NSHAC (2006) 22
NATIONAL SEXUAL HEALTH ADVISORY COMMITTEE
Minutes of the Fourth Meeting held on Monday 26 June 2006 Committee Room 1, Victoria Quay
Attendees:
Chair: Mr Andy Kerr, Minister for Health and Community Care
Vice Chair: Professor Peter Donnelly, Deputy Chief Medical Officer, SEHD
Members:
Jamie Rennie, Chief Executive, LGBT Youth Scotland
Professor Anna Glasier, Head of Planning & Well Women Services, NHS Lothian
Dianna Wolfson, Convenor, Scottish Interfaith Council
Dr Nil Banerjee, Consultant in Genito-Urinary Medicine, NHS Fife
Dr Alison Bigrigg, Director, Sandyford Initiative, Glasgow
Shirley Fraser, Health Improvement Programme Manager, NHS Health Scotland
Miranda Harvey, Parent/Voluntary Director, Scottish Parent/Teacher Council
Hawys Kilday, Chief Executive, Caledonia Youth
Roy Kilpatrick, Chief Executive, HIV Scotland
Myra Lamont, Assistant Director of Nursing Services, Sandyford Initiative, Glasgow
Michael McGrath, Director, Scottish Catholic Education Service
Wendy Peacock, Director Manager (Public Health), NHS Tayside, representing Head of Health Promotion Managers Group
Rev Andrew Philip, Church of Scotland
Tim Street, Director, Family Planning Association (fpa)
Hilary Campbell, Chief Executive, Couple Counselling
Alison McCallum, Director of Public Health, NHS Lothian
Dr Daniel Wight, Senior Researcher, Social and Public Health Sciences Unit, Medical Research Council
Dr Jenny Bennison, Royal College of General Practitioners (RCGPs), Scotland
Dona Milne, Healthy Respect
Dr David Sutherland, NHS Education for Scotland
Fiona Mackenzie, NHS Chief Executives
In attendance:
Joe Logan, Public Health Division, SEHD
Cathy Magee, Health Improvement, SEHD
Cheryl Paris, Public Health Division, SEHD
David L Pattison, Medical Directorate, SEHD
Laura Ross, Health Improvement, SEHD
Brian D West, Public Health Division, SEHD
Dr Katherine Falconer, Qualifications, Assessment & Curriculum Division, SEED
Julie McIlroy, Ministerial Support Team
Dr Jim Chalmers, NHS/NSS/ISD, Scotland
Dr Heinrich Volmink, REACH Community Health Project, Glasgow
Item 1: Welcome and Introductions
1. The Minister welcomed members to the fourth meeting of the National Sexual Health Advisory Committee (NSHAC) and in particular, to Dr Jenny Bennison who is the new representative from the Royal College of General Practitioners, Scotland and has replaced Dr Mairi Scott on the Committee; and Dr Jim Chalmers, NHS/NSS/ISD who is working with Professor Goldberg on the NSHAC action on data collection. Jim would present an interim report from that sub group.
2. The Minister also welcomed Dr Henrich Volmink representing REACH Community Health Project; Cheryl Paris, who replaced Matthew Cormack in the Sexual health team, and Brian West who would take a note of the meeting. He also welcomed Cathy Magee and Laura Ross of the Health Improvement Policy Team who would be joining the meeting to listen to the update from Healthy Respect and the Scottish Catholic Education Service (SCES).
3. The Minister further commented that much work had taken place since the February meeting and that he looked forward to hearing how data collection could be improved and therefore help to illustrate how the strategy is impacting on Scotland's poor Sexual health.
Item 2: Apologies
4. Apologies were received from:
Professor David Goldberg, Epidemiologist, Health Protection Scotland
Alex Davidson, Head of Adult Services, South Lanarkshire Council
Angela Timoney, Chairman, Society's Scottish Executive and Consultant in Pharmaceutical Public Health, Tayside NHS Board.
