burnout and resilience in the NHS and social care inquiry
The Health and Social Care Select Committee inquiry on workforce burnout across the NHS and social care is examining the increased pressures brought by COVID-19 and the resilience of services to cope with high levels of staff stress. FSRH's submission to the inquiry draws on member surveys to illustrate the ways in which the pandemic has had a detrimental impact on the SRH workforce and provision of services. The Inquiry is accepting evidence until 30 October 2020.
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Service standards & guidelines
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The response to COVID-19 is evolving and guidance from key professional organisations may change as new information becomes available. Below are links to regularly updated COVID-19 guidance and resources.
>FSRH
>BASHH
>BHIVA
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Planning for LARC Procedures following the publication of the NICE COVID-19 rapid guideline
The Faculty of Sexual Health & Reproductive Healthcare (FSRH) has issued latest guidance on planning for LARC Procedures following the publication of the NICE COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services. The FSRH guidance is for clinicians working in community settings to ensure SRH practice is adapted to minimise risks associated with COVID-19.
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Key Principles for Intimate Clinical Assessments Undertaken Remotely in Response to COVID-19
This guide, authored by NHS England and NHS Improvement and endorsed by FSRH, focuses on how to safely manage the receipt, storage and use of intimate images taken by patients for clinical purposes. It is aimed at clinicians consulting remotely through a digital channel (e.g. online, email, text, video-link) across healthcare settings.
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Teletriage for Sexual and Reproductive Healthcare Services in response to COVID-19
The British Association for Sexual Health and HIV (BASHH) and FSRH, in collaboration with PHE and Brook, have published a suite of documents to support services to deliver high-quality, safe SRH care remotely. The documents provide tips for setting up or expanding telehealth / telemedicine SRH services, how best to mitigate risk, how to prioritise vulnerable groups, and when to escalate. They are aimed at clinical leads, safeguarding leads, healthcare practitioners and managers assessing the continued use of teletriage for SRH services.
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Tools and resources for understanding impact of service changes during COVID-19
PHE and Central North West London (CNWL) have worked collaboratively to develop a suite of resources to help local areas understand the impact of COVID-19 on SH and SRH services and to inform recovery plans. These include a specialist sexual health service (SSHS) rapid evaluation tool, sample service user and healthcare staff questionnaires and practice examples of how SH and SRH services have adapted during COVID-19.
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BHIVA COVID-19 interim adult antiretroviral guidance
BHIVA has now updated this guidance replacing the earlier version released in May 2020.
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BHIVA/BIA guidelines on the management of opportunistic infection in people living with HIV: The clinical management of gastrointestinal opportunistic infections 2020
The previous BHIVA/British Infection Association (BIA) guidelines for the treatment of opportunistic infection 2011 are being updated chapter by chapter using the same general methodology. This chapter provides guidance on the clinical management of GI opportunistic infection.
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NICE Quality Standard for community pharmacies
This newly published quality standard from NICE covers how community pharmacies can support the health and wellbeing of the local population. It describes high-quality care in priority areas for improvement. This quality standard was developed before the coronavirus pandemic and is intended to support quality improvement as services return to normal.
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NICE draft Quality Standard on abortion care
NICE has also opened a consultation on potential quality improvement areas for abortion care. The consultation on the draft quality standard closes on 21 September 2020.
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BBVs in healthcare workers: health clearance and management guidance
The UK Advisory Panel for Healthcare Workers Infected with Bloodborne Viruses (UKAP) has updated integrated guidance on health clearance of healthcare workers and the management of healthcare workers living with bloodborne viruses (hepatitis B, hepatitis C and HIV).
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National PGD templates for reproductive health and sexual health
FSRH, BASHH and BHIVA have been working with the Specialist Pharmacy Service (SPS) and other specialist stakeholders to produce national Patient Group Direction (PGD) templates for medicines commonly used within reproductive and sexual health services. The templates are aligned with current national guidance and it is hoped that they will save time and significantly reduce workload of commissioners and services by avoiding unnecessary duplication of work across the country. The PGD templates will need to be authorised for use within the local service and can be adapted to reflect local policies, commissioning arrangements if necessary. Click the link to see the updated list of templates.
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Evidence, data & research
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STIs and screening for chlamydia in England, 2019
PHE has published 2019 data for sexually transmitted infections and screening for chlamydia in England. The annual data shows an overall 5% increase in the number of STI diagnoses in 2019, with more significant increases in gonorrhoea (26%) and syphilis (10%) diagnoses. The rise in the number of infections is also accompanied by continued increases in demand for access to sexual health services. The number of consultations at sexual health services rose by a further 7% between 2018 and 2019. Sector organisations have emphasised the need for urgent action including taking forward plans for a new national sexual health strategy to start tackling these year-on-year increases.
