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Health / NHS keen to improve access to sexual health and family planning services

However a bid for funding from reserves to offer full-time, permanent posts in sexual health was turned down

RECRUITMENT is due to get underway shortly on bolstering the sexual health workforce in Shetland – but it will only be for a part-time post after a bid for funding was turned down.

A request for £127,000 was put to Shetland’s health and social care integration joint board (IJB) last week to develop NHS Shetland’s sexual health service.

But members of the board reluctantly turned it down because they felt it was not an appropriate use of IJB reserves, which only has around £430,000 in the pot.

The funding was to cover services for a year from October, and NHS Shetland would be likely to foot the bill afterwards.

There were concerns, however, over what the financial outlook would be for the health board given that it is projecting a £4 million overspend in 2022/23.

NHS Shetland’s director of nursing and acute services Kathleen Carolan said there are currently very few qualified sexual health practitioners who are available to sustain the service, particularly due to turnover in staff.

“The request for funding was to enable us to offer full-time, permanent posts that would mean we could attract nurses who are already experienced sexual health practitioners and/or development posts so that we can provide the full range of sexual health provision for people in Shetland,” she explained after the meeting.

“The current position in terms of the service we can offer is that anyone phoning or emailing the sexual health clinic for advice will receive a call back and we will make plans to put individualised support and treatment in place.

“We do not have the capacity to offer an open access clinic as we have done for many years on a Monday evening.”

The clinics will be limited to one or two per month, depending on staff availability, while patients requesting an intrauterine device (IUD) – such as a coil for contraception – should contact their health centre in the first instance.  

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Anyone requiring support because of sexual assault will be seen immediately by an on-call forensic specialist nurse who are able to provide sexual health care.

Meanwhile anyone requiring advice about the termination of a pregnancy will be supported by the midwives in the maternity unit.

Carolan said: “This arrangement will continue until we can attract a permanent member of the team and we will start recruitment in the coming weeks, but there is no certainty that we will be able to appoint.

“This will be a part-time post, because we were not successful in securing funding from the IJB reserves.”

A report to members said if funding was not approved then the service “would not meet the necessary standards for service provision that NHS boards and IJBs are required to deliver”.

IJB finance officer Karl Williamson said there was a “risk” to the application given possible constraints on NHS Shetland’s funding in the future.

Board member Natasha Cornick said she found the funding application difficult, suggesting it would be like “injecting reserves” to keep a service going.

Councillor Liz Peterson proposed to turn down the application, with SIC colleague Robbie McGregor seconding – but both were reluctant in doing so.

It was not the only reserves funding application to be rejected, however.

Nearly £60,000 was requested from NHS Shetland director of pharmacy Anthony McDavitt to develop an automated primary care intelligence utility.

This digital platform would help staff to prioritise care to those most in need, moving on from the paper patient records and combine existing databases.

McDavitt said the existing procedures across primary care is “quite inefficient” and does not always target the people who is best seen first.

Board members were told that the system, if developed, would save administration time.

It would also “identify areas of poor disease control or inadequate disease monitoring and lead to improved targeting of resources and care”, a report said.

The funding request was for emplyong a senior information analyst for a year.

But while there was praise for the scheme, IJB members similarly felt it was not the most suitable use of reserves and that they needed to take a consistent approach.

McGregor, who has a background in pharmacy, encouraged McDavitt to apply to other funding streams.

Speaking after the meeting, the director of pharmacy said: “For the ShIP project, we’ll will aim to provide new information include a baseline for Shetland and a further description of the benefits of the approach later in the year at further opportunity.”

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