MedFASH provides authoritative responses and briefings to government and other policy-makers on current policy issues. Click here for more information, and for a details of current and past work in this field.

MedFASH is very pleased to announce the launch of the Tackling HIV Testing: increasing detection and diagnosis resource pack.

The resource pack will help increase rates of HIV diagnosis in hospitals. Educational slide sets, template documents and background information will assist HIV specialists who wish to support their colleagues in other specialties to offer HIV testing more routinely in their daily practice. The resource pack is now available to download from the Tackling HIV Testing section of our website.

Recent NHS policy, as well as ongoing implementation of the National strategy for sexual health and HIV (Department of Health, 2001), has led to the commissioning of sexual health services in a wide range of settings. A number of existing documents provide relevant guidance, but there is no single set of agreed standards to govern the operation of all services offering STI management.

BASHH wishes to promote consistency of care and has therefore undertaken this project, in partnership with the Royal College of Physicians (RCP) and other key professional organisations, to define standards relevant to the management of STIs in all settings. The project was managed for BASHH by MedFASH. Click here to read the project summary.

We produced a document for consultation on new draft standards for the management of STIs and we invited organisations and representative bodies to seek the views of their members (where relevant) and submit a response on their behalf.

The standards have been launched in January 2010. You can download:

Standards for the management of sexually transmitted infections (STIs)
Your guide to the Standards for the management of sexually transmitted infections (STIs):

• Version for printing as a leaflet (we recommend printing onto A3 double-sided to be folded to A4)
  
• Electronic version (4 pages)
  

We are happy to announce the launch of SHout Loud, a new website helping you have a say about sexual health, contraceptive and HIV services in England. This is a collaborative project between the six leading sexual health national charities AHPN, Brook, fpa, MedFASH, National AIDS Trust (NAT) and Terrence Higgins Trust (THT).

More and more decisions about health services are now taken at a local level, and decision-makers have to take the views of local communities into account. This means that the voice of the public is more important than ever, and people can have a huge impact on changing and improving sexual health, contraceptive and HIV services locally. SHout Loud aims to empower people to affect local decisions and improve sexual health in their communities.

The SHout Loud website features an interactive map, which you can use to access local sexual health, HIV and teenage pregnancy statistics, find out about local NHS and Local Authority plans and targets related to sexual health, and take action to improve sexual heath in your area by contacting local decision-makers using our 'Take Action' button. Visit the website on www.shoutloud.org.uk to take action now!

Working with the RCGP Sex Drugs and HIV Task Group, MedFASH has managed the development and piloting of an Introductory Certificate in Sexual Health.

Aimed at generalist clinicians and practice nurses already trained and working in general practice this course provides a basic grounding in sexual health issues.

To obtain the certificate, participants need to complete the e-learning module on doctors.net.uk "Sexual Health in General Practice" and attend a face-to-face training day. The cost of the face-to-face day is £190.

For more information about the course and future training dates please check the RCGP website.

The Independent Advisory Group (IAG) on Sexual Health and HIV advises the Government on implementation of the National Strategy for Sexual health and HIV. In 2007, it commissioned MedFASH to undertake a review of the strategy, funded by the Department of Health.

We gathered information through desk research, expert groups and regional meetings with multidisciplinary professional stakeholders and with service users. The review report, Progress and priorities - working together for high quality sexual health. Review of the National Strategy for Sexual Health and HIV, was published in July 2008 and launched at the House of Lords by Baroness Gould, Chair of the IAG.

The report highlights the changing context since the strategy's publication in 2001, outlines progress to date and identifies drivers and barriers to the strategy's implementation. It provides recommendations in five strategic priority areas for action at local, regional and national level.

Click here for a copy of the full report, or here for the executive summary.

The National Strategy for Sexual Health and HIV (2001) set out an ambitious ten-year programme to tackle sexual ill-health and modernise sexual health services in England. A review of the strategy and its implementation was undertaken in 2008, resulting in the report Progress and Priorities - working together for high quality sexual health, produced by MedFASH for the Independent Advisory Group (IAG) on Sexual Health and HIV.

One year on from the publication of Progress and Priorities, this conference provided a unique opportunity to learn about the Government's response to the review and to explore the practicalities of implementing its recommendations at local and regional level.

