Fears for England's sexual health as RCN survey finds clinics struggling to meet patients' needs

RCN survey of 600 nurses uncovers understaffing, job freezes and inadequate training, with staff forced to turn people away from sexual health clinics 

Short-staffing in sexual health clinics in England could be leading to a drop in infection testing, an RCN survey suggests.

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In a new report from the college presented at RCN congress in Belfast today (14 May), nurses say they have had to turn patients away due to a lack of staff and they have fears about the potential effect on public health.

The survey of 600 nurses, which forms part of the report, found services severely understaffed, with few registered nurses, an inadequate mix of skills and little access to training.

'If people are not able to access services then serious STIs could go undiagnosed and untreated – it is a major risk to public health.'

Six in ten respondents said there had been a reduction in the number of registered nurses where they work, with the majority pointing to recruitment freezes as the reason behind shortages. Almost two-thirds of respondents blamed underfunding for a lack of access to staff training.

Shift in funding 

The report highlights how in the five years since the government shifted responsibility for public health services to local authorities, sexual health has seen detrimental changes to commissioning and provision of services, funding reductions and a ‘dangerous recruitment freeze’.

Over the same period, the number of people aged 18-24 being tested for chlamydia, the most common sexual health condition, has fallen by close to half a million. Despite the 25 per cent fall in tests, the most recent figures show a higher level of positive diagnoses, now at 128,000 cases per year. The report also points to an increase of 12 per cent in syphilis diagnoses.

'Worrying picture'

Commenting on the report, RCN professional lead for public health Helen Donovan said: 'This is a worrying picture of understaffed services going to extreme lengths to try to cope, even turning people away – the last thing a health professional ever wants to do.

'If people are not able to access services then serious STIs could go undiagnosed and untreated – it is a major risk to public health.'

Ms Donovan added: 'We want to see well-planned, well-staffed services capable of safeguarding the public’s long-term health. By failing to tackle this problem, the government is storing up problems for the future.'

The report also shows that the introduction of the human papilloma virus (HPV) vaccine for teenage girls contributed to a 74 per cent reduction in genital warts in girls aged 15-17. However, access to cervical screening for HPV has been affected by the same confusion in commissioning and provision.

The impact of STIs remains greatest in heterosexuals aged 15-24 years, black and minority ethnic people and gay, bisexual and other men who have sex with men.

Tipping point

British Association for Sexual Health and HIV president Olwen Williams said: 'These important findings provide yet more evidence that sexual health services have reached tipping point in this country.

'Despite the best efforts of staff to maintain standards, persistent and damaging cuts to the local authority public health budget in recent years have led to clinic closures and a worrying increase in the number of patients being unable to access the care they need.

'With the recent emergence of multi-drug resistant gonorrhoea and record levels of syphilis, these cuts have come at the worst possible time. It is therefore vital that the government reverses the cuts and provides services with the support they desperately need.'

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