By Lilian Anekwe
Local enhanced services in sexual health may be ‘perversely worsening’ the provision of care and creating inequalities in access, according to Health Protection Agency researchers.
An evaluation of all LESs offered across Surrey and Sussex, an area of five PCTs with a population of 2.5 million, found four out of five PCTs offered at least one sexual health LES but that ‘there was wide variation in LES coverage, capacity and also GU medicine capacity between PCTs.’
A national survey by the All Parliamentary Pro-Choice and Sexual Health Group in 2007 found uptake of LESs in sexual health was poor, with only 27% of PCTs and 5% of GP practices offered one.
Lead author Dr Angela Bailey, consultant in genitourinary medicine at Imperial College Healthcare NHS Trust, and a researcher at HPA south east, concluded: ‘There is variation in degree of coverage of sexual health LESs, and in their scope and aims. Despite standards requiring involvement of GUM clinicians and defined care pathways for patients across networks, there is often poor co-ordination and a lack of formal links between LESs and the local GUM clinics. This may be detrimental to patient care.
‘The majority of LESSH identified target young people, with LESSH provision for older adults and other risk groups, such as men who have sex with men, relatively lacking.
‘LESSH are being used to drive provision of the basic STI services, which should be available in most primary care settings.12 This may lead to basic services becoming optional extras, perversely worsening inequalities in access.’
The study is published in the January 2010 issue of the International Journal of STD and AIDS.
Sexual health LESs may be worsening inequalities in access according to HPA researchers