1. Lanarkshire Integrated Sexual Health Service
Anne McLellan
February 2009

2. General Direction
Combined sexual health clinic (s) established (offering all contraception in sexually transmitted infection testing including H.I.V.)
Integration of Genitourinary Medicine and “Sexual and Reproductive health”
Regional Working – West of Scotland Workforce Group
The HUB concept
West of Scotland MCN

3. What is a HUB?
New integrated community clinic bringing resources together
Introduced in partnership with the CHPs
Can operate 2-5 days per week
Provides full range of contraceptive services and testing for STIs including BBVs
Services can be tailored to suit local needs

4. Sexual & Reproductive Health Clinics
FP CLINICS
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
MORNING
9.30 – 11.30am
East Kilbride
Blantyre (not 5th week)
AFTERNOON
1.30 – 3.30pm
Lanark
Wishaw - 1st & 3rd)
Motherwell
Carluke
Viewpark
EVENING
7 – 9pm
Airdrie
Coatbridge
Cumbernuald
Wishaw - 2nd & 4th
Blantyre
(Alternative weeks)
Bellshill
Hamilton
Coatbridge (LARC)
Cumbernauld (LARC)
Hamilton (LARC)
Monklands

5. Genitourinary Medicine Clinics
GU Clinics
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
MORNING
9.30 –
12 noon
Motherwell
Health Centre
138 Windmillhill
Street
ML1 1TB
Central
North Carbrain Rd
Cumbernauld
G67 1BJ
AFTERNOON
1.30 –
4.30 pm
Hunter
Heath Centre
Andrew Street
East Kilbride
G74 1AD
Blantyre
Victoria Street
G72 0BS
EVENINGS
5.30 –
8.30 pm
Monklands
Hospital
Outpatients Dept. Area 1 Airdrie
ML6 0JS
Central Clinic
Orchard Street
Hamilton
ML3 6PB
Sexual Health Clinic
Motherwell
Health Centre
138 Windmillhill Street

6. Lanarkshire Sexual Health Service-0845
Glenalmond House
Coathill Hospital
Hospital Street
Coatbridge ML5 4DN

7. Integration or Colocation
Budgets merged
Staff in “clinical activity centre”
Centralised booking number
Dualskilling of staff working across service
Still specialist clinics

8. Warts and all ! Huge amount of change Not all plain sailing
Clear benefits ahead
Still a huge amount to be done
Look forward to hearing ideas

9. THANKS FOR LISTENING

10. Lanarkshire Sexual Health Service
Clinical Priorities
Lanarkshire Sexual Health Service

11. Standards for Sexual Health Service
Standard 1: Comprehensive provision of specialist sexual health services
Standard 2: Sexual health information provision
Standard 3: Services for young people
Standard 4: Partner Notification
Standard 5: Sexual healthcare for people living with HIV
Standard 6: Termination of pregnancy
Standard 7: Hepatitis B vaccination for men who have sex with men
Standard 8: Intrauterine and implantable methods of contraception
Standard 9: Appropriately trained staff providing sexual health services

12. Report on the Budget Impact for Scotland – May 2008
Cost of key criteria by NHS board
NHS BOARD
COST OF KEY CRITERIA £’000 %
Ayrshire & Arran
275 6
Boarders
182 4
Dumfries & Galloway
208 5
Fife
387 9
Forth Valley
291 7
Grampian
475 11
Greater Glasgow & Clyde
502
Highland
196
Lanarkshire
814 18
Lothian
771 17
Orkney 50 1
Shetland
Tayside
201
Western Isles
Scotland
4,451
100

13. Cost Analysis by Standard
DESCRIPTION
ESTIMATEDCOST £’000
% OF TOTAL 1
Comprehensive provision of specialist sexual health services
1,076 25 2
Sexual health information provision 69 3
Services for young people
297 7 4
Partner notification
149 5
Sexual healthcare for people living with HIV 24 6
Termination of pregnancy 22
Hepatitis B vaccination for men who have sex with men 65 8
Intrauterine and implantable methods of contraception
2,347 55 9
Appropriately trained staff providing sexual health services
252
Total for Scotland
4,300
100

14. Standard 8: Challenge Essential
or more females per 1000 females of reproductive age per year are prescribed intrauterine and implantable contraceptives
Desirable
or more females per 1000 females of reproductive age by the end of 2011

18. IMPLANON

19. All LARC

20. LARC by Procedure/Method

21. Standard 8: Actions Band 6 nurses to be trained to fit implants
G.P.s and practice nurses have been offered training in Implanon & IUD/IUS
Discussion with Primary Care regarding LES
All our in-house doctors to fit IUD/IUS
Well woman clinics to be converted to LARC

22. Standard 3: Challenge
3.1 60% of chlamydia tests per year are taken from males and from females aged under 25 years.
3.2 The annual rate of chlamydia tests performed in the NHS board area is greater than 100 per 1,000 males aged years.
3.3 The annual rate of chlamydia tests performed in the NHS board area is greater than 300 per 1,000 females aged years.

23. Key Clinical Indicators - 2006
Rates of Chlamydia tests performed per 1000 women and percentage of positive tests by age group and NHS board region of testing, 2006.

24. Key Clinical Indicators - 2006
Rates of Chlamydia tests performed per 1000 men and percentage of positive tests by age group and NHS board region of testing, 2006.

25. Partner notification

26. Standard 3: Actions Chlamydia campaign major priority
Postal Chlamydia testing kits on website
Testing and treatment in pharmacies
Expansion and promotion of Young Persons Services ( signposting)
Optout testing inhouse
More staff trained in PN

27. Standard 1: Challenges
1.2 There is a minimum of 2 full days per week of integrated local specialist sexual health service provision available within 30 minutes travel time from each settlement of over 10,000 people.
1.3 80% of individuals with priority sexual health conditions are offered the opportunity to be seen within 2 working days of initial contact with a specialist sexual health service.

28. Standard 1: Action
Looked in more detail at the “settlements” for Lanarkshire.
Reviewed our established clinical services to redesign them into 8 hour HUB model (phase 1)
Submitted our proposed service plan for August 2008 – 2009 to QIS economic analysts.

29. Conclusion LARC Methods available for all
Young persons services / Risk Reduction Clinics
Training/ Education/ Raising Awareness