NHS testing and treatment services in London for sexual health conditions are being “jeopardised” by plans to reconfigure services, according to unions.
The Royal College of Nursing has claimed that chaotic service reconfiguration driven by public health budget cuts of up to 30% was to blame for the situation.
“Sexual health services should be given the priority and funding they need”
The Sexual Health Transformation Programme brings together all 29 London boroughs into a joint commissioning process and is being delivered by the City of London Corporation.
The plan, designed to help councils cope with falling budgets, was intended to see patients being able to access services through the internet, rather than attending a clinic, from April this year.
But the RCN highlighted that there had been a seven-month delay in the roll-out of the new online NHS service, which is designed to replace face-to-face consultations.
Despite this delay, sexual health clinics had begun to close, it claimed and said there must now be a moratorium on further closures until the online service was successfully up and running.
The uncertainty has seen specialist staff walk away from jobs in sexual health and patients with developed symptoms now facing longer waits and journey times for treatment, warned the RCN.
“The chaos created now means specialist sexual health staff are voting with their feet”
The college said the greatest reduction so far has been in tier 3 sexual health services, which treat patients with more complex, symptomatic conditions – such as HIV, syphilis and gonorrhoea.
The college cited a number of examples from across the capital, including Lambeth and Southwark, where it said the overall number of clinics was halved last year.
In the boroughs of Barnet, Camden, Haringey and Islington, four such clinics had closed and up to 50 staff voluntarily left their posts rather than wait to be axed. Another 25 are facing redundancy.
In Wandsworth the transfer of the integrated hub at St George’s University Hospitals NHS Foundation Trust to Bolingbroke Health Centre and Balham Health Centre meant a number of specialist sexual health nurses and staff had decided to find other employment, according to the RCN.
Meanwhile, it said North East London – covering Barking and Dagenham, Havering, Redbridge, Newham, Waltham Forest, Hackney, Tower Hamlets and the City – was proposing to reduce its tier 3 services from three to one.
The RCN warned such closures and staff losses left patients with complex and urgent care needs without adequate service access, with delays in diagnosis or treatment potentially putting them at risk.
Jude Diggins, RCN London’s operational manager, said: “Closing face-to-face services before the online system is successfully up and running is creating dangerous sexual health risks in the capital.
sexual health sign
“The chaos created now means specialist sexual health staff are voting with their feet and patients are having increasing difficulty accessing treatment that used to be easily available in their local community,” she said.
Ms Diggins said the “sensible option” would have been to halt the closure of services until the online service was ready.
“London has the highest rate of STIs anywhere in the country, yet the government unashamedly continues to cut the capital’s public health budget,” she said.
She added: “Sexual health services should be given the priority and funding they need. It is unacceptable to make those who need vital sexual health treatment pay for illogical cuts.”
The capital’s NHS is operating with fewer clinics and staff despite unprecedented demand, noted the college. According to Public Health England, London has the highest STI rate in England, 79% higher than any other region.
Of the top 20 local authorities in England with the highest rates of STI diagnoses, 17 were in London. Cases of syphilis in the capital in between 2012 and 2016 have increased by 104%.
Local authorities have had responsibility for commissioning most sexual health services since April 2013. They are responsible for commissioning comprehensive and integrated sexual health services, including contraception, STI testing and treatment and specialist services – including HIV prevention.