Borders sex clinics record unprecedented rise

CONCERNS have been raised that patients in the region with HIV are receiving “an increasingly unsatisfactory and potentially substandard provision of care”.

The Borders Sexual Health team made the admission in its annual report to NHS Borders, which was released to the Border Telegraph this week.

It revealed more people in the region were diagnosed with the disease last year than ever before.

And fears have been voiced that the increasing complexity of cases could impact on other sexual health services offered by the health board including routine testing for other sexually transmitted infections (STIs).

The report noted that women were already forced to wait up to eight weeks for contraceptive coil insertions, which increased by 164 per cent last year.

And, it claimed, substantial rises in demand which have continued since 2002 were expected to continue to put a strain on sexual health services in the region.

The report, which was written by Dr Dan Clutterbuck, the lead clinician in sexual health at NHS Borders, said: “The increasing HIV care workload has reduced the capacity for routine STI testing in the service and continues to be a significantly clinical pressure.

“We remain without on site pharmacy, social work, psychology, dietetic or other specialist input, so all needs are addressed either informally by medical or nursing staff, or by referral to other services in the Borders.

“This is becoming an increasingly unsatisfactory and potentially substandard provision of care.

“To try to improve HIV care, one clinic a month has been reserved as a HIV clinic, restricting the number of routine GUM patients seen, but with increasing numbers of patients with complex needs, some of whom are rather chaotic, it is impossible to restrict patients to his timetable.”

Nevertheless, it adds: “We are hopeful that the publication of national HIV Action Plan in December 2009 and the QIS HIV care standards, to be published in September 2009, will help to drive improvements in HIV care services to provide a safe, comprehensive and consistently accessible service for patients.”

The report revealed a total of 3912 patient visits were recorded at local sex clinics over the past year – 124 more than 2008/09 and 830 more than 2007/08.

That included an increasing proportion of patients under 25 – including 141 under the age of 16.

However, the Borders Sexual Health team, which is based at the health centre in Galashiels, only employs one full-time member of staff.

And now it has launched a new automated results line in a bid to cope.

Dr Clutterbuck, who splits his week between the Borders and Lothian health boards areas, said: “We have been very good at increasing efficiency and meeting demand by changing the way we do things and although we are fairly stretched we will carry on finding ways of being smarter.

“For example, just this week we have launched a new 24-hour automated results line for anybody who comes into our clinics for routine tests which frees up some staff time and takes the pressure off elsewhere.”

But he added: “While we are continually seeing more patients year on year, and while we continue to try to be smarter in the way we work, we can’t do that endlessly.”

The Borders Sexual Health team, which also runs out-reach clinics in Peebles, Hawick, Duns and Eyemouth, revealed it also recorded further increases in Chlamydia testing this year, although the number of diagnoses reduced.

Small numbers of less common STIs, including gonorrhoea and Hepatitis C, were also diagnosed.

Dr Clutterbuck said: “It’s very easy to think, living in the Borders, that because we’re not in a big city there’s not the same risk of sexually transmitted infections and unwanted pregnancy.

“But, although we’ve got one of the lowest rates of infection in Scotland that’s in the context of Scotland having some of the highest rates in Europe.”

And he added: “There is still massive need for changes in Scottish society in terms of discussing sex and discussing safer sex.”

For more information call The Borders Sexual Health team on: 01896 663700 or log on to their new website – www.borderssexualhealth.org.uk