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Commission On Sex In Prison

2 Mar, 14 | by shaworth

The Howard League For Penal Reform is a charity dedicated to improving prisons, the justice system and crime prevention. As part of their work, they commission research into aspects of life in the prison system and one of their ongoing concerns is the Commission on Sex in Prison which is the first large scale review of sex in prisons in England and Wales.

As prisons are deemed public places, sex in prison is technically unlawful, but previous research suggests that sexual activities are undertaken in the prison environment. There is little evidence on how to best manage the sexual health needs of prisoners, or how relationships developed in prisons should be managed within the prison system.

So far, two interim reports from the Commission have been produced. In 2013 they released their first report on Consensual Sex Amongst Men In Prison and in the last week, have released their first report on women prisoners entitled Women In Prison: Coercive and Consensual Sex. Further reports on coercive sex in prison and healthy sexual development in prison are planned in the future.

The report makes valuable reading. According to the Howard Leagues own statistics, this week in the UK there are 85,469 people in prisons and young offender institutions in England and Wales. This is made up of 81,521 male prisoners and 3,948 female prisoners. 1,229 children are currently in custody, with the split on gender being highly skewed towards the male population, with only 65 girls in this population. Although only 0.002% of the adult population is in prison custody, this population changes over time, with offenders being released after serving their sentence. It is probable that medical professionals will provide healthcare for not just those in prison, who access secondary care through the NHS, but also those who have been released or currently progressing through the justice system. It is therefore important that care providers are familiar with the special needs of prisoners and a detailed report on sexual behaviour in prison is valuable to us.

The most recent report makes harrowing reading in places, detailing the high levels of sexual abuse experienced by women offenders prior to detention, and the risk of sexual assault for those remanded in custody from the prison population, including the specific risk of assault from other prisoners to locate drugs concealed internally, and evidence for coercive sexual activities between staff and prisoners. The report highlights that the sexual health needs of women and men are different, and that specific guidance on relationships between women in prison for staff is required.

The final findings of the report will not be revealed for some time yet, and hopefully will go some way to assisting us professionals in providing better care for this particular group.

NICE PGD good practice guidance implementation tools

29 Jan, 14 | by shellraine, e-Media Editor

NICE has published competency frameworks to support the implementation of patient group directions NICE good practice guidance. The competency frameworks have been produced as developmental tools to support individual people and organisations and may help to:

  • identify training and competency needs
  • develop educational materials
  • establish a comprehensive and appropriate training programme
  • facilitate continuing professional development
  • inform the development of organisational systems and processes.

Three competency frameworks have been produced:

The competency frameworks are available to download under ‘Implementation tools and resources’ on the patient group directions guidance page:

The competency frameworks have been developed to support individuals and organisations commissioning or providing NHS services. They may also be relevant to individual health professionals and organisations delivering non-NHS healthcare services.

In The News: The Risks of ISP Filtering for Young People

19 Jan, 14 | by shaworth

The idea of how to police the internet has always been a complex one, and striking a balance between protecting those who use it, in particular those who are not yet adults, remains something that we have not achieved. The idea of restricting what ISP (Internet Service Provider) subscribers can be allowed to access has been debated as long ago as the turn of the century, and over the last fifteen years we’ve watched our legal system frantically try to modernise to keep up.

Most recently, the Prime Minister David Cameron announced plans to make filters blocking adult material to be the default experience for ISP subscribers. Predictably, this has not gone as planned, and in December there was widespread media coverage of mistakenly blocked websites restricting the subscribers access to sex education, and the websites of several LGBT organisations. Oddly enough, this was an improvement from the prior attempt to turn on the filters which blocked access to Childline, and suicide prevention websites.

Many healthcare professionals will have experience of filtering and blocking, and some of you may well have had the unfortunate experience of phoning your IT service attempting to convince them that you’re not in violation of their policies, but just doing your job. This blogger had the misfortune to be on call one weekend, when the employing trust’s filter reset itself to the full default settings, rendering access to all abortion related content impossible. This was rectified as soon as IT were back in office, but children wishing to access impartial advice about sexual health, seeking help and advice about relationships or worse, those in crisis who need urgent access to information to keep themselves safe, may not have that option.

