NATIONAL SEXUAL HEALTH ADVISORY COMMITTEE
Minutes of the sixth meeting held on Monday 19 February 2007, 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:
Mary Allison, NHS Health Scotland
Dr Eric Baijal, Director of Public Health, NHS Highland
Dr Nil Banerjee, Consultant in Genito-urinary Medicine, NHS Fife
Dr Jenny Bennison, Royal College of General Practitioners (RCGPs), Scotland
Dr Alison Bigrigg, Director, Sandyford Initiative, Glasgow
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
Tim Hopkins, Policy Worker, Equalities Network
Shehla Ihsan, REACH Community Health Project, Glasgow
Hawys Kilday, Chief Executive, Caledonia Youth
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
Wendy Peacock, Infection Control Manager, NHS Tayside
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
Dianna Wolfson, Convenor, Scottish Interfaith Council
In attendance:
Gordon Currie, Qualifications, Assessment & Curriculum Division, SEED
Heather Gourlay, Infection Control Adviser, Scottish Prison Service
Joe Logan, Public Health Division, SEHD
Julie McIlroy, Ministerial Support Team
Dr Rak Nandwani, GUM Consultant Sandyford Initiative
Cheryl Paris, Public Health Division, SEHD
Item 1: Welcome and Introductions
1. The Minister welcomed members to the sixth meeting of the National Sexual Health Advisory Committee (NSHAC) and in particular to Eric Baijal, Director of Public Health, NHS Highland who replaced Lesley McDonald on the Committee; Gayle Campbell, Convenor of the Health Committee, Scottish Youth Parliament who replaced Kerri Rodgers on the Committee (welcomed in her absence as she did not attend) and to Tim Hopkins, Policy Worker, Equalities Network, who replaced John Wilkes on the Committee and who would be chair of Action 2 on equalities.
2. The Minister also welcomed Dr Rak Nandwani and Heather Gourlay to the meeting who would be giving presentations on the production of Clinical Service Standards by NHS Quality Improvement Scotland and Sexual Health Services within the Scottish Prison Service respectively.
Item 2: Apologies
Apologies were received from
Gayle Campbell, Convenor of the Health Committee, Scottish Youth Parliament
Hilary Campbell, Chief Executive, Couple Counselling
Professor Anna Glasier, Lead Clinician, Sexual Health, NHS Lothian
Dr Alison McCallum, Director of Public Health, NHS Lothian
Mr Michael McGrath, Director, Scottish Catholic Education Services
Mr David L Pattison, Medical Directorate, SEHD
Dr Danny Wight, Senior Researcher, Social and Public Health Sciences Unit, Medical Research Council
Item 3: Note of the Fifth Meeting held on 23 October 2006 (NSHAC(2006)29)
3. The Minister advised the Members that the note of the fifth meeting had been circulated. The Group noted that there were two actions ongoing:
· Officials have written to Ronnie O'Connor, Director of Education Services at Glasgow City Council to seek a replacement for Fraser Sanderson
· Response awaited from a couple of sub-groups on updated NSHAC project initiation plans.
Action: Secretariat
4. 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 fifth meeting was agreed.
Item 4: Progress on Recommendations for the Scottish Executive and external agencies (NSHAC (2007)30)
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:
Action 18 - Postal Testing Kits - Joe explained that NHS National Services Scotland had confirmed that there was insufficient demand to merit a national contract. However, Healthy Respect had agreed to process initial orders on postal testing kits for Boards and host a seminar to offer Boards the opportunity to discuss how to make best use of the kits, based on the experience of Healthy Respect. It was also noted that the Health Department would write to Boards to inform them of these arrangements and that the position of a national contract would be reviewed depending on future level of demand.
Action: Secretariat - Discharged, letter sent to Boards 28 February
Action 19 - The Members noted that following research carried out by Scott Porter on postal testing kits, it was agreed that a separate kit to test for gonorrhoea within GP Surgeries, GUM clinics and other clinics run by health care professionals would be developed. Joe explained that Healthy Respect and NHS Lothian had discussed how to develop the kit for other sexually transmitted infections and that the Project Board would meet in the near future to discus proposals further.
Action: Project Board to meet to discuss extensions of Postal Testing Kits
Item 5: Progress on Committee Actions (NSHAC (2007) 31)
7. The Minister invited the chairs of the sub-groups to speak briefly to their work and where appropriate highlight any particular successes or points that have hindered progress.
Action 2: Tim Hopkins - Tim explained that the purpose behind Action 2 was to ensure that the Strategy delivered for everyone in Scotland. The sub-group would meet again as soon as possible to decide how to take its work forward.
