NATIONAL SEXUAL HEALTH ADVISORY COMMITTEE
Minutes of the Fifth Meeting held on Monday 23 October 2006 Committee Room 1, Victoria Quay
Attendees:
Chair: Mr Andy Kerr, Minister for Health and Community Care
Vice Chair: Mr David L Pattison, Medical Directorate, SEHD, in the absence of Professor Peter Donnelly
Members:
Dr Jenny Bennison, Royal College of General Practitioners (RCGPs), Scotland
Dr Alison Bigrigg, Director, Sandyford Initiative, Glasgow
Hilary Campbell, Chief Executive, Couple Counselling
Alex Davidson, Head of Adult Services, South Lanarkshire Council
Marian Flynn, Strategic Co-ordinator, Glasgow's Teenage Pregnancy Steering Group
Shirley Fraser, Health Improvement Programme Manager, NHS Health Scotland
Miranda Harvey, Parent/Voluntary Director, Scottish Parent/Teacher Council
Roy Kilpatrick, Chief Executive, HIV Scotland
Myra Lamont, Assistant Director of Nursing Services, Sandyford Initiative, Glasgow
Dona Milne, Development Manager, Healthy Respect
Fiona MacKenzie, NHS Chief Executives
Dr Alison McCallum, Director of Public Health, NHS Lothian
Michael McGrath, Director, Scottish Catholic Education Service
Wendy Peacock, Director Manager (Public Health), NHS Tayside, representing Head of Health Promotion Managers Group
Rev Andrew Phillip, Church of Scotland
Jamie Rennie, Chief Executive, LGBT Youth Scotland
Tim Street, Director, Family Planning Association (fpa), Scotland
Dr David Sutherland, Associate, NHS Education for Scotland
Angela Timoney, Chairman, Society's Scottish Executive and Consultant in Pharmaceutical Public Health, Tayside NHS Board.
Dr Daniel Wight, Senior Researcher, Social and Public Health Sciences Unit, Medical Research Council
Dianna Wolfson, Convenor, Scottish Interfaith Council
In attendance:
Gordon Currie, Qualifications, Assessment & Curriculum Division, SEED
Joe Logan, Public Health Division, SEHD
Julie McIlroy, Ministerial Support Team
Cheryl Paris, Public Health Division, SEHD
Item 1: Welcome and Introductions
1. The Minister welcomed members to the fifth meeting of the National Sexual Health Advisory Committee (NSHAC) and in particular to Dr Jim Chalmers, Information Services Division, who formally joined the Committee in place of Professor David Goldberg, Health Protection Scotland. Dr Chalmers will lead the sub-group which is taking forward action 13 on the development of a national data collection framework for sexual health. Professor Goldberg will provide input and support as required.
2. The Minister also welcomed Gordon Currie, who has replaced Katherine Falconer, in the Qualification, Assessment and Curriculum Division within the Education Department.
Item 2: Apologies
3. Apologies were received from:
Mary Allison, NHS Health Scotland
Irene Bain, Scottish Partnership Forum
Dr Nil Banerjee, Consultant in Genito-Urinary Medicine, NHS Fife
Professor Peter Donnelly, Deputy Chief Medical Officer, SEHD
Professor Anna Glasier, Lead Clinician, Sexual Health, NHS Lothian
Shehla Ihsan, REACH Community Health Project, Glasgow
Hawys Kilday, Chief Executive, Caledonia Youth
John Wilkes, Director Equal Opportunities Commission Scotland, who had tendered his resignation. A replacement representative will be sought.
The Group also noted that Lesley McDonald, who represented NHS Board Executive Directors on the Committee had retired and that a replacement representative would be sought. The Minister also informed the members that the Secretariat was still in the process of seeking a replacement for Fraser Sanderson.
