Agenda item

(To receive a report by Carol Skye, Health Protection Programme Manager, which provides the Committee with an update on the role of Lincolnshire Community Health Services NHS Trust (LCHS) in providing sexual health services on behalf of the County Council)

Consideration was given to a report which provided an update on the role of Lincolnshire Community Health Services NHS Trust (LCHS) in providing sexual health services on behalf of Lincolnshire County Council.

It was reported that the responsibility for sexual health services passed to the local authority in 2012 under the Health and Social Care Act, and it was one of several public health services that the Council was now responsible for.

Lincolnshire benefitted from what was classed as an integrated sexual health service which included most day to day service delivery.  Most of the services were available in most of the clinics most of the time. 

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         One member commented that they had heard about a tablet which was available in London and the southern counties that could prevent someone from getting HIV and could also prevent it from spreading.  It was confirmed that this was known as PrEP (Pre-Exposure Prophylaxis).

·         It was commented that Lincolnshire services were quite well performing when compared with other comparable areas and outperformed a range of comparator counties on a range of different measures.

·         The indicators measured the number of people who were screened but officers also had an interest in whether the right people were being screened and targeted.

·         It was queried how the service effectively connected with the under 21 age range, and members were pleased to see that social media was used.  Members were advised that sexual health education would be mandatory in schools again from 2020, and the County Council would offer help schools to prepare for this.  It was noted that there was some evidence that the current generation of young people were much better behaved than some of the other previous generations, in terms of drinking less alcohol, smoking less and had better sexual health.  The amount of conversations that took place on anonymous social media/internet platforms also seemed to help.

·         Young people had been involved in the co-development of services and market testing marketing materials for young people.  There had also been work to look at what people felt they needed and there was also work taking place around developing a digital service.

·         The approach was to try and find as many opportunities to offer a service as possible.

·         It was queried what the difference between a flyby clinic and pop up clinic was.  Members were advised that a pop up clinic would be delivered by request, for example in a GP surgery.  Fly by clinics were for those young people who did not want to answer a lot of personal questions, and they could just attend the clinic, have the test and go.

·         It was noted that the clinic map was not an exhaustive list, and there were possibly another 10-12 clinics and were not included as they may have been experimental to see if it would work in that area.

·         The clinic in Monks Road, Lincoln had been open for 3 months, and initial indications were that it was working well, but more data would be available in the coming months.

·         Any patient from anywhere could attend any clinic.  Data was showing that there was a number of people using clinics around the edges of the county, many were doing this for economic reasons.  It was being looked into whether if there were lots of people from Stamford visiting a clinic in Peterborough, then a clinic in Stamford may be successful.

·         It was queried how the re-procurement of the laboratory services was progressing.

·         There had been a lot of success with neighbouring authorities who had been asked to promote LISH (Lincolnshire Integrated Sexual Health) services in their clinics, and an offer had been received to set up a clinic in Grimsby.

·         Concerns were raised for those young people who lived in very rural areas.  It was reported that the mobile unit now had clinical areas and so had to work closely with infection control team, but it was now fit for purpose and ready to come back into use.  It was also noted that the service had been remodelled and was going through a consultation.  Some members of staff had been lost and so the team had been working with a limited number of staff.  Getting into the hard to reach areas had been a challenge, but it was hoped to work up to visits four times per week.  There had been a lot of interest, but the team's ability to meet these requests had been limited due to numbers of staff and drivers.

·         Online screening had been increased as part of the reorganisation of the model.  There was also now a marketing officer to get the message out which it was hoped would make a big difference in rural areas.

·         It was noted that one of the difficulties was that the majority of young people would get transport into and out of school so there was little time to access these services.

·         There had not been many secondary schools that had been willing to bring these services into schools, as there had been some resistance.  It was highlighted that it had always been difficult to do practical sexual health education in schools due to the diversity of parents' beliefs.

·         It was noted that of 50 secondary schools, the service had engaged with 25 to attend training sessions with LISH.

·         It was queried how the County Council monitored the areas for improvement.  Members were advised that this was mainly managed by contract management processes.  There were formal meetings every three months and informal meetings every month.  There was also an annual review.

·         It was commented that 2020 could be significant in terms of sexual health education again becoming mandatory.  Privacy was paramount for this whole conversation.  It was suggested that going back into schools and having an online presence would be a much more proactive approach.  It was also commented that the website and social media needed to be done in a simple way.

·         It was highlighted that one issue that came later in life was the need for relationship guidance after divorce.  It was noted that Relate was the primary relationship guidance organisation used by the service.

·         In recent years, one of the biggest risk areas was the divorced 40+ year olds who were going back into new relationships.

·         Part of the website would include a section for professionals and a section for parents, and a big part of that would focus on how to talk to their children about these issues.

·         It was noted that often one of the weak areas around sexual health and relationships was the relationship aspect.

·         It was highlighted that a lot of teachers did not feel fully qualified to teach sexual health and relationship education, but the introduction of the training for teachers was positive so that they were able to talk to young people about these things.  However, it was suggested it would be better if it was a specialised team going into to schools, but it was understood that this was not always possible in the financial climate.  It was noted that there was an evidence base which showed that young people did respond well to external persons.  

·         It was highlighted that children lived in an open society and it was positive if they were asking questions around this subject.

·         Biology was the easy aspect to find out about and teach, it was the relationship parts, self-esteem and managing themselves and their sexual health and relationships which was more difficult to teach.

·         There was also a need to be aware of potential mental health issues for young people when things went wrong and how that could impact them.

RESOLVED

            That the role of Lincolnshire Community Health Services NHS Trust and their provision of sexual health services in Lincolnshire County Council be noted.