Sexual Health Improvement for Population and Patients HIT successes in 2017-18

Dr Katy Turner, Dr Paddy Horner and Thara Raj look back over the work of the Sexual Health Improvement for Population and Patients Health Integration Team during 2017-18.

The SHIPP (Sexual Health Improvement for Population and Patients Health Integration Team) works to promote evidence-based sexual health improvement.

During the last year our focus has been supporting the mobilisation and transformation of Unity Sexual Health, the new integrated sexual health service for Bristol, North Somerset and South Gloucestershire (BNSSG). University Hospitals Bristol NHS Foundation Trust is the lead provider for the specialist service, which also includes major third sector providers Brook, British Pregnancy Advisory Service, Marie Stopes International, Terrence Higgins Trust and the Eddystone Trust, as well as Weston Area Health Trust in North Somerset.

Unity, which launched in June 2017, is implementing a number of service innovations designed to meet the challenges arising from reduced local authority budgets, combined with an increasing population. This has necessitated an increased focus on the delivery of high quality, cost-effective services that deliver value for money, whilst improving health outcomes. The SHIPP team is now closely aligned with Unity’s research and evaluation group, and also contributes to Unity’s governing senate.

Members of SHIPP were influential in developing outcome-focused key performance indicators for the new sexual health service, during contract negotiations at the start of 2017. This has been a departure from activity-based reporting to public health outcomes: this was an important SHIPP recommendation that commissioners acted on.

SHIPP’s recommendations for the specialist sexual health service to convert to electronic record keeping have enabled the use of routine patient data in service evaluation and needs assessment. This will support further evaluation work.

Unity Sexual Health is a study site for the national PrEP (Pre-exposure prophylaxis) HIV trial. The trial went live in December 2017, and all places for men who have sex with men were filled within the first 36 hours, and further places have now been allocated. SHIPP members are adding value through a local study called CHOP, to evaluate service need, uptake and acceptability. The study started in January 2018 and will provide data on how to best provide services to high risk men who have sex with men.

The IMPACT – PC study explores whether referral of partner management from sexually transmitted infections (STI) diagnoses could be transferred from primary care to a centralised, specialist team run by the sexual health clinic advisors. A successful feasibility pilot study demonstrated this approach was acceptable to patients and care providers. Two funding applications were unsuccessful, but we are continuing to progress the implementation with Unity. This model is now due to be implemented across BNSSG as a prioritised work stream.

Jayne Meyrick, the SHIPP lead for public and patient involvement (PPI), developed an NIHR Research for Patient Benefit application around using PPI to shape sexual health services. Although unsuccessful, the application received positive feedback and we are now seeking pilot funding. PPI audit work undertaken with SHIPP members has now been submitted to the Journal of Sexual and Reproductive Health.

In January 2018, our founder Professor John Macleod stepped down as a director of SHIPP because he’d been appointed to the new role of Director of Primary Care Research. We are very grateful to John for all his efforts in getting SHIPP established and developing a great set of research. He remains closely involved in SHIPP’s work and we have recruited Dr Katy Turner and Dr Paddy Horner who join Thara Raj as Directors. Dr Emma Harding Esch has been appointed as honorary co-director to facilitate links with a wider network of STI researchers. The new appointments help to ensure SHIPP is embedded within commissioner, provider and academia landscapes, and enables a whole system approach to improving sexual health outcomes.