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New Resources

16 Aug, 12 | by shellraine, e-Media Editor

  WHO Guidance – Safe abortion: technical and policy guidance for health systems

The second edition of this guidance has now been published and is available from:  http://extranet.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf

  RCOG – The Initial Management of Chronic Pelvic Pain,  (Green-top 41)

New guidance published in May available from: http://www.rcog.org.uk/womens-health/clinical-guidance/initial-management-chronic-pelvic-pain-green-top-41

RCN – SDI and IUT Accreditation Guidance Documents – Sixth Edition

Accreditation, which is valid for 5 years costs £360 for members and £480 for non-members – re-accrediation is £180 and £240.

Available from: http://www.rcn.org.uk/development/learning/accreditation/LARC_accreditation

“Don’t go in without a skin”

Online condoms and lubes provider the Freedoms Shop (Central & North West London NHS Foundation Trust) has teamed up with Terrence Higgins Trust to launch the Summer Lovin’ campaign – urging gay men across London to use condoms – with a new online health resource. The downloadable resource brings together stacks of health and sexual safety information, presented in a cheeky, accessible way, while Freedoms is providing a half price condoms

 

Faculty Initiatives & Fitness to Practice

24 May, 12 | by shellraine, e-Media Editor

Crucial Issues for Health Joint Strategic Needs Assessments and Local Health & Wellbeing Strategies

Joint Guidance has been published by FSRH, BASHH, fpa, Brook, BHIVA, MedFASH, NAT, THT & NHIVNA to guide and assist Local Authorities who are preparing to commission sexual & reproductive health & HIV services when local government takes up its new public health responsibilities in April 2013.  In the coming months every Local Authority will need to:
- complete a Health Joint Strategic Needs Assessment (JSNA)
- establish a Health & Wellbeing Strategy & investment plan
- prepare to commission public health services.

FSRH response to APPG inquiry

The Faculty has published its response to the APPG on SRH inquiry into restriction on access to contraceptive services as outlined in the blog of 20th April.

Workforce Census 2012

Service representatives are directed to the Faculty Workforce Census for 2012. Forms are available online via the FSRH website and need to be completed by 30th June 2012.

GMC Fitness to Practise reforms

From 11 June 2012 the Medical Practitioners Tribunal Service (MPTS) will be the new impartial adjudication service for the medical profession in the UK. The MPTS will hear all fitness to practise cases about doctors and makes decisions on what action is needed to protect patients, if any. The MPTS is part of the GMC, but it is operationally separate from the GMC’s work in investigating complaints about doctors and presenting cases at hearings. Complete guide to the MPTS available from FSRH website.

News items from April

4 May, 12 | by shellraine, e-Media Editor

Better access to birth control would reduce stress on global resources

as reported by Nigel Hawkes in the BMJ. The rich should consume less and the poor should procreate less, says the Royal Society in a new report. The report was produced by a working party chaired by John Sulston, who headed the UK part of the Human Genome Project, and took 21 months to research and write.

Morning after pill courier service launched

A new service allows women (living in London) to order emergency contraception on the internet, so it arrives within two hours, rather than having to see their GP to obtain the drugs. For £20, women can order the drug by filling out an online form through the internet medical practice DrEd.com. The forms, which ask users to confirm they are aged over 18, will be assessed by doctors before pills are dispatched by courier. Currently they only offer Levonelle®, which can also be purchased in advance and by buying 2 packets for £24.00 at a saving of 37%.

Pharmacists should provide oral contraceptive services, says NHS report

As reported by Jacqui Wise in the BMJ:
“A report from NHS South East London has recommended that trained community pharmacists provide oral contraceptive consultation services after a successful pilot scheme to widen access to contraception.  The part of the report that has received the most media coverage is a recommendation to “consider providing the service to women under 16 years where appropriate.” The report said that this may help reduce numbers of teenage pregnancies.”

Brook and fpa respond to proposal to introduce contraceptive pill in pharmacies

Responding to the proposal that the contraceptive pill should be available from pharmacies without a prescription to young people, including those under 16, the chief executives of Brook and FPA, Simon Blake and Julie Bentley said: “The majority of young people under 16 are not having sex, however we must ensure that those who are can access support and services when they need to. “Although Brook and FPA welcome proposals which could increase young people’s access to sexual health services and information, all the necessary safeguards must be in place to ensure young people can get the information and support they need. “This includes pharmacists having the appropriate clinical knowledge about contraception, being able to communicate effectively with young people, having the right type of environment including a confidential space, as well as the appropriate support and referral networks.”

