Kent has invested in digital technologies to improve the way services are offered. A new website has been launched and that has been followed by a range of online STI tests, which have proved to be very popular. This case study forms part of our sexual health resource.
Responsibilities for the delivery of Kent’s sexual health services were fragmented when much of the commissioning transferred from primary care trusts to local government in April 2013.
Services had been run by two primary care trusts in Kent with different investment and provision.
Integrating and modernising services were seen as key priorities.
In particular, there was a recognition that more needed to be offered digitally.
To achieve this the creation of a single sexual health website was undertaken. Your Sexual Health Matters was launched in 2015 and includes information about STIs, contraception and integrated services as well as links to other related services.
The website has been followed by the development of a comprehensive online STI testing service for over 16s. The service has been developed gradually. In November 2015 Kent started offering HIV home testing kits and then chlamydia screening followed in January 2016.
The changes saw demand increase and insight work undertaken in early 2017 emphasised the need to extend online testing even further.
In October 2017 the online offer was increased to include testing for gonorrhoea, syphilis, Hepatitis B and C. This is dependent upon individual self-identified risk through a detailed algorithm that was developed to help ensure people get the tests they need.
Safeguards have been put in place to try to ensure that those under the age of 16 are supported to access a clinic rather than use the online services.
The C card condom scheme has also been overhauled. An evaluation of the scheme led to the development of a new programme ‘Get It’, including an online service. The scheme has also started to be offered in a more diverse range of locations, including at a local theme park, youth hubs and barbers.
The numbers using the online service has been rising from 500 in October 2017 to 1,500 by October 2018. These represented 22 per cent of all attendances among Kent residents accessing local STI services.
Director of Public Health Andrew Scott-Clark is delighted with how it has gone. “One of the really noticeable things is that we have seen no drop in the numbers using the clinics. That suggests that the online service has filled a gap.
“Either these people were not getting tested in the first place or they had been going out of area. Because of our proximity to London, we know many people go elsewhere. There is a sense that services are better there or they did not know where to go in Kent.”
Positive progress has also been made in terms of condom distribution. The numbers distributed have increased over the past year from 27,000 in the first quarter of 2017/18 to 47,000 in the same period in 2018/19.
Kent implemented an incremental approach to the development of the online testing platform, deciding not to promote it heavily, to ensure that capacity could be met.
Mr Scott-Clark said: “Instead we have simply communicated it. When people come to clinic we have told them about the online offer and through word of mouth people who need it have started to find out about it.”
That contrasts markedly with the promotional effort put into the new condom programme. The launch of that saw the provider run events across the 12 different districts of Kent and at other events such as fresher fairs.
How the approach is being sustained?
Kent has plenty of plans for the future. Creating an online chat service on the website is being looked into as well as exploring the options of offering oral contraception online and conducting consultation for long acting reversible contraception.
A pilot scheme is being run offering dropin psychosexual services at a local college. Currently this specialist service is only available through referral.
But one element that has remained challenging is encouraging those who test positive to inform partners of the result or to enable the service to do this on their behalf. Currently those using the online service can upload information online about who should be contacted in the event of a positive result.
“Informing and encouraging sexual partners to access the online service to access STI testing is an important part of protecting the population. It is obviously vital that people are notified so they can get tested themselves. People often think that they would know if their partner had an STI, but that of course is not the case,” added Mr Scott-Clark.
Public Health Specialist, Kent County Council