Irene Bain, Scottish Partnership Forum
Dr Lesley MacDonald, Director of Public Health, Fife NHS Board
Shehla Ihsan, REACH Community Health Project, Glasgow
Mary Allison, NHS Health Scotland
Carol Stuart, Head Teachers Association
Dr Mairi Scott, Royal College of General Practitioners (RCGPs), Scotland.
John Wilkes Director Equal Opportunities Commission Scotland and
Fraser Sanderson, Director of Education and Community Services, who had tendered his resignation. A replacement representative will be sought.
Action: Secretariat
Item 3: Notes of Third Meeting held on 20 February 2006 (NSHAC 2005) 17)
5. The Minister advised the Members that the note of the third meeting had been circulated. All action points had been discharged. 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 third meeting was agreed.
6. Daniel Wight clarified and corrected some confusing elements of the note on Actions 7 & 8. The note of this meeting provides an up to date report.
Item 4: Progress on Recommendations for the Scottish Executive and external agencies (NSHAC (2006) 19)
7. The Minister asked Joe Logan to update the Group on progress to date with the recommendations for the Scottish Executive and external agencies.
8. Joe made the following points:
• Actions 17 & 18 - Postal Testing Kits - the Executive has written to all NHS Boards to establish whether a national purchasing scheme is warranted. Responses were due by the end of June. The extension of the chlamydia postal testing kit to other Sexually Transmitted Infections (STIs) would be discussed at a meeting with Gordon Scott on 12 July. Note: this meeting has been rearranged to 8 August. Wendy Peacock asked to be included in the discussions.
• Action 20 - Action plan to tackle stigma and discrimination as it relates to Sexual Health - a meeting had been held with the Equality Unit who advised that there were a number of relevant pieces of legislation, including UK wide public sector equality duties, which would contribute to addressing Action 20. The public sector duties require all public bodies to have due regard to promote equality and eliminate discrimination with respect to Race, Disability and Gender and require specific public bodies to produce a Scheme setting out how they intend to meet these duties. To ensure a co-ordinated and consistent approach and in anticipation of future legislation the Executive's scheme will cover all six equality strands :Disability, Race, Gender, Age, Sexual Orientation and Religion and Belief. A key part of meeting the duties is assessing the impact or likely impact of the Executive's policies and procedures on equality groups. To assist colleagues to do this the Equality Unit are planning to provide an Equality Impact Assessment Toolkit. The Executive's Scheme will be published by 4 December 2006.
9. Roy Kilpatrick asked if the schemes would be put out for consultation and also informed the Committee that the Department of Health had consulted on the stigma around Sexual Health & HIV. Mr Logan agreed to report back to Mr Kilpatrick.
Action: Secretariat
• Action 23 - Delivery of approach to high quality SRE - Danny Wight raised the issue of lack of resources to enable teachers to receive training in delivering programmes such as SHARE. Katherine Falconer explained that the current situation is that local authorities receive funding from SEED for Continuing Professional Development across all subject areas, and decisions around the allocation of these funds are made locally according to the priorities of the local authority and its schools. As noted in the report, SEED and Health Scotland are discussing options to ensure local authorities give due weight to CPD for SRE, and to support the provision of training appropriately. Mr Kerr undertook to look into the issue of resourcing for teacher training for SRE.
Action: Mr Kerr
10. The Group noted that Health Promotion Departments within NHS Boards also support teacher training in sex & relationships education.
• Action 65 - Anna Glasier raised concern that there was great difficulty in persuading postgraduate medical deans to provide training places for specialist registrars. Mr Kerr noted her concerns and said he had also been made aware of this issue by the Cross-Party Group. He asked that the matter be taken forward by officials in conjunction with NES, Workforce Planning and Dr Glasier.
Action: Secretariat
11. David Sutherland said NHS/NES would be issuing a new information pack on Sexual health for Community Pharmacies, which would be in place in spring 2007.
Item 5: Progress on Committee Actions (NSHAC(2006) 20)
12. 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.
13. 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 - Joe Logan said information about NHS Boards use of the equality and diversity impact assessment process had been forwarded to Mr Wilkes so that further progress could be made.
