Educating Healthcare Professionals in Sexual Health

Sexpression York member Sam Shergill went to the House of Lords in Westminster to attend the All-Party Parliamentary Group on Sexual and Reproductive Health in the UK event 'Educating Healthcare Professionals in Sexual Health' and wanted to share his experience.

Moving forward with sexual health targets starts with the core value of education. In society, this can be described as following a 'top down' approach that is regularly reviewed. In other words, experts compile the best ways of teaching other health care professionals and then, they spread the word to patients in a variety of settings. As the NHS strives for excellence, it is important to improve upon our standards. The Meeting theme in the APPG on Sexual and Reproductive health explored the issues regarding this first step, 'Educating healthcare professionals (HCPs) in sexual health.'

Sexual and relationship education (SRE) and other sexual health services are fragmented across a variety of specialties across the NHS. It is a topic that is important in every discipline in delivering good patient care, whether it is in the community or in the hospitals themselves.

Diplomas and other teaching opportunities for HCPs are available, but the problem is accessibility and awareness that they actually exist.  The 'Introductory Certificate in Sexual Health' shows there are a relatively high uptake of the E-learning modules but a low uptake for courses with a more practical approach. The problem here is that providing safe and confident sexual health care requires exposure to practical experience. Generally, people shy away from this topic in consultations and brush over potentially important information. Moreover, without proper practice using correct terminology, in particular regards to sexuality and gender, HCPs can actually do more damage for the patient.

80% of contraceptive work is actually dealt with in primary care. In many areas, many nurses have the most patient contact, but sexual health education is either not present or not prioritised in the nursing curriculums. There are hopes to revisit and advocate for the incorporation of sexual health teaching with the Nursing and Midwifery Council (NMC). In regards to medical education, the General Medical Council (GMC) regulates each medical school to provide the same levels of sexual health teaching. However, a recent survey by BASHH shows there are huge inconsistencies with the standards of the teaching in sexual health across UK medical schools. There is still a debate as to how best incorporate it into curricula, whether it is an integrated approach or a solely dedicated block. It is important to remember that each school structure is different so having a blanket type of teaching does not necessarily work.

In regards to postgraduate teaching, there are less tightly controlled goals by the GMC. The recent changes in the way sexual health is going to be delivered, due to cuts, means that there needs to be more focus on providing generic skills in sexual health without losing the quality.

The worry with moving towards the new system in providing these foundation skills amongst specialties was put nicely by Dr Andrew Collier of the BMA, "…a Jack of all trades and a master of none." What will this mean for changing specialties such as HIV physicians? There will certainly be a place for them but the route at which they arrive will be different.

Another theme which came to light in the meeting was the under appreciation of community pharmacists in delivering sexual health services. In many areas they can be the first point of contact for patients and should be incorporated in many decisions regarding the delivery of these services.

The meeting lightly touched on the delivery of services in schools. There is a recurring theme amongst some schools that feel uncomfortable teaching SRE. Schools that feel ill- equipped can sometimes put the youngest teacher in charge of SRE even if they do not feel confident or even have any knowledge, let alone qualifications about sexual health. This is why schools are generally quite welcoming to societies such as Sexpression:UK as it takes the pressure away from the teachers that do not know how to deliver effective SRE.

The take home points from this meeting were to prioritise generic sexual health skills throughout every discipline that can be transferable; advocating for certain specialities such as community pharmacists; reviewing and revisiting the inconsistencies in sexual health within the GMC and NMC and finally, encouraging for more practical experience in sexual health consultations before patient contact. Finally, strengthening systems in delivery of SRE within schools will further help with public awareness and engagement with services.