National Sexual Health Advisory Committee
Notes of Third Meeting held on Monday 20 February 2006
Conference Room 2, Victoria Quay
Attendees:
Chair: Mr Andy Kerr, Minister for Health and Community Care
Vice Chair: Professor Peter Donnelly, Deputy Chief Medical Officer, SEHD
Members:
Alex Davidson, Head of Adult Services, South Lanarkshire Council
Jamie Rennie, Chief Executive, LGBT Youth Scotland
Professor Anna Glasier, Head of Planning & Well Women Services, NHS Lothian
Dianna Wolfson, Convenor, Scottish Interfaith Council
Dr Nil Banerjee, Consultant in Genito-Urinary Medicine, NHS Fife
Dr Alison Bigrigg, Director, Sandyford Initiative, Glasgow
Shirley Fraser, Public Health Advisor, NHS Health Scotland
Professor David Goldberg, Consultant Epidemiologist, Health Protection Scotland
Miranda Harvey, Parent/Voluntary Director, Scottish Parent/Teacher Council
Hawys Kilday, Chief Executive, Caledonia Youth
Roy Kilpatrick, Chief Executive, HIV Scotland
Myra Lamont, Assistant Director of Nursing Services, Sandyford Initiative, Glasgow
Carol Stuart, Head Teachers Association
Michael McGrath, Director, Scottish Catholic Education Service
Wendy Peacock, Director Manager (Public Health), NHS Tayside, representing Head of Health Promotion Managers Group
Rev Andrew Philip, Church of Scotland
Angela Timoney, Royal Pharmaceutical Society (Scotland)
Tim Street, Director, Family Planning Association (fpa)
Hilary Campbell, Chief Executive, Couple Counselling
Alison McCallum, Director of Public Health, NHS Lothian
John Wilkes, Director, Equalities Co-ordinating Group
Dr Daniel Wight, Senior Researcher, Social and Public Health Sciences Unit, Medical Research Council
In attendance:
Matthew Cormack, Public Health Division, SEHD
Joe Logan, Public Health Division, SEHD
David Pattison, Medical Directorate, SEHD
Dr Katherine Falconer, Qualifications, Assessment & Curriculum Division, SEED
Julie McIlroy, Ministerial Support Team
Dr Jim Chalmers, ISD Scotland
Item 1: Welcome and Introductions
1. The Minister welcomed members to the third meeting of the National Sexual Health Advisory Committee and in particular, to Carol Stuart, who has replaced James Leggat as the representative of the Head Teachers Association of Scotland and Dr Jim Chalmers, ISD who is working with Professor Goldberg on the NSHAC action on data collection.
2. The Minister further commented that good progress has been made since the second meeting in October 2005 and he looked forward to another productive discussion.
Item 2: Apologies
3. The Minister reflected on the number of apologies tendered in the few days prior to the meeting and while it is inevitable that there would be occasions when members would be unable to attend a meeting, he asked that every effort be made to attend future meetings. Apologies were received from Dona Milne, David Sutherland, Dr Lesley Macdonald, Irene Bain, Fiona Mackenzie, Dr Mairi Scott, Shehla Ihsan, Mary Allison, Marian Flynn and, Fraser Sanderson.
Item 3: Notes of Second Meeting held on 24 October 2005 (NSHAC (2005) 12)
3. The Minister advised the meeting that only one comment had been received by the Secretariat on the notes of the last meeting, to change Wendy Peacock's job title to Director Manager (Public Health), NHS Tayside, representing Head of Health Promotion Managers Group. John Wilkes advised the meeting that his title was Director, Equalities Co-ordinating Group. Both of these changes will be reflected in future communications. It was agreed to circulate an updated contacts list with the note of the meeting. Action: secretariat.
4. No further comments were received from members and the notes of the second meeting were accepted.
Item 4: Progress on Recommendations for the Scottish Executive Health Department and external agencies (NSHAC (2006) 14)
5. The Minister invited Joe Logan to speak to this paper. Joe said the paper provided an overview of the process for tracking those recommendations attributed to the Scottish Executive Health and Education Departments and external agencies, including NHS Health Scotland and NHS Quality Improvement Scotland.