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Abortion statistics for England and Wales during the COVID-19 pandemic
The Department of Health and Social Care (DHSC) has published new statistics on the number of abortions in the first half of 2020, showing that the introduction of telemedical abortion services has enabled women to undergo abortion at the earliest gestations. Between January to June 2020, 86% of abortions were performed at under 10 weeks, compared with 81% during the same period in 2019. Almost 50% of abortions were performed before 7 weeks gestation from January to June 2020, compared to almost 40% for the same period in 2019. FSRH and RCOG, alongside abortion providers, say that the recent statistics show that access to abortion has been not only maintained but improved through the innovative use of telemedicine.
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NATSAL: National Study of Health and Relationships during COVID-19
The National Survey of Sexual Attitudes and Lifestyles (NATSAL) team has launched an online general population survey to capture the initial impact of COVID-19 on sexual and reproductive health in Britain. The survey of 6000 participants aged 18-59 will focus on whether and how sexual practices have changed, unmet need for SRH services and sexual and relational difficulties. The survey is part of the wider NATSAL study and is being led by University of Glasgow and University College London (UCL), in partnership with London School Hygiene and Tropical Medicine (LSHTM).
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HIV Lens
A reminder that NAM aidsmap has launched a new online interactive mapping tool that visualises the impact of the HIV epidemic on communities across England. The project is in partnership with Watipa and Gilead Sciences Ltd and uses the latest HIV surveillance data from PHE.
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Reports & other resources
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New Community HIV Testing Toolkits
National AIDS Trust (NAT) has published two new resources on community HIV testing. The Community HIV Testing: Intervention Design Toolkit explores key questions to consider when designing and delivering community testing interventions in England and is aimed at community testing providers (CTPs), commissioners and NHS-led sexual health services. The Community HIV Testing: Evaluation Toolkit aims to support the evaluation of community testing interventions.
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Addressing health-related quality of life among older people living with HIV
This briefing from HIV Scotland brings together the voices of communities, healthcare, and the public and voluntary sector to collaboratively discuss the major challenges to quality of life experienced by older adults living with HIV.
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Responding to HIV care challenges presented by COVID-19
This paper from the British Psychological Society looks at the potential psychological impacts of COVID-19 for people living with HIV, on their receipt of healthcare and on the services which deliver that care.
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NAT briefings on impact of COVID-19
NAT has published a series of briefings looking at the impact of COVID-19 on the HIV sector. The most recent briefing looks at considerations for resuming face-to-face HIV support services. Click the link to access this and previous briefings.
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BMA report on menopause challenges for doctors
The BMA has published a report on the challenges faced by doctors working through the menopause and the changes needed to make it easier for doctors to manage their symptoms at work. A group of leading health organisations, including The British Menopause Society (BMS), Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of General Practitioners (RCGP) and FSRH have issued a Position Statement in response to the report highlighting the urgent to raise menopause awareness among all mangers and staff, including the NHS and making a number of additional recommendations for supporting doctors and others during the menopause.
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New Report on Young People and COVID-19
Brook, in partnership with the National Youth Agency, have published Inside Out - Young People's Health and Wellbeing: a response to COVID-19. The report examines the disproportionate impact of the pandemic on young people including access to sexual health and reproductive health services. It offers a series of recommendations on how young people can be better supported in response to COVID-19.
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RSE for disabled pupils and pupils with special educational needs
This short guide produced by the Sex Education Forum (SEF), in partnership with Image in Action and Mencap, is designed as a starting point for schools wanting to review their RSE provision for disabled pupils and those with special educational needs (SEND) to ensure accessibility and quality. It includes answers to frequently asked questions, practical top tips and provides signposting to further resources.
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Get yourself in Gear! SHW 14-20 September
Brook’s Sexual Health Week is now in full swing! Tomorrow (Weds 16 Sept) Brook will be hosting a live nationwide virtual RSE lesson aimed at young people in Year 9 and above. Click on the link to get more information about the week, see the schedule of events and to access resources, including a social media toolkit.
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PHE Reproductive Health, Sexual Health and HIV Innovation Fund 2020-21
A reminder that applications for funding from PHE's Reproductive Health, Sexual Health and HIV Innovation Fund 2020/21 can still be made until 18 September 2020. This year PHE are encouraging applications for projects that focus specifically on Black and Minority Ethnic (BAME) communities. Proposals will be accepted from voluntary sector organisations to deliver projects of up to 12 months in duration of a cost of between £25,000 and £75,000.
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The Sexual Health & HIV Policy eBulletin was originally developed and published by MEDFASH.
It continues to be compiled and edited by Helen Christophers on behalf of FSRH and coalition partners. If you have any comments on the eBulletin or eFeature or suggestions for topics you would like to see covered in future eFeatures please get in touch (ebulletineditor@fsrh.org).
You can access previous eBulletins and eFeatures via the links below:
> eBulletin archive (MEDFASH) > eFeature archive (MEDFASH/FSRH)
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FSRH and coalition partners do not accept responsibility for the content of linked websites/items included in this eBulletin and do not necessarily endorse the views expressed within them.
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