As co-chairs of the Faculty of Public Health’s Sexual and Reproductive Health Special Interest Group (SRH SIG) it was a pleasure to attend the All Party Parliamentary Group for Sexual and Reproductive Health’s (APPG SRH) event on ‘Equipping the NHS to deliver for Women’s Reproductive Health’. Healthcare professionals, parliamentarians and community representatives came together for a fascinating discussion about the challenges currently facing the sexual and reproductive health (SRH) workforce, their impact on women’s reproductive health and what can be done to protect the workforce to ensure that women’s needs are met.
Colleagues described the wide-ranging SRH workforce which comprises doctors from genitourinary medicine (GUM), community sexual and reproductive health (CSRH), general practice and infectious diseases; nurses; midwives and other healthcare professionals. It is responsible for providing contraception, termination of pregnancy and testing and treatment for sexually transmitted infections (STIs) and HIV alongside many other services. Clearly, the SRH workforce not only has an important clinical function but also a public health one; and it was concerning to hear about the difficulties filling training and consultant posts, insufficient funding for some training posts and the fragmentation of the workforce due to the disjointed commissioning arrangements.
It is evident that the challenges facing the SRH workforce have significant public health implications. The APPG SRH’s enquiry into access to contraception identified data showing that nearly half of pregnancies and one-third of births in England are unplanned or ambivalent[1]. Abortion rates in England and Wales are rising and, in 2021, reached their highest rate since the introduction of the Abortion Act[2], suggesting an unmet need for contraception. Black women have disproportionately high rates of abortions and rates are higher among the most deprived populations compared with the least deprived2 indicating the health inequalities faced by these groups. In 2021, the number of consultations by sexual health services rose by nearly 16% from 3,460,100 in 2020 to 4,002,827[3], demonstrating the increased pressure that services are under.
The data paints a stark picture and without intervention things will only get worse. So, what can we do in public health to help protect the SRH workforce?
- With the commissioning of sexual health services being the responsibility of local authorities, it is essential that we consider the impact of our commissioning decisions on the SRH workforce and work with our clinical colleagues when designing service models.
- Using a public health perspective, we can support efforts to promote entry into the SRH workforce, such as the British Association for Sexual Health and HIV LOVE GUM campaign.
As the Faculty of Public Health’s SRH SIG we are keen to support the work that needs to take place to address this hugely important agenda and look forward to more opportunities to engage with the APPG SRH and other partners.
Dr Natalie Daley and Dr Rachael McCarthy
Co-Chairs of the Sexual and Reproductive Health Special Interest Group
[1] https://www.fsrh.org/documents/full-report-december-womens-lives-womens-rights/
[2] https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2021/abortion-statistics-england-and-wales-2021#:~:text=Key%20points%20in%202021,-There%20were%20214%2C256&text=The%20age%20standardised%20abortion%20rate,the%20Abortion%20Act%20was%20introduced.
[3] https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2021-report#overall-trends-in-consultations-sti-testing-and-diagnoses-at-shss-among-england-residents
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