Action 3: Wendy Peacock - Wendy explained that the draft report was circulated in December/January across a wide range of stakeholders. The comments received were being reviewed with the aim of presenting the final report to the next meeting of the Committee in June.
Action 4: Shirley Fraser - Shirley explained that there would be a series of regional seminars for front line practitioners which would take place over April-May 2007.
Action 5: Shirley Fraser - Shirley explained that work was on-going on the development of a communications framework.
Actions 7 & 8: Shirley Fraser - Shirley welcomed the opportunity for wide consultation on the sub-groups proposals before they were put to the Committee later in 2007.
Action 10: Shirley explained that the Aberdeen Research Team's work had been completed and had produced interesting but unsurprising results. These results would be presented to NSHAC once all the information had been completed and analysed. The Group noted that one Local Authority had not yet taken part in the research and that they would be given another opportunity to do so.
Action 11: Roy Kilpatrick - Roy explained that research to scope provision and resource allocations for men who have sex with men (MSM) and for African and Minority Ethnic populations has started and an interim progress report had been received. A first report was due at the end of February and a final report in May.
8. Roy also explained that a two-day seminar which would be held on 7th and 8th March focussing on MSM would draw together current epidemiology, the above research report and results from the Changing the Focus Conference which was held in 2006. Attendees would include key leads and individuals in sexual health and HIV along with voluntary organisations. The aim was to begin to draft a report which would identify key priorities for strategic direction and action in the prevention of HIV among MSM and for the promotion of the HIV related health of HIV positive MSM.
Action 12: Alison Bigrigg - Alison explained that the first 5 Key Clinical Indicators (KCIs) were published on 8th February 2007. The Group noted that while 4 had full data the fifth KCI on Hepatitis B Vaccination for men who have sex with men contains preliminary data.
9. Dr Bigrigg also explained that KCI 6 on Long Acting Reversible Methods of Contraception (LARC) had received Ministerial approval for publication and that the data collection was proceeding well. She also explained that KCI 7 on Sexual Health Care for people living with diagnosed HIV is being taken forward by a Clinical Notes Audit.
10. These KCIs would all be made available to Dr Rak Nandwani who is leading the development of standards for sexual health for NHS Quality Improvement Scotland.
11. Mr Kerr noted that the KCIs continued to be of use and the evidence base which has been developed was most helpful.
Action 13 - Jim Chalmers - NSHAC (2007)33 - Dr Chalmers spoke to his paper which provided a further report on the progress of developing a national information framework for sexual health. Dr Chalmers drew the Members attention to two tables within the paper which detailed options on future work. Table one detailed work which should be modified or not progressed at present and table 2 presented options which should be progressed. He asked the Group to note the paper and to respond to him with comments on table 2.
Action: NSHAC to respond to Dr Chalmers
Action 14 - Myra Lamont - Myra noted that the consultation period was extended to December 2006 to allow further comments and discussion with stakeholders regarding recommendations. Comments had now been received and reviewed and the papers would be updated in light of these comments which would be fed back to the Committee at its meeting in June.
Item 6: NHS Quality Improvement Scotland - Update on National Clinical Standards for Sexual Health - Dr Rak Nandwani (NSHAC (2007) 34)
12. Dr Nandwani presented NSHAC with an overview of the NHS QIS Sexual Health Services Project on the development of National Standards for sexual health services in Scotland. A copy of this presentation has been provided to Members.
13. The Committee noted that NHS QIS had completed a scoping exercise which was undertaken to define in detail the scope of the project i.e. what should and should not be included within the standards and how the project would be delivered and managed. This exercise was completed in December 2006 and a multi-disciplinary project group was appointed to develop the standards. This Group had already met once and it was hoped that the draft standards would be presented to the Committee at its June meeting.
14. The presentation outlined the project aims and objectives which were to ensure that the standards fulfilled the requirements detailed in the NHS QIS Sexual Health Services Scoping Report by:
· encompassing the 6 key areas of access, capacity, choice, equity of service provision, co-ordination of approach and quality of care
· complementing the KCIs developed by NSHAC
· including selected elements relating to clinical governance that are of particular importance to sexual health services, including information provision, professional training and education of sexual health services staff and evidence-based practice
· to produce a robust, accompanying self-assessment framework (SAF) and guidance document to facilitate the capture of high quality data/information from NHS Boards as part of the future live peer review programme.
· to produce a robust peer review methodology, applicable to sexual health services for use in the future live peer review programme.
