Article Text
Abstract
Background In 2000, family planning and reproductive health, genitourinary medicine, and women’s health converged to form integrated sexual health services in Glasgow and Clyde, Scotland - the first large-scale UK example. The service now supports 100, 000 people annually via 250 multi-skilled staff in 20 sites across a large post-industrial area with major deprivation, and 1+ million population. Its services include contraception, termination, HIV and STI testing, young people’s and gay men’s services, counselling and a public library. After ten years, the service commissioned three external evaluations to assess success and potential developments. This paper describes a meta-analysis of these.
Methods The evaluations used qualitative and quantitative methods including reviewing activity; undertaking staff surveys, user engagement, stakeholder interviews, population research and feedback from doctors and health professionals. The meta-analysis systematically reviewed the evaluations to triangulate main themes, patterns and disconnects.
Results The meta-analysis revealed significant themes. For example, only 5% of local young people knew the service at its start and 61% a decade later, whereas people in their 40s did not think it relevant. Strategically, the service was felt to have developed an innovative resource for professionals and policy-makers and to be leading sexual health developments and training nationally, but not engaging with local health care enough.
Conclusion The meta-analysis reveals a service that has demystified sexual health care and influenced nationally and more widely. The paper concludes with recommendations that the service should remain integrated, with inequalities-sensitive practise central, and continue inclusive approaches to staff involvement. The service should better utilise social media; engage more with other health staff; better understand older people’s motivations to use services; focus more on men, especially young men, and young people from deprived and minority ethnic communities; maintain its vision to deliver and promote integrated services, and be flexible in possible developments.
- Integration
- modernisation
- sexual health services