Action: Secretariat
Item 3: Note of the Fourth Meeting held on 26 June 2006 (NSHAC (2006) 23)
4. The Minister advised the Members that the note of the fourth meeting had been circulated. The Group noted that there were four actions ongoing:
Officials have written to Ronnie O'Connor, Director of Education Services at Glasgow City Council to seek replacement for Fraser Sanderson;
Education Department officials are in discussion with NHS Health Scotland and other internal stakeholders regarding possible options for the support of teacher training for sex and relationships education;
the issue of training places for the sub-speciality of sexual and reproductive health is still under discussion;
response awaited from a couple of sub-groups on updated NSHAC project initiation plans.
Action: Secretariat
Members were asked for any comments or to raise any issues not already identified on the agenda. No comments were received and the note of the fourth meeting was agreed.
Item 4: Progress on Recommendations for the Scottish Executive and external agencies (NSHAC 2006)24).
5. The Minister asked Joe Logan to update the Group on progress to date with the recommendations for the Scottish Executive and external agencies.
6. Joe made the following points:
· Actions 17 & 18 - Postal Testing Kits - It was agreed at a meeting with members of Healthy Respect, Dr Gordon Scott and Executive officials that a PTK should be created to test for STI's other than Chlamydia, specifically for Gonorrhoea. However, this would not be combined with the existing PTK as this would increase the complexity of the kit and possibly become off putting for users. Members noted that the main potential of the new Kit would be to reduce the pressure on GUM Clinics.
· Action 19 - clearer guidance on reporting negative HIV tests for insurance purposes - the inconsistent guidance has now been removed from the website of the Association of British Insurers (ABI)
· Action 20 - develop action plan to tackle stigma and discrimination - the Executive will produce an Equality report which will contain a disability equality scheme and a gender equality scheme, the Executive will publish a disability equality scheme on 4 December; a scheme for race equality was published in November 2005. All areas of equality must be taken into account when developing new policy in the Executive.
Item 5: Progress on Committee Actions (NSHAC(2006)25)
7. This is a regular agenda item and follows the template previously provided, highlighting progress to date on those tasks being taken forward by the Committee.
8. The Minister invited the chairs of the sub-groups to speak briefly to their work and where necessary highlighting any particular successes or points that have hindered progress.
Action 2: John Wilkes - No update at present - awaiting replacement for John Wilkes.
Action: Secretariat
Action 3: Wendy Peacock - The Sub-group has met three times. A small editorial group has now been established to draft the report which should be ready for consultation in mid-November. It is anticipated that the report will be brought to the February meeting of NSHAC for discussion.
Actions 4 & 5: Shirley Fraser - The work identifying the sexual health needs of young people from Black and Minority Ethnic Communities was almost complete with a report due to be finished by the end of January 2007. A high level strategic meeting would be held in February under the auspices of addressing Equality and Diversity, followed by regional events for people at a local level.
The work to develop a sexual health communications framework and action plan was ongoing.
Actions 7 & 8: Danny Wight - Members noted the work undertaken to date in scoping the research evidence base and the further work required to identify recommendations for a central research programme on sexual health. Members also discussed the relevance of having a central depository on grey literature research and potential host organisations. Mr Kerr suggested that NHS Education for Scotland may have a locus to hold and maintain this information. Danny and Shirley agreed to consider this further. Action: Shirley Fraser and Danny Wight
Action 10: Shirley Fraser - Shirley advised that efforts were being made to ensure a Scotland-wide coverage in the commissioned review of SRE programmes. Members agreed to support this effort.
Action: Members as appropriate
9. The Group noted that the World Health Organisation had commissioned a review of Sex and Relationships Education in Schools. Shirley advised that this would be published in December.
10. Dianne Wolfson informed the group of anecdotal evidence that children from ethnic minorities within schools were being withdrawn by parents from Sex and Relationships Education. Shirley Fraser said that as far as she was aware the numbers were very small, and that when parents were given sight of relevant materials, they withdrew their objections.
11. The Group discussed the issue and it was suggested that the materials being developed for "Called to Love" may be appropriate. Shirley Fraser agreed to conduct research with parents of ethnic minority to establish whether their concerns were generated by a mis-understanding of the materials used in Sex and Relationships Education.
