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Award-winning student practice has sexual health funding slashed



Exclusive An award winning GP sexual health service for students is having its sexual health funding cut by £20,000 by its local authority, Pulse has learnt.

The Bristol Student Health Service is facing losses after its local public health team issued a new sexual health contract which cuts funding for a range of services including asymptomatic HIV and syphilis testing, as well as for treatment of herpes and genital warts.

Dr Dominique Thompson, a partner at the practice, said patients attending the practice will no longer be able to access free HIV testing unless they express symptoms or are from ‘high-risk’ groups.

She added that the practice will be unable to provide the same level of services as when it came top of Superdrug’s annual Student Sexual Health 2014 report card.

The cuts come as Pulse has reported of a widespread squeeze on sexual health funding for GP practices, despite patients still stating that their GP practice is their preferred provider of the service.

Bristol City Council has changed the terms of the contract it holds with the practice to remove funding for certain activity.

As part of the changes, funding will continue for asymptomatic testing in patients who belong to ‘high risk’ groups – such as men who have sex with men or in patients from countries with a high prevalence of HIV – but not for other patients.

The local authority will continue funding chlamydia and gonorrhoea testing, although the practice will see its reimbursements for this reduced from £5.50 to £5.

Although students will still be able to access tests for blood-borne diseases at a local sexual health clinic, Dr Thompson said that the cost per appointment is more than 10 times what her GP practice charges back to the NHS.

She said: ‘Stopping our funding to do asymptomatic screening of young people who have been educated to get themselves fully checked out before throwing away the condoms is wrong in my mind. That is a significant piece of work [for the practice] but almost as important is the message that it sends, that GPs don’t value this testing any more.’

Commenting on the new contract, she added: ‘It has become a completely arbitrary list of codes, where they say “ok we’ll pay you where someone has secondary syphilis, and we won’t pay you if they’ve got herpes or genital warts”. It is all financial [decision making] because hardly anyone has syphilis, while lots of people have herpes and warts. They are all, to my mind, sexual health [conditions].

‘All it’s done is take away a huge chunk – we estimate probably around £20,000 of the total funding that we were getting – for an excellent, award-winning sexual health service.’

A spokesperson for Bristol City Council said that practices are commissioned by NHS England to offer testing and treatment for STIs (including HIV testing) ‘when clinically indicated or requested by individual patients, where provided as part of “essential services” under the GP contract.

The spokesperson added: ‘The services we commission from Student Health Service were suggested by them at our request. We then sought expert advice and some of the conditions they suggested were considered to be routine and as such would already be funded under their general medical services contract.  Some were therefore excluded for that reason.  The most common infections mentioned above would not normally be referred to a specialist service, they would not require a test but a routine examination which would not require specialist intervention.’

The Superdrug report, which found the student to be the best sexual health student practice in the country, said: ‘The University of Bristol stood out for its forward-thinking delivery methods, setting up dedicated social media profiles to deliver a range of accessible information to help its students make informed choices about their own sexual health needs.’

Dr Elaine Gibbs, president of the Student Health Association amd a GP in Nottingham, told Pulse that moving the responsibility for public health to local councils had caused many student practices problems, including her own.

She said: ‘[It] means that there will be continue to be a postcode lottery in terms of access to these services. It has also been a struggle to get a contract agreed, with the council initially only being prepared to issue a six-month contract; this obviously makes the planning of services very difficult. After a lot of negotiation we have managed to secure a contract up until 31 March 2016. At this point the whole contraception and sexual health contract is up for tender. 

‘My impression is that councils are even more restricted in their availability of funds than the PCTs. They obviously have huge demands on their finances and following the Autumn statement will be even more strapped for cash; this is bound to affect funding for sexual health services.’

It comes as Pulse has also reported of QOF and MPIG funding swings affecting GP practices with high student population, making it ‘not affordable’ to treat students.