Dr Julia Shefras and Sue Hunt Clinical Nurse Specialist from OHFT’s C&SH team.

Our last Health Matters of 2012, on Tuesday 27 November, featured some sex in the city as speakers Dr Julia Shefras, consultant in sexual health, and Sue Hunt, clinical nurse specialist and team leader for BodyZone, discussed the work carried out by the Contraception and Sexual Health Service.

For those who made it through the floods this was a really engaging and insightful talk focusing on the C&SH Service and the work they do providing contraception and sexual health services to the population of Oxfordshire. This includes contraceptive and sexual health advice, chlamydia screening for adults and young people as well as psychosexual therapy.

Sue began the talk by discussing teenage pregnancy. Oxfordshire’s teenage pregnancy rates are lower than the national average; 25.9 compared to national figure of 35.5 per 1000 women, and our C&SH Team have been active in helping reduce teenage pregnancy rates across the county. Since 2009 they have seen a decrease of 9.5%. However, there is still work to do with hotspots remaining in Oxford, Banbury and Didcot with teenage pregnancy rates being typically higher in areas where there is social deprivation, poverty and worklessness.

Raising awareness amongst young people is a priority for the C&SH Team as approximately half of teenage pregnancies end in abortion and can affect young women’s health and wellbeing, as well as limiting their education and career prospects. Sue described how children born to teenage parents can be more likely to experience negative outcomes in later life, and are themselves three times more likely to become teenage parents.

Oxfordshire C&SH services for young people are helping to counteract these risks by providing information and advice about contraception and sexual health and working to reduce subsequent unintended pregnancies in young women who have conceived in teenage years. The team have developed an effective c-card scheme for the distribution of condoms and promote a clear message to young people about the benefits of keeping sexually healthy.

Alongside the Alec Turnbull Centre, their drop in clinic at Raglan House in Oxford, C&SH have actively worked to engage with young people in settings appropriate to them. This includes outreach services involving a dedicated Outreach C&SH Nurse who will meet a young person in their home, health centre or another mutually acceptable place to discuss and organise contraception.

There are now BodyZones in 14 secondary schools across the county providing information and advice about general, mental and sexual health, and contraception where appropriate. Two college nurses providing the same information in four college sites in Oxfordshire also support this service. The team provide a follow up service Teenage and Pregnant (TAP) to ensure signposting to C&SH services for adolescents who have already conceived in their teenage years.

Sue explained how working with young people includes talking about relationships and the appropriateness of starting a sexual relationship, ensuring that sex is mutually consenting, and that there is no pressure to be engaged in sexual activity. Consultations follow the Fraser guidelines and RU Ready criteria to ensure the safety of young people in their sexual relationships. This allows them to be empowered to make their own choices and decisions.

C&SH also offer psychosexual therapy and Sue spoke of some of the options available for clients presenting with vaginismus, orgasmic disorders, painful sex, erectile and ejaculatory problems. This discreet, confidential and private service supports people through one-to-one consultations and the development of a tailored plan of therapy using a variety of techniques including sex therapy, behavioural therapy, sensate focus and specific suggestions. Couples are even asked to do homework! Sue credited the success of this service on allowing dedicated talking time for individuals or couples and very focussed advice.

Dr Julia Shefras led the second half of the evening and began her talk providing context by discussing the number of patients seen by the team. C&SH has a staggering 38000 contacts per year of which approximately 6500 are new contacts. 10% of these new contacts are under 16’s coming from BodyZone and other programmes aimed at young people, and 60% are under 25 years old.

Dr Shefras described improvements made by the team in particular around chlamydia screening in under 25’s for which C&SH are one of the biggest contributors in Oxfordshire. This has been helped in part through the outreach work the service provides across the counties schools and colleges, as well as through their Raglan House clinic where clients are encouraged to ‘self take’ using Chlamydia screening kits available from reception.

Dr Shefras also described an example of improvements made through introducing a new process for the use of ethyl chloride spray rather than anaesthetic injection for insertion of the contraceptive implants Nexplanon. This new development is proving to be quicker, easier (and potentially safer) than the old technique of anaesthetic injection. More implants are provided in a ‘one-stop’ service and most importantly patients report that they like it. The initial evaluation of this technique by staff and patients has been very positive and the C&SH service continue to monitor the introduction of this new technique and its impact on patients and service performance.

Despite the improvements already achieved by C&SH Dr Shefras described how the team are continually looking for ways to improve the successful delivery of the service, so no doubt there will be a lot more still to come from this innovative team.

The evening ended with a lively discussion of the topics covered and some great insights from the audience. Thank you to Sue and Julia for a truly enlightening and enjoyable Health Matters.

We hope you will join us on 29 January 2013 for our next Health Matters where Dr Steve Pearce will be discussing personality disorders with his talk Grace Under Pressure:  Personality disorder and society. For more information about this and other OHFT events please visit https://www.oxfordhealth.nhs.uk/news/whats-on/