Egg-Sharing in Fertility Treatment

Evaluating egg-sharing: new findings on old debates – as reported in BioNews
Egg-sharing refers to a scheme where a woman undergoing fertility treatment donates a portion of her eggs to an anonymously matched recipient in exchange for a reduction in treatment costs. As a very specific form of egg donation, egg-sharing has generated heated debate since its introduction in the UK in 1998. While proponents argue it provides a win-win solution, allowing two women to help each other conceive, critics talk of the potential ethical and psychological consequences. Until recently, there has been very little empirical data to inform these discussions. However, new research conducted by Gurtin and Golombok at the University of Cambridge Centre for Family Research, in collaboration with the London Women’s Clinic, hopes to redress this balance.

Men’s health expert presents to Members of European Parliament

A leading men’s health expert presented a report detailing the health challenges facing men across Europe MEPs and key European decision-makers at the European Parliament in Brussels.

Professor Alan White, Director of the Centre for Men’s Health at Leeds Metropolitan University was commissioned by the European Commission to produce a report which gives the first complete picture of the breadth of issues affecting men’s health across Europe.  Professor White brought together 36 leading researchers from 34 countries across Europe to undertake the research which highlights the state of men’s health in Europe as a serious public health concern. more info

Faculty Consultations

The CEU Guideline on “Barrier Methods-Contraception and STI prevention” is for consultation until 21st May. see FSRH website:

BASHH Mentoring Group is currently seeking new members:

BASHH would like new representatives to support coordination of mentors and mentees within North West regions and Wales. The successful candidates would also be involved in the activities that the Mentoring Group is currently taking forward nationally. Closing date for applications: 16th May 2012.  see BASHH website for more details

And finally – we hear reports that Virgin Care have obtained ‘preferred bidder’ status in the tender to run West Sussex sexual health services .

Celebrating International Women’s Day

9 Mar, 12 | by shellraine, e-Media Editor

“This International Women’s Day, the world’s women have much to celebrate: maternal mortality rates are declining after years of stagnation; the importance of maternal health is receiving unprecedented attention; and one solution in our efforts to save women’s lives during childbirth, misoprostol, is gaining significant traction globally. But we have further to go for the world’s women.”  IWD website has links to a number of events happening around the globe and asks supporters to publish and share their initiatives

fpa and Brook join forces with Durex

Two of the country’s leading sexual health charities and the biggest condom brand in the UK have announced a major collaboration with a three year programme to deliver a number of sexual health initiatives; information events, public awareness campaigns and learning materials.

Media Reaction to Abortion – gender selection and legal issues

in the ongoing debate around gender-selection abortion an Open letter of support for doctors who provide abortion services was published by Reproductive Health Matters, the international journal for sexual and reproductive health and rights, signed by members of Voice for Choice, leaders in womens’ health and abortion care. The letter clarifies many of the misinterpretations of legal issues that have been voiced in much of the ‘popular’ press.

Sexual Health Trainersnew PGA Med Ed (SRH)

The FSRH website has details of the planned changes to ‘training the trainers’.  The current letter of competence (Loc MEd) will be replaced by the new Post Graduate Award in Medical Education (Sexual and Reproductive Health).  In collaboration with Keele University the course is aimed at doctors working in CASH, GP’s, those in GUM and nurses who wish to gain a recognised teachers qualification in sexual health. This PGA will, for doctors, be accepted as appropriate for Primary Trainers for DFSRH purposes.

The GMC Education Update (Feb 2012) includes notification of a consultation on the recognition and approval of trainers.

New Clinical Guidance – Management of Vaginal Discharge in Non-Genitourinary Medicine Settings

The FSRH Clinical Effectiveness Unit (CEU) have published their latest clinical guidance document which updates previous guidance from 2006. Changes include: new tests for gonorrhoea and chlamydia; changes to treatments available for vulvovaginal candidiasis (VVC) & bacterial vaginosis (BV); and new advice on combined hormonal contraception (CHC) and antibiotics.

BPAS website hacked

The British Pregnancy Advisory Service website has been the subject of attempted hacking.  A 27 yr old man has been arrested on suspicion of offences under the Computer Misuse Act.  In a statement issued today BPAS say that:

“Around 26,000 attempts to break into our website were made over a six hour period, but the hacker was unable to access any medical or personal information relating to women who had received treatment at bpas.”

Faculty News

10 Feb, 12 | by shellraine, e-Media Editor

Amendments to FSRH Guidance Documents: Drug Interactions and Emergency Contraception
Drug Interactions (2011): Page 9 of the original version of this CEU Guidance Document (issued in January 2011) incorrectly stated that the interaction between lamotrigine and combined hormonal contraception (CHC) only applies to lamotrigine monotherapy. CHC also reduces lamotrigine levels when lamotrigine is combined with antiepileptic drugs that
do not alter its metabolism.

