NHS sexual health services ‘at breaking point’ amid rise in STIs

NHS sexual health services are “at breaking point” due to rising numbers of sexual transmitted infections (STIs) and financial pressures, a leading sexual health expert has said.

Professor Claudia Estcourt, a professor of sexual health and HIV at Glasgow Caledonian University, warned the Scottish Government may not meet the aims of its sexual health action plan without additional funding.

That plan covers the prevention of blood borne viruses, including the elimination of HIV transmission and Hepatitis-C, and improving access to sexual health services, including contraception.

But several STIs have been reaching record numbers in recent years in Scotland.

According to the latest statistics, gonorrhoea cases reached 5,641 in 2022 – a 49 per cent increase from 2019 levels – while there were 13,148 chlamydia diagnoses in the same year.

The reason for these increases is unclear but Estcourt warned that having to shift prevention spending into treatment had created a “vicious cycle” for the health service.

She said: “It would be really difficult for people to implement all of the elements of the [sexual health action] plan because we’re under tremendous strain with the rise in numbers of STIs and currently also high levels of contraceptive need and abortion.”

She added: “We are at breaking point in terms of the numbers of people needing STI treatment. Services did not come out of Covid in a particularly good state and also then having to cater for an increasing number of people with an increasing number of infections.”

There have also been significant concerns of a recruitment crisis facing sexual health services across the UK.

Scottish chair of professional body the British Association for Sexual Health and HIV Dr Bridie Howe – a consultant in NHS Highland – has warned of empty training places in the specialty.

She said: “When we see a wave of retirees in five years’ time, there’s not going to be people to fill those because there’s nobody starting the training now.

“If we think that there’s pressure now and inequitable access to specialist sexual health services now, it’s not going to get better in a hurry unless there is a drive to fill those places and to recruit into the training programme.”

A report last year by HIV and sexual health charity the Terrence Higgins Trust warned resourcing constraints were already impact access to NHS services.

It found pressures across Great Britain meant there was an “emerging trend of gatekeeping” for face-to-face appointments, yet at the same time many services did not have sufficient alternatives like drop-in services, online appointments or postal testing.

The Trust urged the Scottish Government to roll out a national postal STI testing service – something which ministers have committed to but are yet to deliver.