Partnership working: the key to improving access to a more holistic sexual health service in South London

J.Evans (1), P. Baraitser (2), L. Bacon (1), B. Taylor (3)

Department of Sexual and Reproductive Health, Lewisham Primary Care Trust, UK (1); Department of Public Health, Lewisham Southwark and Lambeth Strategic Health Authority, UK (2); Community Services Pharmacy Team, Southwark Primary Care Trust, UK (3)

Introduction: Lewisham has an ethnically diverse population with significant levels of deprivation and very high rates of fertility, abortion and sexually transmitted infections (STI).

Aim and Methods: To examine the effect of partnership working on three recent local initiatives designed to improve access to a more holistic sexual health service. 1. Improving access to community sexual health services by young people. In 1999 Waldron family planning clinic (FPC) in Deptford extended its opening hours and adopted an open access ‘‘walk-in’’ system. This was combined with a targeted outreach programme, which included developing close links between the clinic and local schools, youth services, social services and voluntary sector organisations. 2. Improving access to Emergency Hormonal Contraception (EHC) by making it available through community pharmacies. In 2000 pharmacists in Lewisham, Southwark and Lambeth, working with the Health Action Zone (HAZ) and the local community sexual health department, were one of the first services to supply EHC under patient group directions. 3. Improving access to STI treatment by providing a community based service for the management of uncomplicated genital infections. In 2001 Lewisham Primary Care Trust (PCT) supported the development of the existing STI testing service in Lewisham FPCs to include treatment and client led partner notification.

Results: 1. Improving access to community sexual health services by young people. The number of new clients under 16 years increased by 12 fold in the first 18 months. The number of young people citing a school education class as their source of information about the clinics increased by more than 5 fold. 2. Emergency Hormonal Contraception (EHC) provision by local pharmacists. 4,164 women were supplied with EHC in 2002/3 and 98% of service users indicated that they were satisfied with the manner in which the pharmacist dealt with their enquiry. Over 70% of women accessed the pharmacy service within 24 hours of unprotected intercourse, significantly higher than equivalent figures from General Practice or FP services. 3. Providing a community based service for the management of uncomplicated genital infections. In 2001/2 Lewisham FPCs treated 648 STI. At Waldron FPC the incidence of chlamydia in the population tested rose from 6.9% to 10.3%. 84% of clients with chlamydia received treatment compared to 52% when clients had to be referred to genitourinary medicine clinics (GUM). The median time from test to treatment fell to 14 days from 19 days when clients had to attend GUM for treatment.

Conclusion: Partnership working amongst local stakeholders is key to developing an easily accessible, innovative, high quality and ultimately more holistic sexual health service in Lewisham.