Emergency Contraception (2011): The original version of this CEU Guidance Document (issued in August 2011) contained some inconsistencies that the CEU has corrected in this version. These amendments are as follows: additional recommendation regarding offering a Cu-IUD to eligible women presenting between 0 and 120 hours of UPSI or within 5 days of expected ovulation added (pages ii and 8); references 12 and 13 updated (page 11); and acknowledgement of chart designer added to Appendix 2 (page 15).

New Examiners for the Multiple Choice Question Paper (MCQ)
The Examination Committee invites applications to join the MCQ Examiner Group of the MFSRH Panel of Examiners. Applicants should be accredited Members of the Faculty and active clinically in the sphere of the Faculty or, to be Clinicians, of equivalent status, with an interest in Sexual and Reproductive Healthcare but whose speciality is GUM, Public Health Medicine, Gynaecology or Primary Care. Further information and application forms from the Faculty website, closing date 29th February.

Committee Vacancies

  • Clinical Standards: for a doctor and a nurse
  • Workforce Planning: for an Associate member and a Fellow/Member/Diplomate

Information and details of how to apply are available from the committee’s page of the Faculty website

and in other news

Oral Ulipristal Proves Highly Effective for Uterine Fibroids
According to 2 studies published this week in the New England Journal of Medicine the oral selective progesterone receptor modulator, ulipristal, proved highly effective as a treatment for symptomatic uterine fibroids rapidly reducing excessive bleeding and reducing the size of uterine fibroids, and was well tolerated. The drug was approved for emergency contraception in 2010. Known as ella (HRA Pharma) in the United States and ellaOne in Europe, ulipristal works by interrupting ovulation. For emergency contraception, a 30-mg dose is used. By contrast, the newly-published studies tested 5-mg and 10-mg daily doses for fibroid treatment. In one of the studies (placebo-controlled) the drug controlled excess menstrual bleeding in over 90% of cases with a high incidence of amenorrhoea. If and when a product becomes available in the UK (Esmya is already approved and licensed in other countries) the issue of contraception will need to be highlighted to those that might use it because of the interaction with hormonal contraception.

Journal: January 2012 and News

3 Feb, 12 | by shellraine, e-Media Editor

The January edition of the Journal of Family Planning and Reproductive Health Care includes a number of articles previously available at Online First (the Dinger/Shapiro VTE commentary, Advances in IUD training by Connolly & Rybowski and Brown’s study looking at young mens’ views on contraception) as well as:

  • a thought-provoking commentary by Raine-Fenning et al on pregnancy of unknown location (PUL) which points out that a recent recommendation from CMACE to abandon the term is at odds with current scientific evidence and clinical experience;
  • a commentary by Wilkins of the Men’s Health Forum on men and sexual health;
  • a study by Draper et al on 525 GP fittings over a period of 30 years confirms that routine IUD checks confer no benefit.  The paper suggested that current guidelines recommend annual checks though this is based on a statement from Australia dated 2007 and USA advice from 2000 and ignores more up to date FSRH and WHO guidance;
  • a questionnaire study of clinic attendees and staff about what we should call ‘attendees’. This appears to show that there is a preference to retain the term ‘patient’ but was based on the respondents picking from only 4 options (‘patient’, ‘client’, ‘user’ or ‘customer’ – ie didn’t include ‘women’ and ‘men’) or asking them what they would prefer to be called;
  • Kipp et al highlight the unmet need for effective methods of FP in HIV+ individuals in rural Uganda;
  • womens’ views of the use of their leftover LBC samples for research purposes (Cooper et al);
  • an important restrospective audit comparing unscheduled reattendance among women having EMA (early medical abortion) at home vs hospital (Astle et al);
  • a review of appropriate use of Co-cyprindiol in a general practice (Tandy);
  • a review of Clomifene use for ovulation induction in general practice (Wilkes & Murdoch)

Plus at Online First on 31 January 2012: Encouraging IUD uptake after medical TOP [Cameron et al.] 

Sharon Cameron and her colleagues in Edinburgh created a fast-track referral service so that women who had undergone early medical abortion who wished to use intrauterine contraception afterwards could be seen promptly for IUD/IUS fitting. However, only about half the women who were given appointments actually attended. In their article they analyse the differences between the attenders and the non-attenders and suggest ways to enhance the uptake of these effective methods for the prevention of further unwanted pregnancies. While some women would benefit from IUD/IUS insertion at the place of abortion, provision of a fast-track service to the family planning clinic may yet remain the best strategy for maximising uptake of intrauterine contraception in this specific client group. from David Horwell, Advisory Editor, JFPRHC

Journal Fiction Book Reviews for April 2012:
The fiction book that has been reviewed for the next Journal is:
“Sense of an Ending” by Julian Barnes.  Read this and see if your views coincide with our reviewer.  If anyone has read “The Marriage Plot” by Jeffrey Eugenides and would like to review it and see their review in print in the April issue please submit a maximum of 400 words to journal@fsrh.org by 12 February at the latest.  In addition, let us know if there are any other books you have read recently that you feel would be of interest to readers.