15. The Group noted the following key milestones for the standards:
· Sign off draft standards by project group: June 2007
· Publication date of draft standards: July 2007
· Open meetings: September 2007
· Pilot Visits: November 2007
· Publication of final standards: March 2008
16. On behalf of the Committee the Minister thanked Dr Nandwani for his presentation on NHS QIS's approach to developing clinical standards for sexual health. Following a discussion the following points were raised:
· Shirley Fraser agreed to meet with Dr Nandwani to discuss where non-clinical sexual health promotion / prevention would feed into the process.
Action: Shirley Fraser and Rak Nandwani
· The Committee members agreed that it was extremely important to have appropriately trained staff including health promotion staff however, it should be recognised that everyone has a role in health promotion. This should include working towards including relationships as part of the overall sexual health message and to encouraged responsibility among the general public for their own health. Myra Lamont encouraged this approach and asked that NHS QIS work closely with the training sub-group. Action Myra: Lamont & Rak Nandwani
· It was also noted that sexual health standards should join up/ read across with other connected areas within the wider health agenda e.g. mental health. Subsequent to the meeting there has been correspondence between Dr Nandwani and the policy officers in mental health.
Item 7. Review of Respect and Responsibility - Joe Logan (NSHAC (2007) 34)
17. Joe explained that paper NSHAC (2007) 34 incorporated the views of the members so far and that further comments would be welcome at the meeting or by e-mail.
18. Members noted that the paper provided background to Respect and Responsibility and the role of NSHAC. It also outlined progress to date and how this had been reported. The Group noted that it was envisaged that NHS Health Scotland would assist the Department in letting a contract to carry out the review and the requirements would be the capacity and skills to carry out the exercise; familiarity with the subject matter; an understanding of the NHS in Scotland and knowledge of developments in this field in the rest of the UK and abroad. Paragraph 17 of the paper outlined the purpose of the review which was to ensure that the Strategy was fit for purpose, identify any gaps, to ensure that sexual health is joined up with the wider health agenda and to ensure that there was a logical and robust monitoring and evaluation system in place.
19. Mr Kerr noted his approval of the review and asked for comments from the Group.
20. Shirley Fraser suggested that the review should be used to prioritise the recommendations contained within Respect & Responsibility.
21. Roy Kilpatrick raised concern that HIV did not feature strongly enough within the original strategy and that the review should take account of this.
22. The Committee noted that the process would be managed by a steering Group which would be represented by the Health Department, Education Department, the office of the Chief Medical Officer, NHS Health Scotland and representatives from NSHAC. Joe explained that the Secretariat would write to the Committee inviting nominations for the steering Group and any further comments on the paper.
Action: Secretariat
Item 8. Scottish Prison Service - Heather Gourlay
23. Heather Gourlay gave an interesting presentation on the challenges that face the Scottish Prison Service regarding sexual health.
24. The Committee noted there were a number of Well Man Clinics and Health Promotion Clinics within some prisons however, it was hugely important to provide comprehensive training for prison staff to help break down barriers therefore ensuring that any health promotion scheme would be well supported.
25. The Committee also noted that it was important for NHS Boards and prisons to work closely together and that Prisons should feature on NHS Board's local plans. Ms Gourlay encouraged members of the Committee to visit prisons within their Board areas and see the challenges which they face. Fiona MacKenzie agreed to feed this back to the Chief Executives Group.
26. A full copy of Heather Gourlay's presentation has been circulated to Members.
The Committee Members thanked Heather for her presentation and raised the following points:
· Roy Kilpatrick was encouraged to hear that attitudes within prisons were changing and that condom distribution schemes were being rolled out across Scottish Prisons.
· The Group noted the importance of training for staff and prisoners. They also noted the importance of confidentiality issues. Myra Lamont suggested that the Scottish Prison Service also feed into the training sub-group. Heather agreed to discuss this further with Myra.
Action: Heather Gourlay & Myra Lamont
· It was also noted that it was important to retain good quality staff within the Prison Service and that NSHAC would help in any way it could to ensure this happened.
· Heather noted the importance of communication between Prisons and prisoner's GP's on release. The Group explained that it was on occasion difficult to access a patient's records from the Prison Service which in some cases could delay appropriate treatments.
Item 9: Any other Business
27. There was no other business
Item 10: Date of Next meeting
28. The Minister asked members to note that the next meeting will take place on 25 June 2007.
Closing remark
29. 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
Health and Substance Misuse Division
Sexual Health Team
SEHD
0131 244 3457
March 2007