NSHAC (2007) 40
NATIONAL SEXUAL HEALTH ADVISORY COMMITTEE
Minutes of the seventh meeting held on Monday 25 June 2007, Committee Room 1, Victoria Quay
Attendees:
Chair: Ms Shona Robison, Minister for Public Health
Vice Chair: Professor Peter Donnelly, Deputy Chief Medical Officer, CMO Directorate, DG-Health and Wellbeing
Members:
Mary Allison, NHS Health Scotland
Dr Nil Banerjee, Consultant in Genito-urinary Medicine, NHS Fife
Dr Jenny Bennison, Royal College of General Practitioners
Hilary Campbell, Relate Scotland
Dr Jim Chalmers, Information Services Division
Msgr. Joseph Chambers, Catholic Education Commission
Shirley Fraser, Health Improvement Programme Manager, NHS Health Scotland
Dr Monika Fotedar, REACH Community Health Project
Professor Anna Glasier, Lead Clinician, Sexual Health, NHS Lothian
Miranda Harvey, Scottish Parent Teacher Council
Hawys Kilday, Caledonia Youth
Roy Kilpatrick, HIV Scotland
Myra Lamont, Royal College of Nursing
Donald Mackay, Directors of Education
Dr Alison McCallum, Director of Public Health, NHS Lothian
Dona Milne, Development Manager, Healthy Respect
Wendy Peacock, Infection Control Manager, NHS Tayside
Rev Andrew Phillip, Church of Scotland
Tim Street, Director, Family Planning Association (fpa), Scotland
Dr David Sutherland, Associate, NHS Education for Scotland
Angela Timony, Chair, Society's Scottish Executive and Consultant in Pharmaceutical Public Health, Tayside NHS Board
Dianna Wolfson, Convenor, Scottish Interfaith Council
In attendance:
Gordon Currie, Schools Directorate, Curriculum Health
Joe Logan, Public Health and Substance Misuse Division, Health and Wellbeing Directorate
David Pattison, Specialist Public Health Adviser, CMO Directorate
Cheryl Paris, Public Health and Substance Misuse Division, Health and Wellbeing Directorate
Catriona Loots, NHS Health Scotland
Alison Craig, NHS Lothian
Item 1: Welcome and Introductions
1. The Minister welcomed members to the seventh meeting of the National Sexual Health Advisory Committee (NSHAC) and in particular to Donald Mackay and David Cameron who were new members of the Committee representing Directors of Education and the Association of the Directors of Social Work respectively.
2. The Minister also welcomed Alison Craig and Catriona Loots who were attending the Committee with Myra Lamont; and Monsignor Joseph Chambers who represented Michael McGrath and Monika Fotedar who was present on behalf of Shehla Ishan of REACH Community Health Network.
3. The members noted that Alison would be replacing Myra Lamont on the Committee as the RCN representative given that Myra would be retiring shortly.
4. Ms Robison stated that the new Government was committed to improving sexual health services and in particular to ensuring that access to services was equally available throughout Scotland be that urban or rural areas.
5. The Minister then invited the Committee members to provide a brief introduction of their background and which organisation they represented on the committee.
Item 2: Apologies
6. Apologies were received from
Eric Baijal, Director of Public Health, NHS Highland
Irene Bain, UNISON
Alison Bigrigg, Director, Sandyford Initiative, Glasgow
David Cameron, Association of Directors of Social Work
Gayle Campbell, Convenor of the Health Committee, Scottish Youth Parliament
Marian Flynn, Strategic Co-ordinator, Glasgow's Teenage Pregnancy Steering Group
Fiona MacKenzie, NHS Chief Executives
Michael McGrath, Director, Scottish Catholic Education Service
Shehla Ishan, REACH Community Health Project, Glasgow
Jamie Rennie, Chief Executive, LGBT Youth Scotland
The Members noted that Tim Hopkins had resigned as the equality representative on NSHAC. The Group agreed the importance of seeking a new equalities representative. The Secretariat would seek a replacement for Tim. It was also noted that Carol Stewart had resigned as the representative from the Association of Head Teachers. The Secretariat agreed to seek a replacement for Carol.