New GMC Guidance
Two new documents have been published by the GMC: Raising concerns about patient safety and Leadership and management for all doctors 2012 which they “hope will contribute to a culture change within the health service – where raising and acting on concerns becomes part of every day practise in the UK.”

New mobile website for Brook
Brook, the young people’s sexual health charity, have launched a version of their website optimised for viewing on a mobile phone, funded by the JLS Foundation. See a screenshot of the new site below:

Review of the year 2011

6 Jan, 12 | by shellraine, e-Media Editor

It has been a busy and eventful year in sexual and reproductive health:

January

saw the launch of the new-look Journal of Family Planning & Reproductive Health Care as it joined the BMJ family. Readers will have noticed many improvements, not least the website and early online publishing.

February

The joint Faculty / e-Learning for Health, e-SRH, was named winner in the e-Government National Award: excellence, Learning & Skills section (now renamed UK Public Sector Digital Awards)

March saw the MDU statement: GPs need suitable training to fit contraceptive implants

April saw the Faculty response to EC being made available through pharmacies in Wales

May saw the publication of the new Missed Pill Recommendations

June

saw Chris Wilkinson become the newly elected President of the Faculty and in
July his appoinment was acknowledged in BMA News


August

saw the publication of the Emergency Contraception Guidelines



September
saw the publication of the amended Drug Interactions with Hormonal Contraception and the launch of this Blog !!

October saw the publication of the Combined Hormonal Contraception Guidelines as the world population broke the 7 billion mark.

November
saw the CEU being awarded NHS Accreditation for its guidelines and the publication of the Service Standards for SRH

December
saw the 23rd World AIDS Day with the theme: Getting to Zero

And so to 2012 – wishing all our readers a Happy New Year

COC / VTE Controversy continues

2 Dec, 11 | by shellraine, e-Media Editor

Following publication of the extended analysis of the Danish Cohort Study on VTE risk (with combined oral contraceptives with different progestogens and oestrogen doses) in the BMJ and the rapid responses since, Shapiro S and Dinger J have now produced a Commentary for the January 2012 edition of the Journal of Family Planning and Reproductive Healthcare (JFPRHC). This is now published at BMJ Online First.

To accompany the commentary Anne Szarewski, Editor in Chief of the JFPRHC writes

VTE and the Pill … again

The re-analysis of the Danish Cohort Study has recently been published in the British Medical Journal (BMJ). Unfortunately, there are still many methodological issues with it, as discussed in this commentary by Dinger and Shapiro. They also point out that the important analysis that was actually requested by the regulatory authority (but not published in the BMJ paper) showed no difference in risk between combined oral contraceptives.

FSRH Workforce Planning Committee

The Faculty has vacancies for 2 members on its Workforce Planning Committe (1 associate member and 1 diplomate, member or fellow). Details available on the Faculty website.

2 New Publications for Nurses -

as reported by Wendy Moore, Vice Chair of the Faculty Associate Members’ Working Group

RCN Competences for nurses undertaking bimanual pelvic examinations

Nurses working in sexual and reproductive health are increasingly extending their role, benefitting both the nurses and their client groups. The ability to carry out pelvic and bimanual examinations is now a key requirement for nurses working in these specialisms in primary, secondary and community care. The purpose of the competency framework is to ensure that women requiring a pelvic exam are cared for safely and that training and assessment processes are in line with local guidance.

RCN Competences for nurses assessing and counselling women who request and/or receive long-acting reversible methods of contraception (LARC)

Aimed at sexual and reproductive health practitioners this new set of competences is aimed at nurses who are assessing and counselling women who have requested or received long-acting reversible methods of contraception (LARC). The purpose of this competency framework is to ensure such women are cared for safely and helps professionals to identify their training needs, ensuring they have the skills and knowledge to undertake the delivery of contraception services competently and safely.

And finally we hope that reports from America that Apple’s new voice recognition software, Siri, is anti-abortion are exaggerated – the ‘tech’ giant says it will improve the software’s unintentional omissions so that it doesn’t say it cannot find abortion clinics. Knowing the age we live in we suspect this ‘issue’ will run for a while in blogs and tweets around the world.