Action: Shirley Fraser
Action 11: Roy Kilpatrick - Roy reported that work is progressing through the subgroups. He explained that there were three sub-groups which focused on Gay Men, African Communities and HIV Treatment.
12. The members noted that the sub-group on HIV Treatment was not yet off the ground, however, that there was good representation on Scottish HIV and AIDS Group (SHIVAG) and Roy would continue to monitor the situation.
13. Roy explained that the sub-group on African Communities was still to meet. The Group noted that this was due to seeking African Community ownership of the sub-group. This sub-group was expected to meet later in November.
14. Roy also explained that the sub-group on Gay Men had still to appoint a researcher. However, the sub-group has agreed terms of reference, scope of audit and have agreed to focus on key risk factors.
Action 12: Alison Bigrigg - Dr Bigrigg stated that the statistical analysis and commentary on the 5 agreed Key Clinical Indicators would be sent to the Executive by the end of December 2006. She also informed the Group that data sources for Key Clinical Indicator 6 on Long Acting Reversible Methods of Contraception had been identified and were being validated. The sub-group is on course to produce data and commentary by April/May 2007.
15. Key Clinical Indicator 7 - Sexual Health Care in People Living with HIV - A preferred method of data collection had been identified and could therefore be taken forward if NSHAC was in agreement. The members agreed.
16. The Group agreed that Joe and Alison should meet to discuss the release of data for KCI 6.
Action: Alison Bigrigg and Joe Logan
Action 13 - Jim Chalmers - Dr Chalmers informed the Group he was due to meet Joe Logan and David Pattison on 25 October to discuss further work.
Action: Dr Chalmers, Joe Logan & David Pattison
Action 14 - Myra Lamont - Myra referred the members to paper NSHAC (2006) 26. The Group noted that the Education and Training Task Group was established in October 2005, jointly chaired by Myra Lamont and Tim Street. The Group comprised of representatives from statutory and voluntary sectors, NHS Education for Scotland, Scottish Executive and NHS Health Scotland.
17. Myra highlighted a number of issues which had been highlighted by the Group, these included:
· Lack of coordination between stakeholders involved and variable approaches to education and training across Health Board areas and staff groups
· Conflicting priorities in relation to Continuous Professional Development (CPD) and career development
· Sub-speciality training for medical staff is an ongoing concern
· Workforce issues for nurses and clinicians - cannot get released for training and continued professional development
· In relation to pharmacy services and non-clinical sexual health services, a lack of standards for training, agreed competency frameworks and accreditation of learning undertaken
· Limited training resources available
· No service model agreement for sexual health services throughout Scotland
· Myra highlighted a number of proposed recommendations/comments within the discussion paper. The recommendations/comments have been grouped in the following areas: Health promotion (non-clinical); Pharmacy; Counselling; Nursing and Midwifery; Medical - Undergraduate and Postgraduate Education;.
18. Mr Kerr thanked Myra and Tim and suggested that the recommendations should be prioritised. He asked that following further consultation with constituencies a meeting should take place between Joe, David, Myra and Tim to set timescales, discuss recommendations, key players and how to progress.
Action: Myra Lamont, Tim Street, Joe Logan, David Pattison.
Item 6: Annual Updates - Feedback from NHS Boards and Local Authorities
19. The Minister invited David Pattison to report on the general themes emerging from the annual updates submitted by NHS Boards and their local authority partners.
20. David said that each NHS Board with local authority partners had provided a financial breakdown of how they have spent additional funding for sexual health. Joe Logan, David Pattison and Shirley Fraser had met with almost all Territorial and Special Health Boards. These meetings had proved extremely helpful to expand knowledge and bring out the good work which is being undertaken within Boards and encourage them to continue with their work. David stated that the meetings had also been a useful tool to discuss with Boards their progress reports which were to be accessible to stakeholders at the launch of the first Annual Report.