FSRH nominated for UK Sexual Health Award

15 Jan, 14 | by shellraine, e-Media Editor

SH awards




The FSRH Quality Training Project has been nominated in the ‘Adult Sexual Health Service/Project of the Year’ category of this year’s Brook fpa awards. The shortlisted finalists were announced this week.

The Awards recognise outstanding people, projects, services, campaigns and media in sexual health.  Winners will be announced at a glittering awards dinner and ceremony in central London on Friday 14 March.

Other categories include: Sexual health professional of the year; Young person of the year; Young people’s sexual health service/project of the year; The Pamela Sheridan Sex and Relationships Education Award; Sexual health media campaign/storyline of the year; Rosemary Goodchild Award for excellence in sexual health journalism.

More details from Brook/fpa

The Price of Competitive Tendering

12 Jan, 14 | by shaworth

As part of the new NHS reforms, which came into effect on the 1st of April 2013, NHS services in England were required to be placed on the open market. Service providers are now allowed to bid for services as part of these tendering arrangements. As part of the new reforms, responsibility for sexual health services was passed to local councils.

Last month, representatives of BASHH and the Royal College of Physicians, wrote to all councils in England warning about the dangers of competitive tendering. Whilst not all councils are currently commissioning services on a competitive basis, many have indicated intention to do so. In Derby, sexual health cuts of £430,000 have been suggested as the council works to find a further £9 million of funds through cuts. Awarding service contracts to the cheapest provider may well be the only way that sexual health services can still be provided, even if it means the quality of patient care has to be sacrificed.

As Dr Janet Wilson and Sir Richard Thomson say in their letter, tendering may mean greater choice for patients, and potential savings, but they also give examples of the negative impact on the provision of sexual health services: delays awaiting premises for service, the loss of highly trained staff and effects on morale of staff providing services.

For many of us, the memory of the costs of PFI initiatives remains fresh. It remains to be seen whether competitive tendering will turn out to be more costly in the long run.

Clinical Effectiveness Unit – Your Views Please

9 Jan, 14 | by shellraine, e-Media Editor


The FSRH will be holding a focus group on Wednesday January 22nd from 10.30 – 12.30 at the Faculty Offices in Regent’s Park to discuss the role of the Clinical Effectiveness Unit (CEU).

The CEU produces the NICE-accredited Clinical Guidelines as well as running the Members’ Enquiry Service.  We are keen to hear from our members about your experiences of the Faculty CEU services to help us to ensure they are as useful as possible when the Unit is re-tendered later this year.

To register your place please email Jane Hatfield asap via You can also use this email to send us your thoughts if unable to attend.

The FSRH will pay travel expenses and provide lunch following the focus group.

We look forward to hearing your views.

The Week The Women Came

23 Dec, 13 | by shaworth

Channel 4′s The Week The Women Came is a behind-the-scenes look at the world of psychosexual counselling, in which the sexual difficulties of two couples are explored and solved. Counsellor Trudy Hannington practises in Yorkshire, and has been working in her field for over ten years. She is Chair of The College of Sexual and Relationship Therapists (COSRT).


Her first couple, Fiona and Adam, are experiencing difficulty with mismatched levels of sexual desire, a problem that Trudy tells us is not only common, but rarely just about sexual desire itself. In this case, she is correct, and over the program it is established that Fiona has long-standing fears of abandonment, and bad experiences with previous sexual partners. In addition, the fact that the couple are unable to talk about the issue together is established. After several sessions, she is joined by her husband and the issues are explored together whilst a plan of management is started.


Her second couple, Elaine and Keith are older, and their problem stems from Elaine’s menopause, after which vaginal intercourse became extremely painful. Trudy explores alternative methods of sexual contact with the couple, allowing them to re-establish intimacy.


A major criticism of the program surrounds the second couple. Elaine’s problem stems from vaginal atrophy and she has declined HRT. We’re never told the reasons for this, other than she has considered the risks, but we’re never told what kind of consultation regarding HRT, if any, she has experienced. Writing off HRT as something too inherently risky without knowing why, potentially exacerbates some of the misinformation that’s perpetuated on the subject.