Action: Secretariat
Item 3: Note of the Sixth Meeting held on 19 February 2007 (NSHAC (2007)35)
7. The Minister advised the Members that the note of the sixth meeting had been circulated. The Group noted that the actions from the previous meeting had been discharged. These were:
8. Seek a replacement for Fraser Sanderson - Donald MacKay had agreed to be the Education representative on the Group.
9. Invite nominations from the Committee to form a steering Group for the forthcoming review of Respect and Responsibility - Dr Alison Bigrigg, Professor Anna Glasier, Shehla Ishan and Hawys Kilday volunteered to represent NSHAC on the Project Board. Given their similar background Anna Glasier and Alison Bigrigg agreed to deputise for each other at meetings of the project board.
10. Members were asked for any comments or to raise any issues not already identified on the agenda. No comments were received and the note of the sixth meeting was agreed.
Item 4: Progress on Recommendations for the Scottish Executive and external agencies (NSHAC (2007) 37)
11. Ongoing discussions have been taking place with regard to Action 19 - considering the development and testing of STI diagnostic kits in rural and urban settings. Gordon Scott, GUM Consultant, NHS Lothian, Anna Glasier and Dona Milne recently met with a number of GPs, who fed back on the need for practical guidance and support for GPs. It was therefore proposed that a testing kit for gonorrhoea would be piloted in 6 GP surgeries throughout NHS Lothian and would be aimed at men who have sex with men.
12. Wendy Peacock noted that postal testing kits for diseases other than chlamydia could be particularly helpful for people in rural Scotland as a means of encouraging greater access to testing and treatment. Dona Milne said there was a need to consider the prevalence of gonorrhoea against the additional costs to develop a postal testing kit for a limited section of the population.
Item 5: Progress on Committee Actions (NSHAC (2007) 38)
13. The Minister invited the chairs of the sub-groups to speak briefly to their work and where appropriate highlight any particular successes or points that have hindered progress.
Action 2: Tim Hopkins - The Members noted that as Tim Hopkins had resigned there was no update on action 2. The secretariat will consider how best to take forward this action.
Action: Secretariat
Action 3: Wendy Peacock - Wendy explained that the Report on access to rural services had been re-drafted following consultation and would be circulated to stakeholders for final agreement of its recommendations. The final report will be presented to NSHAC at its October meeting.
Action 4: Shirley Fraser - Shirley explained that the first in a series of dissemination events around the evidence and practice on the sexual health needs of young people with learning disabilities and those from minority ethnic communities was held on 28 February. This was aimed at strategic policymakers. She also explained that the first of 3 regional events for front line practitioners to share practical experiences was being held on 26 June to consider the needs of young people with learning disabilities. It was oversubscribed and a further event on learning disabilities issues IS to be held in September with one on the sexual health needs of those from black and minority ethnic communities taking place in December. The Members noted that the research reports on learning disability issues would be available on the NHS Health Scotland website week beginning 2 July with the BME reports becoming available shortly thereafter.
Action 5: Shirley Fraser - Shirley explained that the development of a communications strategy had been put on hold pending the outcome of the Executive's review of Health Improvement communications activities.
Action 7 & 8: Danny Wight - Danny explained that a scoping review of existing research had been commissioned by NHS Health Scotland, the results of which will allow the sub-group to establish priorities for future research. The initial results of this review had been presented to the January NSHAC meeting and work was almost complete on finalising the results. Once completed, the sub-group will consult on whether future literature reviews should be undertaken by NHS Health Scotland or others with a view to providing proposed future action at the next meeting.
Action 10: Shirley Fraser - The Group was pleased to note that all local authorities in Scotland have now taken part in the review of secondary schools SRE programmes. The findings of the review will be presented at the next meeting of the Committee in October.