21. Mr Kerr noted that the progress in Boards was excellent and that Boards were using good innovation in all aspects of work including service re-design.
22. The Group noted that NHS Health Scotland, Confederation of Scottish Local Authorities and the Education Department of the Executive were holding a conference to look at how Local Authorities could be more engaged in addressing the sexual health agenda and what additional support would facilitate this. Shirley agreed to feed back on the outcomes of this meeting.
Action: Shirley Fraser
Item 7: Communications Update
23. The Minister asked Joe Logan to speak to this item.
24. Joe said that the Annual Report would provide an overview of progress, and provide examples of good practice from across the country for the last 18 months. The Report will be available in hard copy and on the Executive's publication website. The Sexual Health website will also provide progress on actions for the Scottish Executive Health and Education Departments, Special Health Boards and the Scottish Prison Service. In addition there will be a link to each NHS Board for access to progress on local actions and the financial breakdown of how Boards used the additional funding which was provided to support implementation of Respect & Responsibility. Hard copies of this material will be provided if required.
25. The Group noted that the Report would be issued to: the Health Committee, and placed in the Scottish Parliament Information Centre (SPICe); the Cross Party Group on Sexual Health; members of the National Sexual Health Advisory Committee; NHS Board Chief Executives, Directors of Public Health, lead Executive Directors and lead clinicians for sexual health; Local Authority Directors of Education and local sexual health leads; Teachers Associations, Faith Groups and the Voluntary Sector. The Scottish Executive Communications Department had also prepared a media plan which would engage with local media. The Report was due to be published in mid November.
Action: Secretariat
26. Joe also explained that officials had met with NHS Health Scotland to discuss a proposed review of progress so far under Respect & Responsibility. This would be a stocktaking review, whether we are working in a joined up manner and how we should take the strategy forward.
27. Joe explained that key stakeholders would be given an opportunity to input into this process.
Action: Secretariat
Item 8: International Aids Conference
The Minister invited Roy Kilpatrick to give a brief update on his take of the main themes presented at the recent 16th International Aids Conference held in Toronto, which had been attended by staff from Health Protection Scotland, the Medical Research Council, and HIV Scotland.
28. Roy listed the following main themes from the conference:
· Political Leadership is paramount - as seen in the attendance by ex US President Bill Clinton and the UN Aids Envoy for Africa.
· Gender Equality
· A strong focus on Africa
· Development of new technologies - circumcision - which may reduce the scope for transmitting the HIV Virus. Developments in research and success of new anti-virals which will add a new class of drugs. Complementary therapies - a number of which are not consistent with Anti retroviral drugs.
· Prevention - new technologies and the need to link treatment and prevention.
Need to view how clinical and community services work together to reduce stigma and discrimination around HIV/AIDS.
· Human Rights - gender equality - Need to link HIV Care and reproductive health.
29. The Group noted that it would be useful to look at the process adopted by the UN Aids Envoy and that this may be able to fit into the Equality and Diversity Scheme.
30. Roy agreed to send a copy of his presentation and information on the UN Envoy to the Secretariat.
Action: Roy Kilpatrick
31. Danny Wight enquired whether there had been any mention of the increasing evidence of an infective form of anti-biotic resistant TB at the conference. Roy acknowledged that it was already a potential problem with 1 or 2 cases having already been diagnosed in London. The Group noted that this would not be specifically mentioned within the HPA Scottish Report.
Item 9: Any other Business
32. There was no other business.
Item 10: Date of Next meeting
33. The Minister asked members to note that the next meeting will take place on 19 February 2007.
Note: Due to Ministerial commitment the meeting will now take place at 10 am on 19 February 2007, in Conference Room 1, Victoria Quay.
Closing Remarks
34. The Minister thanked the members for their contribution to the meeting and for their ongoing contributions in the individual actions. He expressed gratitude that good progress had again been made.
Secretariat
Public Health and Substance Misuse Division
Sexual Health Team
SEHD
0131 244 3457
December 2006