6. Joe Logan made the following points:
• Action 15 - the Executive has asked boards to ensure their strategies address inequalities and the needs of people who are socially disadvantaged.
• Action 17 - the Executive has received detailed information on the costs associated with taking forward this action, and would be considering this with NHS central procurement contacts - a further update would be provided at the next NSHAC meeting.
• Action 19 - the Executive will be contacting the Association of British Insurers (ABI) to discuss the guidance on their website
• Action 20 - the Sexual Health Team will meet the policy colleagues in Equalities and Diversity team to consider a co-ordinated approach to this action.
• Action 69 - NHS 24 are in the process of updating their algorithm
• Action 74 - the Sexual Health Team will ask NHS QIS for an update on progress as part of the process for producing an annual report on the national strategy.
Item 5: Progress on Committee Actions (NSHAC (2006) 15)
7. This is a regular agenda item to provide progress on the Committee's actions. The Minister asked that the initial discussion should focus on the paper on key clinical indicators, followed by the other Project Initiation Plan (PIP) leads reporting on progress in taking forward their tasks. This being agreed, he invited Dr Bigrigg to present her paper on Action 12 (Appendix B to NSHAC (2006) 15).
8. Alison commented that there were proposals for nine key clinical indicators. Of these, five were put forward for immediate implementation i.e. from April 2006 onwards:
Chlamydia Testing - Targeted testing to analyse the prevalence of Chlamydia within each NHS Board area. Issues around data collection for this indicator;
Access to Male & Female Sterilisation - to consider the provision of sterilisation within NHS Board areas and the waiting times for these procedures. Some Boards not providing good service;
Termination of Pregnancy - This indicator to determine percentage of terminations taking place at less than, or equal to 9 weeks gestation, by NHS Board.
HIV Therapy - To consider the proportion of HIV+ people in specialist care eligible for anti-retroviral therapy (ART), and those treated who have an undetectable viral load. The meeting was informed that not all Boards had submitted data to complete this action. The Minister suggested that someone needed to go back to them and would expect all Boards to comply; and
Hepatitis B Vaccination for MSM - To research the proportion of men who have sex with men attending GUM clinics and eligible for Hepatitis B vaccine who first access it in this setting.
Four further key indicators were identified:
Long-acting Reversible Methods of Contraception (LARC) - To consider numbers of women using LARC by NHS Board. Most of the data needed is available but still some tidying up to do;
Sexual Health Care for people living with diagnosed HIV - To consider proportion of people living with diagnosed HIV who have a sexual health screen every 6-12 months;
Staffing of Sexual Health Services - This is important as the only reliable method of measuring sexual health capacity within Boards. Increasing service capacity is essential to the successful implementation of the strategy; and
Individuals with Symptoms Suggestive of an Acute STI - Dealing with priority group who need prompt access to services. A good start has been made to finalise this indicator and plan to discuss with Scottish Executive contacts.
However, the four indicators require further work to bring them to a stage amendable for implementation, potentially in the autumn of 2007.
9. The group noted that redressing the lack of data on inequalities should be a priority. There were also some problems with data systems which the group would be trying to address e.g. through the introduction of a new data collection (Chlamydia Testing) and going back to NHS Boards for data which has not been provided (HIV Therapy). It was noted that further consideration on data collection needs by NHS Board Lead Clinicians would be made at a meeting convened by Dr Bigrigg. Action: Dr Bigrigg.
10. It was raised that voluntary bodies also need to be aware of the development of the key indicators, particularly where they were providing services commissioned from NHS Boards. This would be taken into account by the Executive when deciding how best to take these indicators forward, including a dissemination strategy. The key indicators were not agreed at the meeting and would receive further consideration. Action: Scottish Executive.
11. The leads of each of the other PIPs gave a brief presentation on progress to date. The presentations were based on the progress update reports contained in the paper, NSHAC (2006) 15.
Action 2: John Wilkes - Some evidence of good practice has been noted in the local plans submitted by Boards and these will be studied closely. However, there is a need to go back to Boards to scrutinise the policies and data used. Need to ensure good communications with other sub-groups tackling equality and diversity issues.
