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Advances in digital health and novel diagnostics for STIs and HIV have created new opportunities for people to access information, testing and, in some cases, treatment remote from traditional healthcare settings.
Legislation and regulation can facilitate or impede innovation in service delivery. For example, the Health and Social Care Act of 2012 moved responsibility for public health, including the majority of sexual health services, from the National Health Service (NHS) to local government. Shifts in commissioning and service delivery have occurred, with major disinvestment in sexual health services, which has led to innovative models of care being introduced, including online services.1
There is an underlying but un-evidenced assumption that online sexual health services will preserve access and increase uptake at a reduced cost. This has led many services to introduce or expand their online presence, which ranges from simple unidirectional health promotion to more ambitious self-sampling services that aim to ‘channel shift’ those without symptoms away from face-to-face services and into online care.
All healthcare professionals, healthcare services, and the medicines and devices they use are regulated, whether care is ‘traditional’ or remote, including online. Most regulations were established in the pre-digital era, although many professional bodies in the UK have adapted their existing guidance to incorporate online services. There are three key areas of regulation that are particularly relevant to online care:
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