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ENHANCING SEXUAL WELLBEING IN SCOTLAND - A SEXUAL HEALTH AND RELATIONSHIPS STRATEGY: Analysis of Written Responses to the Public Consultation
CHAPTER 14: CLINICAL SERVICE TARGETS FOR SEXUALLY TRANSMITTED INFECTIONS
NHS Boards, through the local managed sexual health networks, should ensure the local adoption of the interim national clinical service targets set to address STIs including HIV |
14.1 Many of the Individual and Faith Group responses noted that the only way to reduce STIs is to promote the idea of sexual activity being delayed until in a stable relationship - preferably marriage.
14.2 Specific clinical service targets were generally discussed by Health Professionals and were broadly supported. The key points to note are that some professionals believed that the targets should be flexible to reflect issues in different areas and the timescales be more realistic as they are currently too tight. Conversely, others thought that some of the targets were too weak and that deadlines could be brought forward.
"Many outcomes will improve slowly - this must be accepted and acknowledged" (Medical Health)
"We would recommend that the development of standards is not restricted to clinical issues. Our research with young people has shown the importance of confidentiality, accessibility to services and the service environment to users and we would encourage their addition to the areas in which services should develop standards." (Education and Young People)
14.3 It was noted that some of the targets need further consideration and discussion between the Scottish Executive and representatives of Health Professionals. There is a need for specific dates by which these targets should be achieved and a clear indication of which of the large number of interim targets should be prioritised. Particular targets of concern are:
Some Medical Health respondents thought that the recommendation that boards take 18 months to review current Chlamydia test levels is far too weak. They recommend a national target for uptake of Chlamydia testing as a proportion of the population under 25 and this should be increased at intervals as part of a national screening programme. Boards who fail to meet this would then be required to demonstrate how they will respond in their annual reports.
In relation to the targets for treatment and partner notification for Chlamydia and gonorrhoea, timing "from patient receipt of results" was considered weak by one Medical Health respondent who suggested a more stringent target of 4 weeks "from taking a specimen".
Another specific issue relating to Chlamydia was that the interim targets should be more specific - e.g. targeting specific groups such as women aged under 25 years attending for antenatal care."
A few respondents suggested that HIV testing targets should relate to the proportion offered, rather than the proportion accepted.
NHS Boards should support the role of Tiers Four and Five in providing a leadership role, and developing and implementing service standards across the tiered service approach through protected time/training resources |
14.4 This was supported but there were concerns about whether adequate resources would be forthcoming.
NHS Boards should identify the impact on laboratory resources in meeting the clinical service targets. The Scottish Executive should consider proposals for additional laboratory resources that result from the Boards' reviews |
14.5 This was supported by the Medical Health respondents who commented and it was particularly noted that the impact of postal testing on laboratory resources would need to be assessed.
Lead Clinicians should ensure targets for service accessibility, for example, local knowledge, acceptability and use of services, and involvement of patients in service redesign are developed. Improving gender sensitivity and gender competency is a key aspect of this responsibility |
14.6 Again, there were concerns from Medical Health respondents about resources for this and it was noted that there were particular difficulties in rural areas.
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