GPs are not giving a universally good enough service for sexual health, according to a national report reviewing England’s performance in this area.
Progress and priorities – working together for high quality sexual health is a review that looks at what impact the National Strategy for Sexual Health and HIV has had so far, what has been achieved and what key barriers are still there preventing more success.
The review, funded by the Department of Health, of the 10-year strategy launched in 2001, says considerable progress has been made with many of the strategy’s commitments achieved, and improvements made in the sexual health of the population and in service provision.
Successes since 2001, include:
- falling teenage pregnancy rates
- improvements in access to NHS-funded abortions
- transformed genitourinary medicine services with significantly improved access to testing and treatment
- introduction of chlamydia screening in every PCT across the country.
However, although there are more modern, integrated services, services are still patchy, says the report, caused by many factors such as constant policy reform since 2001 and the burden of financial deficits.
The report was produced for the Independent Advisory Group on Sexual and HIV by the Medical Foundation for AIDS & Sexual Health (MedFASH).
Key barriers that have held the strategy back from succeeding further include national targets and indicators that include only some elements of sexual health, and diversion of sexual health funds and top slicing to meet PCT deficits.
There has also been variable progress in engaging GPs in providing sexual health services, says the report, continued disinvestment in community contraceptive clinics, and competition and conflict between primary care, community and hospital-based services.
The result is that there are increasing diagnoses of HIV and sexually transmitted infections (STIs), and growing demand for abortions.
Among its many recommendations, the report says that sexual health should be included in the future development of the Quality and Outcomes Framework (QOF) for GPs and there should be an increase in the level and quality of services provided by general practice.
Ruth Lowbury, Executive Director of MEDFASH and co-author of the report, said: “There are examples of really wonderful practice by family doctors.
“But there are some GPs, we have heard, who haven't really been interested in engaging with sexual health. We clearly need to provide a mechanism to put in place improvements across the board, rather than the patchy situation we have at the moment.”
Professor Steve Field, Chairman of the RCGP, said: “Sexual health, in its broadest sense, is a central part of a GP’s job. Part of the problem is the link between generalist services and specialist services – that is patchy.
“Services would be better if the commissioning took into account a much more integrated approach between GPs and specialists.
“The report highlights some deficiencies which I am sure GPs will reflect on, but I don’t see this as a criticism of general practice."