Yet overall, this is a sensitive documentary that does explore both of these couples’ problems without judgement and allows Trudy the space to show her specialty as one that is engaging, holistic and actively working with clients to help resolve their problems. The program allows her to be frank with couples, and doesn’t shy away from exploring their histories perceptively. Both couples are able to solve their problems, and the documentary ends with them successfully achieving sexual intimacy with each other: a good advertisement for the counselling process. Considering that Channel 4 is best known for producing medical documentaries that are essentially revivials of the Victorian side-show, a la Embarressing Bodies, this was quite a refreshing take on a potentially difficult subject.


From a public health point of view, The Week The Women Came is a genuinely useful documentary that could provide a starting point for those raising the issue of psychosexual counselling with their patients. Psychosexual counselling is presented as something that should not be feared, even if it explores complex areas; although the issue of HRT information and use needs to be addressed.


The Week The Women Came can be seen on Channel 4′s on-demand service at 4OD.


Dr Sacha Haworth

Historic News for Nurse Training in SRH

26 Nov, 13 | by shellraine, e-Media Editor

Members of the Faculty of Sexual & Reproductive Healthcare (FSRH) have voted overwhelmingly to widen membership to include nurses, paving the way for the development of a new nationally recognised qualification for nurses working in sexual health. This happened last Thursday at an extraordinary general meeting before the Current Choices Conference in London, after which Dr Chris Wilkinson made a formal announcement it in his President’s opening address to the conference. This brought forth spontaneous applause and positive comments from Minister for Public Health, Jane Ellison MP, who said:

“This announcement is a groundbreaking moment for multi-disciplinary working in the health service. I am delighted to see the Faculty of Sexual and Reproductive Healthcare leading the way in opening up their membership to nurses, ensuring that doctors and nurses work together to set standards and improve patient care. I hope this will act as an example for all services.”

and Director of Nursing for Public Health England, Professor Viv Bennett, who added:

“Effective accessible sexual health services need highly skilled teams. It is fantastic that the Faculty is valuing the key roles of nurses in the multi-disciplinary team, providing the opportunity for nurses in sexual health to gain a nationally recognised qualification and through membership to the Faculty ensuring nurses play a national strategic role in developing sexual health services as well as providing high quality services to people locally”

The FSRH becomes one of the very few medical Colleges and Faculties to include nurses within its membership, reflecting the key role that nurses play in the delivery of sexual health care, and the organisation’s desire to promote and develop multi-disciplinary working in sexual health.

What this means in practice is that from January 2014 nurses will be able to become full members of the FSRH by following the same route as doctors and completing the Nurse Diploma. Within the new training structure (for doctors and nurses) there will be a new online knowledge assessment (eKA) which will test the theoretical knowledge gained from the e-SRH or elsewhere. Those who wish to go on to complete a diploma will (after passing the eKA) complete the Course of 5 workshops followed by the ACPs (assessments of clinical practice) as doctors currently do. All of these will be logged via an online e-portfolio. An additional change is that doctors and nurses will, in future, be able to undertake the LoCs (Letters of Competence) for either SDIs or IUTs without first having to complete the diploma – they will, however, have to pass the eKA first.

Further information will be posted on the FSRH website nearer the time of launch.

NICE PGDs – Template & Baseline assessment tool

1 Oct, 13 | by shellraine, e-Media Editor

Two implementation tools have now been published to support the patient group directions NICE good practice guidance. These are available from the NICE website at the links below:

GPG 2 Patient group directions: baseline assessment tool

GPG 2 Patient group directions: template

Azithromycin, PGDs and Peanuts.

30 Sep, 13 | by shellraine, e-Media Editor


Did you know that peanuts are not nuts but are part of the soya family?

Some formulations of azithromycin contain soya as an excipient.

Some services that have drugs supplied by local pharmacies may get different formulations of drugs delivered on different occasions.

Does your azithromycin PGD have peanut/soya allergy as a warning, exclusion criteria?

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