Action 3: Wendy Peacock - Members to consider main issues with peer groups. Devising good practice guidance and on-line survey.
Actions 4 & 5: Shirley Fraser (and Action 5 Mary Allison) - Nothing of substance to add to what is in NSHAC (2006) 15 (page 34). On Action 4, expect to have feedback on Black Minority & Ethnic groups by June 2006. On Action 5, undertaking literature review and considering what resources are being made available to consider this. The Minister added that he wants consistent information and communications that can apply across the whole of Scotland.
Actions 7 & 8: Danny Wight - The sub-group has held two meetings to map out available literature in Scotland, including educational to help take forward actions. Start by addressing Scottish/UK legislation but may ultimately extend to worldwide. Evaluation of intervention will only rely on published data. Next meeting scheduled for June but this is dependent on NHS Health Scotland.
Action 10: Fraser Sanderson (James Leggat has left the Committee. Carol Stuart to take forward) - Nothing of substance to add to what is in NSHAC (2006) 15 (page 35). Need to review what currently goes on in SRE programmes and consider where changes need to be made.
Action 11: Roy Kilpatrick/David Goldberg - Good progress. Sub-group has met and set up three support sub-groups to consider issues around gay and bi-sexual men, needs of African and BME populations and in HIV access, treatment and care.
Action 13: David Goldberg - Work is progressing well. The sub-group are putting together a list of 'often asked' questions to ensure that all possible questions are addressed. This includes data from clinical and non-clinical sources, including public surveys.
Action 14: Myra Lamont - Sub-group have set up a number of clinical and non-clinical working groups, gathering information for workforce surveys and learning from nursing reviews.
The Minister noted that whilst there were obviously some challenges to overcome, there appeared to be no major problems and good progress continues to be made.
Item 6: Clinical Service Plans and Interagency Sexual Health Strategies (NSHAC (2006)16)
12. The Minister invited David Pattison to provide feedback on the current status of the interagency sexual health strategies.
13. David thanked the Boards and partner organisations for their good response. The Boards have included within their Plans good performance indicators and have confirmed that they either have, or will incorporate equality and diversity assessments. Boards have also been asked to set out how they have included key stakeholders. All of this will be included in Boards' Annual Reports which should give a good indication of how we are progressing in this area.
14. In order to ensure consistency of reporting a reporting framework will be circulated to all NHS Boards. This would also form the basis of the national report to be prepared by NSHAC. To assist this process, members were asked for comments on the outline template at Appendix A, the template for the national SHS Annual Report for 2005-06 and Appendix B, the reporting template for Boards' SHS annual updates to their local Annual Reports. Appendices A and B are based on the template used by NHS Lothian for their 2005-06 report.
15. It was suggested that Appendix A should have a section on 'Challenges to Success' and on 'GP Reporting'. David asked if members could e-mail either himself, or Joe direct with other comments as soon as possible. Action: Members to e-mail comments on templates.
Item 7: Communications - Oral Report
16. The sexual health strategy website is now up and running. Joe reported that links to local strategies were now being added although there had been some technical difficulties and these are being resolved. Action: Joe indicated that he would write to members with an update on progress in March/April.
17. Joe also advised that it was intended to hold a series of meetings with NHS Boards and special Health Boards as a follow up to a request for an update on progress to date with their actions in Respect & Responsibility. The meetings will provide an opportunity to obtain feedback on progress to date, discuss any outstanding issues and will contribute to the production of the annual report on the national strategy.
18. Joe is in discussion with the Executive's communications team about the best way to inform the general public and in particular young people, on the progress of the national Strategy.
19. It was noted that the Minister had offered to meet with the Cross Party Group on sexual health which would be one means of disseminating the Committee's work to the wider field. Action: The Minister will consider timing for another meeting with the cross-party group on Sexual Health.
Item 8: Any Other Business
20. There was no other Business
Item 8: Date of next meeting
21. The next meeting of the NSHAC will take place, same time and venue, on 26 June 2006.
Closing Remarks
22. The Minister closed the meeting by thanking members for their contribution at today's meeting and for their ongoing contributions in the individual actions. Good progress has again been made.
Secretariat
April 2006