World AIDS Day 2011

1 Dec, 11 | by shellraine, e-Media Editor

On the 23rd World AIDS Day

As part of a piece in the Chelsea & Westminster GP Newsletter, Consultant Rachel Jones and Specialist Registrar Michael Rayment write of the situation in the UK:

Treatment is freely available, but is limited to those who know their HIV sero-status.  The HIV epidemic in the UK continues to grow, and the fraction of undiagnosed HIV remains frustratingly constant.  The number of people living with HIV in the UK is estimated to be 91500 in 2010. There were an estimated 6660 new HIV diagnoses in the last year alone.  In men who have sex with men, there were 3000 new diagnoses – the highest ever annual figure recorded in this risk group.  An estimated one in four of all individuals with HIV infection remains unaware of their sero-status.  Of those newly diagnosed, half were diagnosed with CD4 counts below 350 cells/μl, the current threshold for the initiation of antiretroviral therapy. Of the 680 people with HIV who died in 2010, two thirds had been diagnosed late.

and they suggest that:

The largest barrier rests with us, the healthcare providers: our own HIV testing prejudices need to be broken down.  We need to engage commissioners to develop services and strategies to tackle HIV infection in our community.  A key strength of the pilot studies to date has been the close cooperation between Sexual Health services and local primary and secondary care providers.  We would urge you to work with your local Sexual Health colleagues.  They will be keen to work with you to provide education, support, clinical expertise and guidance to keep this issue high on your local health agenda.  Please engage with us, and Getting to Zero may be a feasible and very real vision here on our own doorstep.

The Health Protection Agency (HPA) recommends ‘universal testing’ for HIV, as they publish new data on 30 years of HIV in the UK.

The British HIV Association (BHIVA), Medical Foundation for AIDS and Sexual Health (MedFASH) and the British Psychological Society launch Standards to ensure high quality support for people with HIV.

Half of the 14 million people living in poorer countries who need HIV drugs get them according to the UNAIDS World AIDS Day Report 2011 – “How to get to zero, Faster, Smarter, Better”

This is the good news. The bad news is that at this crucial time, when the end may be in sight, we also hear that the one thing that will fuel the hoped for future is being cut off:

BMA News warns that Sexual Health is under threat (again).
As co
uncils and private companies take control of NHS sexual health services, are they unnecessarily changing an open-access system that already works wonders?
In the Report, sexual health organisations have expressed grave concerns and a number of clinicians give examples of difficulties already being experienced.

The Global fund to Fight AIDS, TB & Malaria has cut its latest round of funding. In its press release yesterday it states:

A sharply deteriorating economic situation, which is placing severe pressure on donor countries’ budgets, has prompted the Global Fund to revise its forecasts of available resources over the next two years and to take this difficult decision.

RCOG – Abortion Guidelines & Honorary Fellowships

25 Nov, 11 | by shellraine, e-Media Editor

The Royal College of Obstetricians and Gynaecologists (RCOG) has, this week, published its revised guidelines on the care of women requesting induced abortion. The recommendations cover commissioning and organising services, possible side effects and complications, pre-abortion management, abortion procedures and follow up care.  A summary of new and improved recommendations and link to Q&A’s are in the RCOG press release.

Medical Students for Choice (MSFC) – based in the US, is a non-profit organisation recognising the need to create abortion providers for tomorrow:  www.medicalstudentsforchoice.org. They aim to try and correct the drastically falling numbers of providers in the US and Canada – 57% of current providers are over 50. This along with targeted violence, restrictive legislation and medical schools not addressing the issue means doctors are qualifying with little knowledge of abortion.

RCOG Honorary Fellowship

Toni Belfield

Our friend and colleague, Toni Belfield, has, today, been awarded an RCOG honorary fellowship in recognition of her long service in the field of contraception and sexual health and passionate dedication to providing accessible, evidence-based information for men and women. Included in the citation Professor Janice Rymer noted responses from colleagues who said Toni is “One of the most knowledgeable people in women’s health” and “Her contribution is always very sound”.  Her many friends in the field know, love and respect her as an ardent advocate for service users (never patients or clients!) and as someone who always keeps us on our toes when it comes to accurate use of terminology – we always fit IUDs never coils! Congratulations Toni.

Take Action! Respond to the PSHE Review – Deadline 30th November

The Department for Education is running a Review of PSHE including Sex & Relationships Education with a view to improving its delivery in state funded schools. You can read the review and respond online by following the link. The British Humanist Association has succintly summarised the situation and the fears of many in its statement to accompany its own response.


Latest from JFPRHC

Latest from JFPRHC