Three Hounslow sexual health clinics have become the first so-called ‘lead providers’ in London, changing the model for NHS provided sexual healthcare in the city.
Sexual Health Hounslow (SHH), which comprises three clinics across Hounslow and Feltham, is now in charge of all NHS sexual health services in the borough.
This decision sets SHH apart from NHS services in other London boroughs.
Elsewhere, clinics are still operating under the old model, whereby their council’s sexual health commissioning service pay for all borough-related sexual health matters individually.
The old system uses a three-way approach. It provides health commissioners with financial means to pay for sexual health services, GPs with funds to provide Long Acting Reversible Contraception (LARC), and helps pharmacies to stock emergency contraception.
In Hounslow, however, SHH’s lead provider role puts them in direct control of these actions, removing the need to consult the council’s director for public health.
London currently has the highest rates of sexually transmitted infections (STIs) in the country. And, according to the UK Health Security Agency, gonorrhoea cases across England in 2022 were at their highest since records began in 1918.
However, Dr Lauren Bull, acting service lead at SHH, says that she hasn’t seen a noticeable rise in Hounslow’s cases.
The decision to change to the lead provider role was made in an effort to limit bureaucracy, and open up choices for patients, rather than as a reaction to STI rates.
SHH also deals with vulnerable populations. Hounslow’s population rose by 13.1% between 2011 and 2021 according to the national census, and the Feltham clinic’s proximity to an asylum hotel means that they are working with more high-risk patients than before.
Dr Bull, 41, who has been at SHH since 2019, hopes the move to lead provider will increase options for all patients, including the most vulnerable.
She stressed that sexual health is also much more than who does and does not have an STI. She noted that the clinic often serves as a place for people who feel they cannot go to their GP.
Dr Bull said: “It’s easy to reduce public and sexual health to ‘how will we know we’ve done well? Well, rates have gone down,’ but we’re so much more than that.
“There’s so many things we see on a daily basis.”
She added: “We’re a very sex positive service as well. Good health is not just avoidance of the bad health.”
In an effort to treat sexual health beyond simply testing for STIs, they have implemented a multidisciplinary approach to their work.
The clinics work closely with independent domestic and sexual violence advocates, provide interpreters through Language Link to non-English speakers, and ask all patients sexual vulnerability questions as part of their care.
SHH aims to be as involved with community health as possible. Most recently, they have been working with GPs to launch a campaign aimed at residents who speak a variety of South Asian languages.
SHH has seen more than 30 GP surgeries and more than 20 pharmacies sign up to make changes to their sexual health services. Dr Bull hopes this will increase options for patients.
SHH’s locations and opening hours can be found here.