Experiences of Sexual Health Services

Between September 2018 and February 2019, Healthwatch Cheshire East and Healthwatch Cheshire West undertook research regarding people’s experiences of using Sexual Health services. This was timed to coincide with the recommissioning process of Sexual Health Services in Cheshire East and Cheshire West and Chester. This work follows on from a previous report in January 2017 which looked into Sexual Health services in Cheshire West and Chester.

The research methods included:

• Two Enter and View visits to Go Sexual Health Hubs in Macclesfield and Chester. 
•  Desktop research of the Go Sexual Health website and sampling 10 GP Practice websites in each of Cheshire East and Cheshire West and Chester.
• Two Mystery Shopper visits to Sexual Health clinics in Crewe and Winsford.
• 199 responses to a survey of people’s experiences of Sexual Health services, available in paper or online format.
• Targeted and general engagement events to obtain people’s views

Findings

 A number of people said they regularly use Sexual Health services but often encounter difficulties in getting appointments/accessing services due to a lack of available staff and large queues.

Most respondents to the survey stated that they had used the service for contraception. Several women told Healthwatch that they had difficulty in getting a GP appointment, therefore would attend Go Sexual Health clinics for repeat prescriptions of the contraceptive pill or that their GP did not offer coil fittings.

 Those people who had used the service for ‘testing and diagnosis’ told us they felt Go Sexual Health clinics offered a non-judgmental and supportive service.

People across Cheshire expressed concern about the lack of services available in rural communities. They stated that this is further complicated due to the lack of transport available and the limited number of clinics in the evening and at weekends.

During visits to various clinics there was clear evidence that staff delivering services have a detailed understanding of the needs of communities and work hard to overcome any challenges to provide a quality service.

The clinics and drop-ins advertised on the Go Sexual Health website are a true reflection of what is available, providing patients with confidence in the services.

GP Practice websites differ widely on the services they offer. These include those that offer a full range of services available at the surgery or local clinics to generic links to Sexual Health information leaflets. Furthermore, there is inconsistency in advice and signposting.

Body Positive deliver a wide number of outreach services across Cheshire that are aimed at both the general public and some targeted groups, such as Youth, LGBTQ+, the Homeless, and Sex Workers. However, the conversations Healthwatch have had would suggest that the knowledge of these services amongst the general public is poor, particularly in areas that do not have a Go Sexual Health Hub, and that any additional services and outreach would be welcomed and utilised.

The outreach that Body Positive undertakes within colleges is very well received by students who told Healthwatch that they regularly go for advice.

Recommendations in Cheshire East

• Undertake a review into outreach services in small towns and rural areas, giving consideration to accessibility issues, including transport and availability and frequency of clinics.
• Increase the number of GP Practices that offer long-acting reversible contraceptives such as coil fittings. This could reduce waiting times for fitting and address accessibility issues due to limited transport.
• Review clinic times in consultation with local people.
• Consider providing weekend clinics in accessible locations for both young people and those who work Monday to Friday.
• Increase capacity within local GOSH clinics such as at Eagle Bridge Health and Wellbeing Centre.
• Continue and increase the outreach programme delivered by Body Positive. Having a bespoke agenda for each area and audience taking into consideration cultural differences.
• Provide consistent and easy ways to find information and advice within GP Practices and their websites.

Recommendations in Chester and Cheshire West

• Identify challenges in promoting Sexual Health within hard to reach groups and tailor services to meet their specific needs, e.g. young people who may not attend college and are reluctant to attend GP Practices and Sexual Health clinics.
• Consider providing weekend clinics in accessible locations for both young people and those who work during Monday to Friday.
• Increase capacity within the Winsford GOSH Clinic at Dene Drive Primary Care Centre. This could take the form of a standalone Hub to meet the demand and provide a full range of Sexual Health services.
• Review clinic times in consultation with local people.
• Review the existing online and telephone booking systems to increase capacity.
• Consider online ordering of STI tests to a wider audience.
• Provide consistent and easy ways to find information and advice within GP Practices and their websites.
• Improve existing provision with CCGs to provide psychosexual treatment to patients