Action 11: Roy Kilpatrick -
African and Minority Ethnic populations
Roy explained that the African and Minority Ethnic sub-group membership is being brought together by the African and Minority Ethnic HIV Project Network. This sub-group will mirror the approach taken in the MSM sub-group and is likely to make good progress in identifying priorities and in reporting.
Men who have Sex with Men - this will be dealt with under Agenda Item 7.
Treatment, Care and Support
Following discussions across various bodies, the responsibilities originally outlined for this sub-group have been adopted by other bodies from within the Scottish Executive, British HIV Association and the Scottish HIV and AIDS group. The sub-group has therefore been dropped in the meantime.
Action 12: Alison Bigrigg - Jim Chalmers on behalf of Alison Bigrigg explained that the first 5 Key Clinical Indicators (KCIs) were published in February 2007. The Group noted that KCI 6 on Long Acting Reversible Contraception had received Ministerial agreement for publication. KCI 7 on Sexual Health Care for People Living with Diagnosed HIV had been taken forward by a Clinical Notes Audit and that KCI 8 on Dedicated Staffing of sexual Health Services was on hold pending consultation with the National Workforce Planning Group.
Action 13: Jim Chalmers - Jim explained that the framework on health information had been presented at the February meeting of NSHAC. Since February further work had taken place and in particular, agreement had been reached to develop electronic recording of the Scottish Woman Held Maternity Record. Consideration was also being given to information collected through routine surveys and the potential for enhancing/changing these to providing a better and more coherent picture of sexual health attitudes, behaviour and activity.
Item 6: Education and Training - Myra Lamont (NSHAC (2007)39)
14. The sub-group reviewing education and training had been led by Myra with a remit of reviewing current provision of sexual health and wellbeing education and training across voluntary, private sector, NHS, local authority and other statutory bodies. The Group were required to:
· Identify gaps in education and training;
· Identify training issues from other workstreams; and to
· Inform the development of a national training strategy for sexual health and wellbeing
15. The sub-group undertook the research through:
· Desk based research of policy context;
· Identifying existing training and competency frameworks;
· Interviews and focus groups with practitioners, education and training; providers, employers and professional groups; and
· Surveys
16. A large number of recommendations have been identified and detailed within the report. These recommendations span a range of issues such as policy content i.e. workforce planning, joint working, integrated planning; workforce i.e. need for a national needs assessment, training and recruitment for staff in remote and rural areas; and education and training i.e. common themes such as child protection.
17. A copy of Myra's presentation is attached for information.
18. Hilary Campbell apologised to the Committee for being unable to contribute to the report so far. However she asked to meet with Tim Street, the co-chair of the sub-group on education and training, to allow issues around counselling to be considered as part of the Education and Training Report.
Action: Hilary Campbell and Tim Street
19. Shirley Fraser stressed that sexual health services, including information and advice, were not just the responsibility of health care professionals but also the responsibility of education professionals, youth workers and others with a sexual health improvement remit. She explained that the difficulty faced was equipping people with the required knowledge across differing fields of professionals and in ensuring that those responsible for developing competency frameworks recognised sexual health skills and competencies out with the NHS setting.
20. Myra explained that the NHS QIS standards currently being developed would promote training for multi-disciplinary staff and that a competency based framework would be developed and would demonstrate training needed in all areas.
21. Myra also explained that it was important for this document to link with the workstream looking at Sex and Relationship Education programmes when it was complete.
22. The Committee also agreed that prevention work was essential to cut down the number of people requiring clinical intervention and that there was a need to reach out to young people in their community settings.
23. Tim Street commented that the role of the voluntary sector in providing advice and training on sexual health matters could be better exploited by statutory agencies, as was recognised by the report.
24. The Minister thanked Myra Lamont for the large amount of work she had undertaken in producing the report. Ms Robison explained that she would consider the recommendations within the report in detail with officials and report back to the Committee with her conclusions.
