1. Sexual health & Being a Clinical Lead In It

2. Difficulties as sexual health clinical lead No definition of sexual health No definition of sexual health No job description No job description No champion in PCT management No champion in PCT management No lead practice nurse No lead practice nurse No clear lines of accountability No clear lines of accountability Meetings frequently cancelled Meetings frequently cancelled My many competing commitments My many competing commitments

3. Scope of sexual health Sexually transmitted diseases Sexually transmitted diseases HIV/AIDS - and others HIV/AIDS - and others Prevention - mostly not a clinical area Prevention - mostly not a clinical area Treatment - primary care or GUM? Treatment - primary care or GUM? Contraception Contraception Teenage pregnancy strategy? Teenage pregnancy strategy? Termination of pregnancy services? Termination of pregnancy services? Psychosexual problems/erectile dysfunction etc??? Psychosexual problems/erectile dysfunction etc???

4. How to improve sexual health in NBPCT? Map existing provision in PCT Liaison, with Public Health, F/P, GUM Bradford-wide strategies National guidance, targets, strategies Training for Primary Care Staff Look at good practice elsewhere Liaison with PCT groups with overlapping remit eg young people

5. National guidance, targets, strategies National Strategy for Sexual Health and HIV 2001 National Strategy for Sexual Health and HIV 2001 Provisions of new GMS contract for levels of service in Sexual Health Provisions of new GMS contract for levels of service in Sexual Health Teenage pregnancy strategy Teenage pregnancy strategy

6. Sexual Health Implementation Group (Bradford wide) All PCTs All PCTs Health Promotion Health Promotion Social Services Social Services Voluntary Sector Voluntary Sector Education Education

7. Liaison with Public Health, FP services, GUM, microbiology (Bradford wide) GUM monitoring group (no longer meeting) GUM monitoring group (no longer meeting) Proposed clinical sexual health group (not met yet) Proposed clinical sexual health group (not met yet)

8. Existing PCT provision Most contraception now practice based Most contraception now practice based Much FP work by practice nurses Much FP work by practice nurses TOP contract with Lilac clinic inadequate TOP contract with Lilac clinic inadequate Shipley Young Peoples Health project Shipley Young Peoples Health project STDs - partly primary care, partly GUM clinic STDs - partly primary care, partly GUM clinic Variation between practices and probably within practices Variation between practices and probably within practices

9. Overlap with other PCT activities Young peoples health group Young peoples health group Cervical smear targets Cervical smear targets Commissioning for TOPs Commissioning for TOPs ? Mental health (psychosexual) ? Mental health (psychosexual) ? Urology (erectile dysfunction) ? Urology (erectile dysfunction)

10. Training for primary care staff Identify needs of each group of staff Identify needs of each group of staff Identify areas of training needed Identify areas of training needed E g organising user friendly services, diagnosis of STDs, referral, treatment, contact tracing E g organising user friendly services, diagnosis of STDs, referral, treatment, contact tracing Provide training, e g at PLTs Provide training, e g at PLTs

11. Look at good practice elsewhere Why reinvent the wheel? Why reinvent the wheel?

12. What we need now GP lead with time, energy and commitment GP lead with time, energy and commitment Practice nurse lead with time, energy and commitment Practice nurse lead with time, energy and commitment PCT manager with clear remit to support clinical leads PCT manager with clear remit to support clinical leads