In East Riding a mobile sexual health clinic has been established, allowing staff to take services direct to where people are. It forms part of a multi-pronged approach to reach out to local people, especially the young. PrEP is a pill which prevents infection with HIV by stopping the virus from replicating.
From health promotion to a mobile clinic
East Riding’s sexual health service has done sexual health promotion outreach work in a variety of settings for many years. A team of support workers has toured schools, colleges, pupil referral units and army bases ever since public health moved into local government.
The team provides advice and raises awareness about the importance of looking after sexual health as well as handing out testing kits, free condoms and pregnancy tests and book appointments remotely. A health promotion bus was also used from time to time to do some mobile outreach work.
When the contract for sexual health services was once again awarded to City Health Care Partnership CIC in 2020 it was decided to build on the outreach model.
A converted Mercedes van was purchased to provide a full-time sexual health clinic on wheels with the support workers upskilled so they could have one-to-ones and discuss concerns during the health promotion visits.
‘The mobile unit has great potential’
Sexual Health Associate Practitioner Tonian Lowe, who leads the outreach work, said: “The mobile unit has given us a much more comprehensive offer for our outreach work. Before we were largely focussed on prevention and awareness. Some of the talks in schools were really hard-hitting and created lots of questions.
“Now we have the mobile unit there it gives pupils more of a chance to go and ask questions, get tested and get contraception. We are doing rolling pop-up clinics in all the colleges and the majority of the sixth forms. We also visit hostels, looked after children’s homes and festivals, LGBTQ+ communities and support young people with a learning disability.”
She said the service is now looking to build on the work that has been done by exploring doing community visits to neighbourhoods with high rates of STIs.
“We have done a pilot one – it was not so popular. At schools and hostels you have a captured audience which was not the case for this. We want to look at how else it could work. At the moment, we are trying to get agreement to offer LARC (long-acting reversible contraception) implants and injections and issue pills – it could be a good way to build an offer that will prove attractive when we do these community visits. The mobile unit has great potential.”
The alternative routes in
But alongside the outreach work Ms Lowe said it was also important to provide alternative routes in for young people. “Getting them to book an appointment in a clinic is not easy. Young people are often anxious or worried about accessing help – I’ve noticed that especially after Covid.
“We have a text service and a virtual clinic on the website as the feedback suggests young people shy away from face-to-face consultations initially. With the texting service the only demographic we receive is their mobile number - they receive a text back immediately stating it has been received and they will be called back. The anonymous part of this is attractive to young people and has been very successful.
“But once we chat to them and have their confidence we then find they are happy to book an appointment. They can do that in a clinic or we can come to their school or home, whatever works for them.”
The service also has a system in place to flag when anyone accessing STI testing online or an appointment has a highlighted safeguarding concern registered against them. They then get a follow-up call.
There is an email service for professionals too, allowing the likes of school nurses, health visitors, midwives and mental health staff to refer directly into the service. “We have worked really hard to reach out to young people in a variety of different ways,” said Ms Lowe.
‘We’re maximising the use of our resources’
Sexual Health Commissioning Lead Isabel Carrick is delighted with how the approach is working, saying it is making a much more cost-effective use of resources.
“We are responding and taking services to where they are needed most – and that is allowing us to make sure we are maximising the use our resources. We share a main hub sexual health clinic with commissioners in Hull and this is open six days a week.
“Being a large rural area, we have also always had spoke clinics in GP centres, community hospitals and other locations. However smaller spoke clinics with limited hours a week were not getting high enough footfall or being open at times when residents needed them.
“The new service model with fewer static clinics and a focus on the mobile clinic is able to provide a much more agile service, reaching out to where there is sexual health need.”