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““Sexual Health In The UK Sexual Health In The UK Protecting Our Future”Protecting Our Future”
Barry Sheerman MPBarry Sheerman MPChairman of the EducationChairman of the Education
And Skills Select CommitteeAnd Skills Select Committee
House of Commons - Thursday 3rd March 2005
““Sexual Health In The UK Sexual Health In The UK Protecting Our Future”Protecting Our Future”
Dr Alison BigriggDr Alison BigriggPresident FFPRHCPresident FFPRHC
“Sexual Health In The UK - Protecting Our Future”
11,000 medical members:• All the consultants in family planning and reproductive health• About 8,000 GPs• Specialists in obstetrics & gynaecology, GUM and Public Health• Associate nursing members
Within our specialist field the Faculty:• Sets standards• Provides training an education programmes• Promotes research and evidence based practise• Represents the interests of our members
Core Principles:• Informed choice• Personalisation• Working together
Faculty of Family Planning & Reproductive Health Care (FFPRHC)
“Sexual Health In The UK - Protecting Our Future”
Current situation of the UK
White Paper - Funding:
• No funding was announced with The White Paper
• But the Department of Health has secured £300 million for sexual health
Will this be used solely to cut waiting times in acute services?
What about investment in community services keen to follow principles of The White Paper?
“Sexual Health In The UK - Protecting Our Future”
In November 2004 a Survey was conducted amongst 2750 clinicians:
• GPs• Nurses• Obstetricians and Gynaecologists• Consultants in Family Planning and
Reproductive Health
FFPRHCSurvey Report
2005
(Conducted by TNS)
The aim was to assess current investment, practice and service levels across the country in the area of family planning and reproductive health care
“Sexual Health In The UK - Protecting Our Future”
The survey looked at key areas:
• Investment in family planning services by PCTs
• Access to contraception
• Abortion
• Quality of contraception services
“Sexual Health In The UK - Protecting Our Future”
84%Say NO
Investment in Family Planning Services by PCTs
84% of GPs reported NO additional resources or a reduction in level of resource in last year
DESPITE+ increased demand+ increased costs + National Sexual Health Strategy
BUT
Nearly 90% of all those questioned believed greater investment in community contraceptive & sexual health services is required to improve the UK’s reproductive health statistics
“Sexual Health In The UK - Protecting Our Future”
• Less than 5% of PCTs have seen strong investment in this area in the past year
• Of those who reported a decrease in funding nearly 50% said this had led to fewer clinic sites or numbers
• 34% said there are longer waits for appointments
• 20% said they have turned clients away from open access clinics due to overwhelming demand
Investment in Family Planning Services
“Sexual Health In The UK - Protecting Our Future”
Nearly all respondents supported the principle that people should have a choice as to where to go for sexual and reproductive health care:
• 97% GPs• 100% Nurses• 94% Obstetricians and Gynaecologists• 98% Consultants in Family Planning and Reproductive
Health Care
Over 90% believe PCTs should offer open access or walk-in clinics
Access to Contraception
“Sexual Health In The UK - Protecting Our Future”
Investment in Family Planning Services
“Sexual Health In The UK - Protecting Our Future”
In theory, contraception has been freeat point of delivery in UK for over 30 years: • Up to 30% of PCTs now restrict access to some forms of
contraception
• Methods most commonly restricted are new methods and long acting reversible methods
Availability of Contraception
e.g. 1/3 of GPs and 2/3 hospital specialists reported restricted access to contraceptive implants
“Sexual Health In The UK - Protecting Our Future”
ImplantOral
Contraceptive PillCondoms
1 year continuation
82% 40% 52%
2 year continuation
64% 34% 42%
Urban teens using Implant, pills or condoms (Darney et al Am J O & G 1999)
“Sexual Health In The UK - Protecting Our Future”
Urban teens using Implant, pills or condoms (Darney et al Am J O & G 1999)
ImplantOral
Contraceptive PillCondoms
1 year continuation
82% 40% 52%
2 year continuation
64% 34% 42%
Pregnancies None 30% 33%
“Sexual Health In The UK - Protecting Our Future”
• 80% agree with the distribution of condoms to young people as part of the strategy to combat the UK’s high sexually transmitted infection rate
BUT• 30% of GPs admit condom provision is restricted
Availability of contraception
“Sexual Health In The UK - Protecting Our Future”
• Restrictions have major consequences for individuals and society
• All forms of contraception are extremely cost effective
health interventions
Restricted access to end availability of contraceptive methods
Why are they being rationed?
“Sexual Health In The UK - Protecting Our Future”
• 76% of GPs say there is variation in access to abortion services depending on where you live
• 30% said it was common for a woman to travel outside the area because of inadequate local provision
• More than 99% of clinicians believe that a choice between medical and surgical abortion is important for women
• The majority of doctors believe:• Community clinics should play a greater role in provision
of abortion services• Nurses should be allowed a greater role in providing
TOP services
Abortion services
“Sexual Health In The UK - Protecting Our Future”
Our survey shows:
• Current services are sub-optimal and in some areas of the country not ‘fit for purpose’
• New ways of working would improve services throughout the UK
Abortion services
“Sexual Health In The UK - Protecting Our Future”
45% of nurses and 40% of GPs thought that there was inadequate availability of training locally
Recommended consultation time for a new patient is 20 minutes – only half of nurses and less than a quarter of GPs surveyed can currently offer this 0
51015202530354045
Nurses GPs
45% 40%
Quality of contraception services
“Sexual Health In The UK - Protecting Our Future”
Our survey provides evidence of lack of investment in contraceptive and abortion services leading to:
• Loss of clinic sites and numbers• Longer waiting times for appointments• Clients being turned away from walk-in services• Restricted access to effective contraceptive methods• Post code lottery in abortion services
“Sexual Health In The UK - Protecting Our Future”
The survey also shows clinicians want the Department of Health to have a stronger involvement in ensuring our
‘‘Cinderella Specialty’Cinderella Specialty’
is treated fairly for the sake of all women and men who use it
“Sexual Health In The UK - Protecting Our Future”
Why has this happened?• Over the past three generations women’s lives have
been transformed by contraception
• Women now vital to the economy
• Women no longer have to campaign - have access to all forms of contraception and abortion services
BUT
Summary
Are we taking for granted the services that make it all possible?
“Sexual Health In The UK - Protecting Our Future”
• Fully supports The White Paper and the Department of Health plans to do its own survey of PCT Chief Executives
• Is keen to work with the Department of Health to ensure investment goes into community and primary care services
• Recognises that clinical services alone will not solve the rising number of STIs or teenage pregnancies, but they are a vital component
The Faculty …
“Sexual Health In The UK - Protecting Our Future”
““Sexual Health In The UK Sexual Health In The UK Protecting Our Future”Protecting Our Future”