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Jane Hatfield on the future plans for the Sexual Health & HIV Policy eBulletin
Date: 15 Feb 2018
Author: Jane Hatfield - CEO of FSRH
In this first eFeature for 2018, Jane Hatfield CEO of FSRH, touches on plans for the future with this key publication for the sector.
The Sexual Health & HIV Policy eBulletin will be supported by a coalition of interested organisations from across the sexual health, sexual and reproductive health and HIV sectors in 2018. Jane Hatfield is confident that the move to work together on the eBulletin will serve to emphasise the common ground between the sectors. However, she also acknowledges the challenge faced by individual organisations of reconciling the need to represent sector interests and ‘fight corners’ with the aspiration of working as part of a larger health and social system in which seamless care is – ideally, at least – built around the needs of the patient.
I am delighted that we have been able to sustain this eBulletin since MEDFASH closed down over a year ago now. It is a credit to their hard work that they produced something that is relevant to all of us working across the sexual health, sexual and reproductive health and HIV (SH, SRH and HIV) fields. Given some of the divisions that the Health and Social Care Act introduced or reinforced when it came into being 5 years ago (which this eBulletin was a response to), it is a small miracle that it has survived. I would like to thank the MAC AIDS Fund for continuing to support the eBulletin and I am very much looking forward to it being supported via a coalition of interested organisations from across these sectors in 2018 and beyond.
I am struck by how hard it can be to reconcile our need to 'fight our corners' in our sectors and also to work as part of a larger health and social system in which seamless care built around the needs of the patient is (rightly) the aspiration. Many of us in this sector work for charities that have specific aims built into our constitutions – for instance, to represent a particular part of the workforce or to advocate for a particular issue. So not only are we following an interest or passion, but we are also representing the interests of our members and doing right by our trustees. On the one hand we need the specialist knowledge and understanding and the advocacy to make progress, as the early pioneers in 'family planning' and HIV/AIDS so clearly demonstrated. On the other hand there can be unintended consequences to us fighting for our specific causes. We need to ensure that appropriate specialist expertise is available when needed, and also passed on, via appropriate training, to nurses, GPs and allied professionals. But is a woman living with HIV, who is trying to avoid pregnancy, due a smear and might want to become a mother in the near future, served well by our NHS as it is currently constructed? And what about her gynaecological care before and after birth? This woman needs input from a range of specialists (and non-specialists) in a service with clear and accessible pathways of care. Certainly, our attempts to design services around the patient/person appear to be easier to achieve where commissioning silos are less pronounced and funds less constrained.
When the FSRH agreed to find funding for this eBulletin to continue, we did consider – with a range of partners and readers – whether there was still a need for a bulletin that highlights emerging policy developments and pulls together guidance, tools and resources across the SH/SRH/HIV sectors. The conclusion was that although there is less confusion than there was when it was launched 5 years ago, it is very important that there is a source of information that encourages us to understand and be up to date in the areas that are not our focus but are our concern. Commissioning silos remain and there is a danger that because of the pressure on funding, understanding of the need for a range of specialities and specialisms is lost. This is leading to (unintended perhaps) consequences for patients.
There are many examples of organisations in this sector working well together – for example over access to pre-exposure prophylaxis (PREP) or the coalition work to get high quality Sex and Relationships Education (SRE) in all schools - to achieve better outcomes for our communities. I hope the fact that this eBulletin provides information about what is going on across our sectors will support the efforts of those who are working on the common ground between us. I can hardly suggest that this eBulletin has the power to overcome barriers in our sector by itself, but I hope that by working together to produce something that works across the fields of SH, SRH and HIV then it will be moving in the right direction and will be a fitting legacy to the work of MEDFASH.