Agenda item

To receive an update on sexual health within Westminster including emerging trends and services provided.

5.1       Helen Byrne (Senior Commissioning Manager) and Gaynor Driscoll (Head of Public Health Commissioning) introduced the report, which provided an overview of access to sexual and reproductive health services across Westminster. The Committee also invited Alan McGowan (Lead Consultant at the Dean Street Clinic – Chelsea and Westminster Foundation Trust) and Leigh Chislett (Clinic Manager at Dean Street Clinic) to join the discussion on this item.

5.2       The Committee was provided with an outline of the sexual health services available within Westminster, how they were being developed and the challenges facing the Council and providers. There were two large sexual health clinics located in Westminster offering a wide range of services. They had a clear objective of trying to reach high-risk communities and this had been successful in reducing the number of new HIV diagnoses in Westminster by 81% between 2016 and 2018. Extensive work with other communities such as the Chinese community, rough sleepers and the transsexual community continued in an effort to reduce HIV as more treatment methods became available.

5.3       Sexualised drug use had emerged as a significant issue and WCC clinics were regarded as leaders in addressing chemsex. Pathways and systems had been developed with local providers to deliver innovative ways of working with this group. This included joint working with the Club Drug Clinic to deliver care packages to affected individuals for both their sexual health and their drug and alcohol use. A ‘party pack’ was being piloted to minimise the harm caused by chemsex practices and these would provide harm minimisation advice and help to reduce the transmission of blood borne viruses and sexually transmitted infections.

5.4       The Committee was interested to learn what methods were used to engage the various communities in Westminster. It was explained that e-services were available as part of a London wide initiative. The service had received positive feedback and continued to grow. Local services were also continued to be strengthened with an emphasis on prevention, diagnosis, treatment and care of STIs with a focus on the population including young adults, Black Asian Minority Ethnic (BAME) and Men who have sex with Men (MSM). To achieve this, flexible services were being commissioned that addressed the changing needs of the population. It was acknowledged that services were particularly challenged due to the high number of people attending the clinics, many from outside Westminster. This was being managed through implementing action plans and demand management strategies to divert people to the online offer, although access to services across London remained an issue.

5.5       An update on the use of Pre-Exposure Prophylaxis (PrEP) was provided which was a medication used to help prevent people from developing HIV if they had been exposed to the virus. The medication had not been implemented fully across England but was operating as a trial, which started in 2019 and was due to be completed by 2022. The Committee discussed the cost of PrEP, the number of people participating in the trial, the criteria for their selection and how the Council could encourage further uptake of its use. It was suggested that in order to assist people at high risk who had need but not the ability to fund the treatment the Council should investigate if it could be offered by the NHS without cost or failing this investigate potential ways of helping support a hardship fund.

5.6       The Committee provided thanks to Helen Byrne, Alan McGowan and Leigh Chislett for attending the meeting and providing an interesting and informative update. A recent site visit to the Dean Street Clinic had been well received and those Members who were unable to attend it were urged to arrange a visit to experience the excellent work being undertaken there.

RESOLVED: That the Committee recommends that PrEP be made available on the NHS without cost. If this was not possible the Council should explore arrangements to support the development of a hardship fund for those people considered at high risk of developing HIV who could not afford to purchase PrEP medication.