We are very grateful to the speakers who have all agreed to share their presentations via the MedFASH website. To download them, please click on each speaker's name:

Ruth Lowbury, Chief Executive, MedFASH

Andrea Duncan, Programme Manager Sexual Health and HIV, Department of Health

Dr Isabel Oliver, Regional Epidemiologist, Health Protection Agency South West and Regional Policy lead for Sexual Health in the South West

Peter Taylor, Acute Services Development Manager, NHS County Durham and NHS Darlington

Professor Graham Hart, Director, Centre for Sexual Health and HIV research, University College London

Simon Henning, Network Lead, Cheshire and Merseyside Sexual Health Network

Dr Kate Guthrie, Clinical Director, Sexual and Reproductive Health Care Partnership for Hull and East Yorkshire

Dr Philippa Matthews, General Practitioner, Islington PCT

MedFASH has managed the first sexual health needs assessment and service mapping for London, in partnership with the London Health Observatory (LHO) and Health Protection Agency (HPA).

The project was established to assist the NHS in London in its task of further developing and delivering high quality and world class sexual health services. It set out to provide a detailed picture of sexual health needs and the current commissioning and configuration of sexual health services. It also aimed to provide national learning for the Department of Health (DH) about the process of undertaking a regional needs assessment and service mapping.

Commissioned by Lambeth Primary Care Trust (PCT) on behalf of London PCTs for the London Sexual Health Programme, the project was jointly funded by the DH Sexual Health Policy Team, the DH National Support Team for Sexual Health and the London Sexual Health Programme. In managing the project, MedFASH commissioned the LHO which worked with the HPA to produce the needs assessment. A Project Advisory Group, whose membership was drawn from commissioners and providers across London, offered expert advice and guidance throughout the project.

The following project reports are published by MedFASH (November 2008).

Report 1: London sexual health indicators: a data-driven needs assessment prepared by the London Health Observatory and the Health Protection Agency for MedFASH.

Report 2: London sexual health service mapping: results & analysis. A report by MedFASH based on questionnaire responses from PCT commissioners and sexual health service providers.

Report 3: Sex and our city: project findings & recommendations for London. This report by MedFASH combines the findings of the needs assessment and service mapping, and makes recommendations for the NHS in London.

In addition, the LHO has produced an interactive web tool enabling comparison between sexual health indicators at London borough level, and a workbook with supplementary tables. The web tool can be accessed at the LHO website.

MedFASH has developed a booklet for healthcare professionals in secondary care who are not HIV specialists, to help them improve their skills and confidence in diagnosing HIV. The booklet complements new national HIV testing guidelines and supports the aims of the National strategy for sexual health and HIV (Department of Health, 2001) to reduce the prevalence of undiagnosed HIV, and the stigma associated with HIV infection.

The purpose of the project was to normalise consideration of HIV in non-HIV specialist clinical settings, and thereby increase opportunities for early diagnosis of HIV infection, and also to improve the quality of healthcare for people with diagnosed HIV in those settings. Click here to download a copy of the booklet. To order copies, click here.

The booklet is now part of our new resource pack Tackling HIV Testing: increasing detection and diagnosis produced to help increase rates of HIV diagnosis in hospitals. Its educational slide sets, template documents and background information will assist HIV specialists who wish to support their colleagues in other specialties to offer HIV testing more routinely in their daily practice. The resource pack is available to download from the Tackling HIV Testing section of our website.

The 10 High Impact Changes best practice guide provides measures that can be implemented quickly and on a scale that will enable 48-hour access to a local GUM service by March 2008.

We were commissioned by the Department of Health to organise an expert reference group, collate feedback, comments and case studies from this group, and draft a practical guide for the Department of Health to refine and publish (December 2006).

In 2004 we were commissioned by the Department of Health to manage a national review of genito-urinary medicine (GUM) services, as part of the implementation action plan for The National Strategy for Sexual Health and HIV. The review aimed to:

• undertake an assessment of each GUM service in England, highlighting factors which help or hinder their ability to offer a prompt and high quality service
• offer recommendations for service improvement and modernisation arising from each assessment, relevant for GUM service providers, their local primary care trusts and strategic health authorities
• provide findings and recommendations from the review to the Department of Health

Initiated in partnership with the British Association for Sexual Health and HIV (BASHH), the project started in June 2004 and the programme of visits was completed in May 2007. Click here for more information on the project.

