Young people's sexual health services in Hounslow

Healthwatch Hounslow were commissioned by the London Borough of Hounslow to carry out a research project seeking insights into the provision of existing sexual health services for young people in Hounslow.  They wanted to find out young people’s experiences of sexual health services including access, and how pharmacies delivered sexual health services to young people. They undertook a survey to which 112 people responded , two focus groups of Year 11 young people and mystery shopping of local pharmacies.

Awareness by young people of the Condom Card (C-Card) and National Chlamydia Screening Programme (NCSP) was very low. Often they simply had not heard of the free condom scheme or STI test-kits and so were not using them.

PHSE teachers were keen to share information on sexual health services with students but had limited resources and time to research local sexual health services themselves. As well as PHSE classes and assemblies, teachers suggested they can improve communication with students through weekly e-bulletins and display screens around the premises.

The group of 16 year old mystery shoppers could only vaguely remember one occasion where they might have been given information in class on sexual health services. Furthermore, teachers said that 16 year olds had missed out on two years of PHSE classes due to covid – as such they are behind on their knowledge of the subject.

At times there was a reluctance to engage with discussions by some students as they considered that the topic didn’t affect them as ‘sex outside of marriage’ was against their religious beliefs.

The survey results and the mystery shopping exercises revealed the importance of privacy to young people. The young people appreciated the use of private rooms in pharmacies for some of their conversations. Some students were also nervous about their information being shared online. Recommendation: For privacy, specially allocated rooms for discussions were important. The mystery shoppers got around discussing sexual health matters out loud in a pharmacy by saying ‘I’ve got something personal/embarrassing to ask’ – which meant pharmacists immediately took them to private rooms. However, some had no idea that a private room was even an option so promoting this service may help privacy and engagement.

The survey results showed that young people were very interested in accessing Sexual Transmitted Infection (STI) test kits from pharmacies and GPs. This perhaps reflects the need for anonymity, convenience and accessibility. Young people expressed a particular interest in accessing services from venues they regularly visit such as Boots, Superdrug and supermarkets.

During discussions in the focus groups, many students were keen for more access to free contraception and STI kits through schools – as long as they could do so with some degree of anonymity.

Some young people said that there was societal pressure to have sex before they were ready.

The majority of pharmacies were not able to offer young people core sexual health services they had signed up to provide. As a result, young people have lost a key venue for accessing services.

There was minimal signage of sexual health services within the pharmacies, and when it was present it was in the private room which is too late if serving as a promotion tool.

It is conjecture but noticeable that on the final day of the visits pharmacies started giving more help. They may have realised that mystery shoppers were active. The responses seemed to be better as they gave out different leaflets, but were still scrambling for phone numbers on google – and in general did not have the resources to give young people up to date information.

Healthwatch Hounslow were surprised by the lack of ‘participating’ pharmacies in the centre of Feltham. Despite a sexual health centre in central Feltham, this only has limited hours and local young people were unaware of its existence.

There were on two occasions worrying comments made to the mystery shoppers by staff in pharmacies. Additionally, several pharmacies were directing the mystery shoppers to GPs for sexually transmitted infection (STI) testing. Not all GPs provide such screening.

A couple of pharmacies noted the disbandment of the sexual service had arisen because they no longer received reimbursements.

The report contains recommendations to address all the findings.