Action 3: Wendy Peacock - the sub-group has met twice, a literature review has been completed and the next meeting of the sub-group will focus on consultation. The sub-group hopes to produce a report by January 2007.
Actions 4 & 5: Shirley Fraser - The collation of promising case studies on the Sexual health needs of young people from Black and Minority Groups was almost complete and that an outline of the findings would be presented to the next meeting. In relation to the development of a communications framework, an initial meeting of key stakeholders was scheduled for 27 July with the aim of identifying key messages, learning points and any gaps. This issue is also on the agenda for the next meeting of the lead clinicians for Sexual health.
Actions 7 & 8: Danny Wight - a lengthy piece of work, but progressing well with the support of a short term postholder. Currently collating literature relating to Scotland and the rest of the UK on Sexual health. By the end of July there should be one database of available research material.
14. Mr Kerr encouraged the sub-group to seek ways to use the existing postholder, who is due to move to a permanent position in another organisation, to carry out the analysis of the gaps in the available material.
Action 10: Shirley Fraser - The commissioned work on the review of SRE programmes was progressing although further negotiation with some local authorities was underway to encourage participation. It was still anticipated that this work will be reported on early in 2007. In addition, it was noted that a joint Health Scotland/Scottish Catholic Education Service seminar had brought together staff from primary and secondary education to discuss sex and relationships education practice.
Action 11: Roy Kilpatrick - Roy updated the Committee on progress of the three subgroups, and that there would be a more detailed presentation in October.
Action 12: Alison Bigrigg - Dr Bigrigg reminded the Group that 5 Key Clinical Indicators had been agreed and that Health Boards had still to be formally informed of the arrangements. David Pattison explained that he had brought this to the attention of Lead Clinicians and that a formal letter would be sent. It was also suggested that this letter should remind Health Boards of the priority of Sexual Health.
Action: Secretariat
Action 14: Myra Lamont - The Group again noted the issue of sub-specialty training and that it was important to be able to report back to the sub-group on this issue. The members also noted that a meeting had been arranged with officials within the Health Department to discuss these issues.
15. Mr Kerr invited Jim Chalmers to present his interim paper on data collection Paper NSHAC (2006) 20 - Appendix A .
16. Jim reminded the Committee of the purpose of the report which is to develop a national information framework for Sexual health. While there is at present a variety of high quality data available, there are some areas for improvement, e.g. a lack of a standard approach to gathering information on the provision of contraception or contraception failure. Following feedback from stakeholders, and taking into account the proposals for Key Clinical Indicators by another sub group of NSHAC, there is a need for a more integrated approach to Sexual health information involving NHS and non-NHS services and recognising the links between Sexual ill health, poverty, discrimination and other forms of social exclusion. The paper recommended the establishment of national clinical data definition standards, developed as part of the National Dataset Development Programme and proposed a number of long-term and short-term options to achieve this objective.
17. In discussion the following points were made:
• the sub-group were commended for their approach and work carried out to date;
• the proposed IT system for GUM and Family Planning clinics should help simplify the collection of data
• ultimately there should be a link with GP data systems, taking into account the need for patient confidentiality
• the project needed to agree timescales
• the sub-group should link with the work being done on the methodology and content on the Scottish Health Survey, again taking into account the need for reassurance on patient confidentiality
• data collection should be from large samples and consideration should be given to buying into a larger number of questions in the National Survey of Sexual Attitudes and Lifestyles (NATSAL).
• any research should seek to use the most representative sample of patients
• there should be further discussion on the direction of the project with Joe Logan and David Pattison
Action: Dr Jim Chalmers and Secretariat.
18. The Minister thanked contributors for their updates and was pleased with progress so far and looked forward to seeing the final results of this work at future meetings. The Minister also thanked to Dr Chalmers, Professor Goldberg and the sub-group for the work undertaken to date and looked forward to receiving a further updated report in due course.