During the project, we produced a 'top tips' guide to support delivery of the 48 hour access target for GUM. This guide drew on lessons learnt from reviews of GUM services and was circulated by Richard Gleave to SHA chief executives with a covering letter.

The more recent 10 high impact changes for genito-urinary medicine 48-hour access expanded on this to give more detailed practical guidance for providers and commissioners.

In December 2004, we published HIV in primary care, an essential guide for GPs, practice nurses and other members of the primary healthcare team, written by GPs Dr Sara Madge, Dr Philippa Matthews, Dr Surinder Singh and Dr Nick Theobald. The full-colour booklet focuses particularly on clinical diagnosis, offering HIV testing, side-effects of antiretroviral therapy which may be seen in primary care, and how GPs can complement specialist care for people with HIV. It presents practical information in an attractive and easy-to-use format, with photographs to illustrate the section on the main HIV-related conditions and their symptoms. Click here for more information about the publication, of which printed copies are available free on request to GPs and primary healthcare teams in England.

In March 2005, we published Recommended standards for sexual health services (download pdf or order a printed copy).

A key tool for providers, commissioners, performance managers and service users, the recommended standards will support local delivery of commitments in the public health White Paper and the National strategy for sexual health and HIV. Covering 10 aspects of service provision, including guidance on service networks, they are relevant to all settings providing NHS-funded sexual health services, including general practice, hospital and community-based clinics, pharmacies, and organisations in the voluntary and independent sectors. Supported by an expert advisory group, MedFASH developed the standards through consultation with a wide range of stakeholders.

MedFASH also commissioned a review of the evidence supporting each recommended standard. Click to download Summaries of references for key interventions (pdf).

The recommended standards are based on the principle of delivery through service networks. MedFASH organised a national conference, on 16 May 2005, on sexual health service networks. To access the conference presentations click here.

We will be publishing a practical guide to the development of sexual health and HIV networks in 2006.

Click here for more information about the Recommended standards and networks for sexual health services project.

In October 2003 we published new recommended standards for NHS HIV services (pdf document to download or contact us to order a printed copy)

A cornerstone of the National Strategy for Sexual Health and HIV, the new Recommended standards for NHS HIV services cover 12 aspects of service provision for people with HIV and offer guidance on managed service networks. The recommended standards will serve as a tool for planning and auditing service development, a framework for commissioning and a resource for partnership between service users and providers. The House of Commons Health Select Committee has recommended their use by strategic health authorities in the performance management of trusts.

We have been finding out about network development in HIV and other areas of healthcare, and drafted a guide for HIV network development. During the guide's development, we held five multidisciplinary seminars in different parts of England which offered support to those who are, or may shortly be, involved in developing such networks. Participants were given a working draft of the practice guide and their feedback, plus that of some stakeholder organisations, is being used to help us improve on the first draft.

Click here for more information about the HIV standards and networks project.

For further information about the project, please email to enquiries.medfash@medfash.bma.org.uk

We mapped and facilitated the development of HIV service networks in the NHS in four parts of England - the south-east (Kent, Surrey & Sussex), west and north Yorkshire, the south-west, and the West Midlands.

The project report contains recommendations and key findings. To order a printed copy click here. You can also find a short description of what we learnt in an article in the July 2001 edition of the AIDS and Hepatitis Digest from the Royal Society of Medicine Press.

In December 2004 we published HIV in primary care, an essential guide to HIV for GPs, practice nurses and other members of the primary healthcare team. This full colour illustrated booklet written by GPs, offers practical help on clinical diagnosis and how to offer an HIV test.

We also participated in a BASHH group drafting clinical effectiveness guidelines for HIV testing, (now on the BASHH website). A version for non-HIV specialists - HIV testing for patients attending general medical services - was also published by the Royal College of Physicians on their website.

Earlier work included partnership with the Sheffield Department of GU Medicine to develop and pilot a patient leaflet on testing in GUM clinics - see Use of a leaflet to replace verbal pretest discussion for HIV: effects and acceptability, published in the journal of Sexually Transmitted Infections (2003;79:243-245). Our leaflet for non-HIV specialists, Take the HIV Test, is still available to download.