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Sexual Health Developing the role of Primary Care using PBC

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Sexual Health Developing the role of Primary Care using PBC
Sexual Health
Developing the role of
Primary Care
using PBC
Health Needs Analysis - Key Points
• Ten wards in Birmingham have high levels of sexual
health problems – eight in HoB
• High levels of unwanted and teenage pregnancy and
repeat terminations
• High levels of all STIs
• Problems meeting chlamydia screening targets
• Over reliance on specialist services for routine
contraception and STI
• Young people not accessing services
• Long acting reversible methods of contraception (LARC)
not widely available
• Late presentation of HIV in Soho and Ladywood
Ward
IMD
Teen
Concept
ion Rate
per 1000
women
aged 1517
TOP
Rate
women
per 1000
women
aged 1544
BME
>50%
No of
FPCs
in
ward
seeing
>6
people
per
session
?
HIV
Rate
Chlamydia
Infection
Rate per
1000
population
aged 15-44
Gonorrhoea
Infection
Rate per
1000
population
aged 15-44
Priority
Heart of Birmingham Teaching PCT
Aston
60.81
70.4
37.0
Yes
0
High
6.8
3.2
Highest
Handsworth (now Lozells & East
Sandwell)
53.42
47.6
39.3
Yes
1
High
6.45
2.84
Highest
Ladywood
50.86
94.2
30.0
Yes
1*
V High
6.73
3.09
Highest
Nechells
55.99
55.2
28.5
Yes
0
Low
4.1
2.37
Highest
Perry Bar
20.21
29.5
19.7
No
0
Low
2.62
0.47
Lower
Sandwell (now Handsworth Wood)
34.58
36.4
23.7
Yes
0
High
4.63
1.8
Highest
Small Heath
50.07
31.6
16.2
Yes
0
Low
2.26
1.07
Medium
Soho
57.54
65.3
38.3
Yes
1
V High
7.54
4.27
Highest
Sparkbrook
61.76
48.7
21.9
Yes
3
Average
3.34
1.22
Higher
Sparkhill
46.34
29
20.2
Yes
1
High
1.64
0.91
Medium
Local Issues
• Small single handed practices – few female GPs
• Cultural sensitivities (especially for women)
• Good local training schemes but difficult for primary care
staff to find time to attend
• Limited engagement with the chlamydia screening
programme
• Community providers swamped by routine work
• No integration between GUM and RSH
Approach
• Radical change of approach needed to tackle major
issues with existing system
• Pan Birmingham Strategy in line with national guidance
• Consultation with local community through specially
designed campaign and events
• In HoB - PBC is leading on developing services in
primary care – consultation through local GP meetings
City Wide Strategy
• Plurality of providers and services available for
uncomplicated needs (primary and community care)
• Holistic integrated services at all levels – ideally one stop
consultation
• Improve accessibility – especially for young people –
times and venues
• Strengthen role of specialist services in supporting
Levels 1 and 2
Level 1 – Funded through PBC
Local Enhanced Service to support practices to:
– engage with SHIP training
– adopt You’re Welcome quality standards
– routinely risk assess patients and treat accordingly
– increase targeted chlamydia testing
– normalise HIV testing
– improve recording
LES for contraceptive implants (and improved training
provision) to help improve access to long acting
reversible contraception (LARC)
Level 2 Locality Centres
• Integrated (not just co-located) services from any
willing provider (GP, HoB provider or third sector)
• Each centre sited in accessible community location to
provide Level 2 services with failsafe for Level 1
• Shared Community Health Advisors to support contact
tracing
• Specification to cover range of services, staff
competencies, and accessibility (particularly for young
people)
Training
Increase the skills of people working in primary care and in
the community to deliver integrated sexual health services
– Co-ordination between SHIP and BRASH to cover
primary and community care staff – risk assessment
approach
– Establish training database to allow monitoring of
workforce development
– Increase access to practical training for both GUM
(STIF) and contraception (DFRSH)
– Create clinical network and community of practice for
local healthcare professionals
Level 3 (specialist)
• Reorganise and rationalise existing family planning
services to move towards integrated provision of
specialist services – discharge of Level 1 to primary
care
• Concentrate services at City Centre Hub (build on
success at Boots) with outreach where appropriate
for vulnerable groups
• Build role for both GUM and RSH in signposting to
and supporting Level 1 and 2 providers (training and
advice)
Any questions?
[email protected]
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