Within a digital NHS, sexual healthcare systems need ways of helping people get into the right care pathway for their needs. For some, ideal pathways to appropriate care are online, for others face-to-face, or a combination of both. Currently people are getting less or no choice in available care pathways. This could make things worse and cost more. Some people with the poorest sexual health already find it hard to engage with existing services; we need to make sure nobody is left behind as NHS care shifts online.
We aim to improve health outcomes for people with sexually transmitted infections (STIs) and their sex partners by creating clinical care pathways fit for a digital NHS, and measuring how well they work in getting people the care they need. We believe we're tackling the problems important to people in the groups most affected by STIs, by securing safe and equitable care for all.
Background: STIs are rising. They have a huge impact on people's lives and are very costly for the NHS. Sexual health funding has been cut; online STI testing (self-sampling) is replacing face-to-face care. This could help many people, but others might find it difficult to use, particularly people at greater risk of STIs. We need to understand what hinders/helps people at high risk and how we can best engage them with a range of options for testing, treating and preventing STIs, within inclusive, good-value-for-money services.
We'll take advantage of our new technology, the eSexual Health Clinic, the first NHS service to offer an online automated consultation and ePrescribing in a web-app. It was very successful in treating people with chlamydia in early studies. But it isn't the finished product yet, hasn't been tested out large-scale and we don't know if it suits the people at highest risk of STIs.
Design and methods: We'll talk to service users and staff, and use routinely collected data to learn about the pros/ cons of online and other pathways for testing/treatment/prevention. We'll use this information to further develop some of these pathways within the eSexual Health Clinic. We'll make them as inclusive as possible and measure their effectiveness, value for money, and who does and doesn't use them in a clinical trial. We'll look at services for partners of people with STIs too.