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 all boards had now submitted their initial reports on progress to date, including actions for local authorities. In addition reports had been received from special health boards and the Scottish Prison Service. In general good progress was being made although it had to be recognised that interagency Sexual health strategies were at different stages of development, which reflected different circumstances. A series of meetings with each board was taking place and involved himself, Shirley Fraser and Joe Logan. The purpose of the meetings is to update boards on progress with the national strategy, provide feedback on the local progress report and discuss whether any help or assistance could be provided to resolve outstanding issues. In addition the Executive will write to all boards outlining the arrangements for the annual report on the strategy.
Action: Secretariat
21. In discussion the following points were made:
• boards should be encouraged to engage with non-clinical and non-statutory stakeholders on a regular basis
Action: Secretariat
• existing arrangements in other areas, e.g. community panels, might provide a good model for achieving improved consultation with local stakeholders
• there were issues around long term recruitment of staff, which are related to the funding arrangements to support the strategy, i.e. funding beyond 2007/08 will not be clear until after the next spending review.
22. The Minister thanked the Committee for their comments and reminded them it was the intention to ask NHS Boards to put these reports on their website with links to the Executive website.
Item 7: Communications Update (NSHAC (2006) 21)
23. The Minister asked Joe Logan to speak to this paper.
24. Joe informed the meeting that the technical difficulties with the Executive website had now been resolved and that all NHS board local inter-agency strategies could now be accessed.
25. A revised format for the annual report on the strategy had been agreed with the Minister, following feedback from the previous meeting of the Committee. The annual report will be an overview of general progress to date and will include examples of good practice from across Scotland. A more detailed list of progress against each recommendation at national level will be made available on the Executive website and there will be a link to each local board website which will contain local progress to date against each of the relevant recommendations and a breakdown of how boards allocated their share of the funds to support the strategy. In addition, to help publicise progress with the strategy and promote key Sexual health messages, we would seek to encourage local and specialist media coverage by promoting relevant examples of good practice, innovative approaches, local service redesign etc. The annual report will be published in the autumn.
Action: Secretariat
26. It was agreed to update NSHAC project initiation plans.
Action: Secretariat
Item 8: Healthy Respect Phase 2
27. The Minister invited Dona Milne to update the Committee on Phase 2 of the national health demonstration project on young people's Sexual health, Healthy Respect, and for Donna and Michael McGrath to update the Committee on the work with Catholic Schools in this area.
28. Dona outlined the strategic aims, objectives, values and success criteria of Healthy Respect's second phase. The 4 key objectives are: Schools based sex and relationships education (SRE); Sex and relationships support for young people at risk; Access to services; and Improved attitudes to Sexual health and relationships using communication. SEHD investment in phase two (2005-2008) is £2.015m; this includes £170k for Called to Love, jointly funded by SEHD and SEED.
29. Michael outlined the aims of Called to Love, the partnership project between Healthy Respect and the Scottish Catholic Education Service (SCES). It aims to produce a package of teaching resources and Continuing Professional Development (CPD) to support the delivery of appropriate programmes of Relationships & Moral Education in Catholic secondary schools.
30. Further information can be found on the Healthy Respect, Sexual Health Learning Network and SCES websites.
31. In discussion the following points were made:
• the Committee welcomed progress to date on both Phase 2 and Called to Love
• it is important to measure the outcomes of both projects through independent evaluation and the SRE assessment criteria, as well as by asking for young people's views
• children and young people should be given skills and information to protect them
• the Committee may want further updates on the work of Healthy Respect at future meetings.
32. The Minister thanked Dona and Michael for their interesting presentation and looked forward to hearing how both Healthy Respect progresses and how the work with SCES develops.
Item 9: Any Other Business
33. Hilary Campbell advised the membership that Couple Counselling were changing their name to Relate Scotland.
Item 10: Date of Next Meeting
34. The Minister asked Members to note that the next meeting will take place on 23 October 2006 at 14:00.
35. The dates for 2007 meetings were noted as:
• 19 February 2007
• 25 June 2007
• 29 October 2007.
36. All meetings will be held in Committee Room 1, Victoria Quay, Edinburgh, commencing at 14:00.
37. The Minister also said the minutes of this meeting should be available in approximately 6 weeks.
Closing Remarks
38. The Minister thanked 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
August 2006