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Comprehensive Sexual Heath Needs Assessment Wakefield 2007

Comprehensive Sexual Heath Needs Assessment Wakefield 2007. By Design Options for NHS Wakefield District/YHSHA. Evidence for the Report. Key documents and strategies Interviews with key informants (commissioners, providers, patients, service users, etc)

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Comprehensive Sexual Heath Needs Assessment Wakefield 2007

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  1. Comprehensive Sexual Heath Needs Assessment Wakefield 2007 By Design Options for NHS Wakefield District/YHSHA

  2. Evidence for the Report • Key documents and strategies • Interviews with key informants (commissioners, providers, patients, service users, etc) • Stakeholder workshop (September 2007) • Workshops with high risk groups • Service mapping exercise (availability and configuration) • Local epidemiology

  3. Local epidemiology (1) • STI infection rates increased by 41% between 2000 and 2005 • STIs in under 19s accounted for 27% of the diagnoses in 2005 • Chlamydia infection rates increased by 116% between 2000 and 2005 • Gonorrhoea infection rates increased by 56% in women between 2000 and 2005 • Syphilis infection rates increased gradually in MSM between 2004 and 2006

  4. Local epidemiology (2) • Herpes Simplex Virus(Herpes) infection rates are increasing significantly in under 19s, under 25s and men over 45 • Human Papilloma Virus (Genital warts) infection rates increased by 67% in women between 2000 and 2007 and by 60% for men over 35 • HIV diagnoses increased by 234% between 2002 and 2006 • Wakefield was not meeting the local targets for teenage pregnancy rates (Under 16s and 18s)

  5. Service demand • The GUM Clinic had met the “offered within 48 hours” target but not the “seen within 48 hours” target (by the time of printing the report) • Data collection in contraception services did not reflect the full range of work (e.g. training, STI diagnosis and treatment, tertiary referrals etc) • No abortion or termination of pregnancy services in the district. Services are available only at Marie Stoopes (Leeds) and BPAS (Doncaster)

  6. Vulnerable/At Risk Groups (1) • Geographical inequality and access (physical isolation, absolute/relative poverty, cultural factors, stigma around sexual health and identity in the older mining communities, etc) • Young people • Looked after children • Asylum seekers and failed asylum seekers • Non-asylum seeking immigrants • Other black and ethnic minority communities

  7. Vulnerable/At Risk Groups (2) • Prisoners • Men who have sex with men (MSM) • Sex workers • Substance users • Mental health

  8. Sexual health services in Wakefield (1) • One single consultant GUM Clinic at Clayton Hospital (Josephine Butler Centre for Sexual Health) and no GUM Clinic in Pontefract • A limited number and variety of venues for the Chlamydia Screening Programme • Uneven distribution of contraceptive and sexual health services was a major barrier for access • No local termination of pregnancy service

  9. Sexual health services in Wakefield (2) • No dedicated services for sex workers • Little sexual health service provision by school nurses/health services • Inadequate provision of sexual health services in primary care and community pharmacies • Terrence Higgins Trust (THT)/Brook and other local agencies provided community based sexual health advice and testing services

  10. Gaps and needs (1) • Summary of sexual health needs • Rising rates of STIs (excluding HIV) • Relatively high numbers of individuals presenting with late diagnoses of HIV • Strategic issues • Service integration at strategic and operational levels • User engagement in service development • Information Management • Service specifications • Human resources and skill mix • Innovation in service development

  11. Gaps and needs (2) • Service Model • Integration of contraception, GUM, general practice and other primary care services • Geographical distribution of community contraception services and GUM services • Sexual health provision within general practice • Community contraception services (CASH) • Information technology (IT) development • Pharmacy venues • Specialist services • School nursing and community health services

  12. Operational issues (1) • Awareness raising • Health promotion (limited advice and information, etc) • Sexual and Relationship Education (SRE) Strategy • Access • Opening hours and Walk-in services (limited) • Booking system (no centralized booking system, etc) • Service experience • Service experience (transport, parking, location, etc)  • Targeted services (high risk groups) • Barriers to access for young people (including disengaged young people)

  13. Operational issues (2) • Service experience (Cont’d) • MSM (bisexuals) • Service provision for sex workers (no dedicated service) • Barriers to access for ethnic minorities (attitudes, cultural values, obstructive gate keeping, etc) • Barriers to access for refugees and asylum seekers (attitude, cultural values, language, etc0) • Sexual health in prisons • Care pathways for victims of sexual assault • Local services that are easily accessed by drugs and substance users

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