Action: Secretariat
Item 7: Men who have sex with Men (MSM) - Roy Kilpatrick
25. Roy explained that research to scope provision and resource allocations for MSM had been completed. The report would be made available to the Committee at its next meeting in October.
26. In addition, Roy explained that the project group and sub-group had reviewed the existing strategy and focused on its various strands including policy, training, professional development, research and evaluation and practice development at local NHS levels. This revealed a number of issues including:
· The importance of retaining central ring fenced funding for Blood Borne Virus activities
· The importance of ensuring that mechanisms continued to capture the information currently collated through the AIDS Control Act, if this was to be repealed under the forthcoming Public Health legislation.
27. It was noted that the majority of new HIV infections were among men who had sex with men. Danny Wight also noted that a high proportion of the men who were diagnosed within the 'HIV Prevalence and Undiagnosed Infection Among a Community Sample of Gay Men in Scotland - Lisa M. Williamson, MPhil and Graham J. Hart' study were men who had previously had a negative HIV result and therefore emphasised the importance of specifically targeting those men who receive negative results.
Item 8: Respect and Responsibility: Annual Updates - Feedback from NHS Boards and Local Authorities - David Pattison
28. David Pattison informed the Committee that a number of reports had been received and that the return date was Friday 29 June. The reports would be reviewed over the summer months. The reports would be deliberately kept to the same format as last year including additional information on the Key Clinical Indicators, thus allowing some comparability.
29. Face to face visits with NHS boards and local authorities were in the process of being arranged again this year with the visit to Lanarkshire being held on local authority premises. David, Joe and Shirley looked forward to meeting all NHS Boards, special Health Boards and partners this year to discuss good practice and any issues of concern.
Item 9: Communications Update - Joe Logan
30. Joe explained that we would again this year publish an annual report on progress with the strategy. This would take the same format as last year and include examples of good practice. The report would provide an opportunity to promote local improvements in sexual health services. The report is likely to be published in November 2007.
31. There was some discussion around the publication date for the annual report and whether or not this should coincide with World Aids Day on 1 December. It was agreed that the annual report would be published as planned in November.
32. Joe also explained that a stock taking review of the implementation of Respect and Responsibility would soon commence. The aim of the review is to identify any gaps in the implementation of the strategy and offer recommendations on how best to address them.
33. The members noted that a competitive tendering exercise had taken place and that officials were hoping to appoint the review team within the next few days. Note: since the meeting a review team from the Universities of Abertay and Dundee had been appointed.
34. Members who had volunteered to be part of the steering group for the review would be contacted by officials with suitable dates for its first meeting. Note: since the meeting the first date of the steering group will take place on 2 August.
Action: Secretariat
35. The review team would provide a progress report to NSHAC at its October meeting and provide the final report in February.
Item 10: Any Other Business
HPV Vaccination
36. Myra questioned whether an education pack would be developed to accompany the HPV Vaccine in collaboration with public health professionals and school nurses.
37. Peter Donnelly assured the Committee that there would be a focused effort by the Executive and Health Protection Scotland, which would include communications material.
Future agenda Items
38. Shirley Fraser suggested that having a themed discussion at future meetings might be useful and offered up "the role of parents in sexual health matters, particularly as sexual health educators" as a starter. This might involve those NSHAC members whose work included parents providing short presentations to generate debate. It was agreed the Secretariat would consider this in light of the next meeting's Agenda.
Action: Secretariat
Item 11: Date of next meeting, closing remarks and dates of meetings in 2008
39. The Minister asked members to note the next meeting will take place on 29 October 2007. Future meeting would be held on 4 February, 16 June and 6 October 2008.
40. Finally, the Minister thanked Myra for her contribution over many years to the public sector and for the considerable amount of work she had put into the report on training. On behalf of the committee Ms Robison wished Myra a long and happy retirement.
Secretariat Health and Substance Misuse Division
Sexual Health Team Health and Wellbeing Directorate
0131 244 3457
July 2007