A President's Year - Month 1

9th February 2015

The members’ survey responses included quite a few requests to learn more about what senior BASHH officers do. This article is a first attempt to give you a flavour of my work as President, and how that fits with my work and life in Leeds and London.

I spend one or two days a week on average on BASHH matters, flexing my clinics to continue to deliver an agreed quota of HIV and GU clinics. Much of this BASHH time is in London, and I try to cram as many meetings into these days away as I can. Writing time and phone conversations usually happen after work or at weekends, though I try to have one day of the weekend completely free from the smartphone!

An additional part of my work this month was fitting in my Trust appraisal and job planning meetings -both processes needing a lot of work but were successfully completed for the year.

The month is marked by some regular calls. Munro and Forster, our communications and policy advisors, help to compose press releases, tweets and emails, develop briefings for us before we meet ministers and MPs, take notes of those meetings and set up teleconferences. Most Mondays I speak with M+F to set up the week’s work.

The email traffic is dense, with around 30 BASHH related emails needing action every single day from BASHH officers and members, from commissioners and from the related groups we work with (FRSH, NAT, BHIVA, RCP, etc). I have regular discussions with Dr Liz Foley, the general secretary and Dr Elizabeth Carlin, vice president, and there are many other calls to BASHH officers, BASHH groups and BASHH members. This month, there have been frequent discussions with FRSH chair Chris Wilkinson and BHIVA chair David Asboe. Most of the calls happen out of clinic hours, and I find the 2 hour rail journey between Leeds and London useful in catching up with work.

Some workstreams this month include-

  • Working with Health Education England on ensuring nurse and doctor training is included in considerations of English sexual health commissioning;
  • Pressing DH to ensure confidentiality is maintained on sexual health records, with a formal letter from BASHH and NAT sent to reinforce the benefit of separate sexual health notes;
  • Welcoming new Board members and determining their roles for BASHH;
  • Advising the DH vaccination team ( a group new to discussing sexual health) on issues around implementation of HPV vaccination to MSM within GU clinics and
  • Developing resources for English members going through commissioning processes.

The first week included a quarterly update meeting with DH. Topics for discussion include direct discussion about areas where tendering may be problematical. This level of contact does need facts. Please keep sending details of your tendering experiences to me. We want to build a dossier for evidence to present directly to ministers and policymakers.

In a single day I met with Deborah Gold from NAT to discuss confidentiality issues, had a teleconference with the DH vaccination team regarding HPV and lectured on the staff health week at the RCP. That evening I had an email from the BMJ editorial team- could I cut our rapid response letter responding to the BMJ contracting survey to one-third its original length and resubmit within 24 hours? Yes I could!

The combination of a night owl (Elizabeth Carlin) and an early bird (me) managed to submit the amendments, and we were delighted to see our letter achieved publication. The longer version and the edited one can be accessed here. http://www.bmj.com/content/349/bmj.g7606/rapid-responses - http://www.bmj.com/content/349/bmj.g7606/rr

The end of the first week marked our AGM day- I had an interesting and stimulating discussion over lunch with some of our past presidents followed by the OGMs (now to be known as scientific meetings). I gave a paper, presided over the AGM, chaired the final session and hosted the speaker’s dinner after this.

The second week was more based in Leeds I spent half a day doing MMI interviews for the medical school entry this year. I am so impressed by the quality of the young applicants- I’m sure I wouldn’t get far in the current competition!

I hosted a site visit to Leeds sexual health clinic by Carolyn Heaney, a deputy director of the DH vaccine team. She came to learn about the practical aspects of HPV vaccine delivery to MSMs attending clinic. (Carolyn pictured here with Helen, me and Tim in the male floor laboratory)

It was a media month for the family- our daughter Katie made her debut performance as travelling member of the popular female punk band Sleater Kinney on the Letterman show in New York. https://www.youtube.com/watch?v=QLwD1to3dZU. Our son Patrick had a game review in the Observer http://gu.com/p/45a78/stw and I appeared on MadeinLeeds, our local TV station. Beth Wilson interviewed me about local options for getting STI and HIV testing while I tried dispelling a few myths and legends about umbrellas and urethras…

The third week was a policy and politics week. BASHH supports the all party parliamentary group on SRH, and I am part of the advisory team to the parliamentarians planning and delivering the programme. An important project this session was the inquiry into accountability for the sexual and reproductive health services, with many written submissions and oral witness sessions. There was a short session this week at the House of Lords with the APPG inquiry team presenting some first impressions of the evidence. I asked them to consider the impact of commissioning changes on education, training and research, and stressed our concerns about loss of ring fencing of public health budgets after 2016/7. Baroness Gould of Potternewton, who is the inquiry chair and APPG lead, closed the meeting by announcing a final version of the report is expected to be published in time for the new government starting business in early June.

Dr Liat Sarner (lead clinician at Barts and a BASHH board member) and I met with the chair of the Health Select Committee, Dr Sarah Wollaston MP, to discuss confidentiality, funding and fragmentation of commissioning. We discussed co-commissioning options, the care.data consultation and repeated our concern about loss of ring fencing of public health funding. I called on the HSC to push for an investigation of the impact of all the changes on patient care. Dr Wollaston gave some useful advice on the Parliamentary timetable around the election and how BASHH may communicate with the new HSC. I am composing letters and suggested parliamentary questions to follow up.

I also held a meeting with clinicians running web-based sexual health testing and treatment services. There have been concerns about online prescription of oral therapy for gonorrhoea. It was useful to hear how they work. I followed this up with an email to the CMO, Dame Sally Davies to alert her to our continuing worries about antimicrobial resistance in gonorrhoea and how we can encourage safe prescribing practice. The CMO is encouraging everyone to sign up to be antibiotic champions - see http://antibiotic-action.com/champions/.

The final week of January was a busy week in Leeds and in London. I attended a meeting at the RCP in London around the update of “Consultant Physicians Working with Patients” where I represented the specialty as chair of the Joint Specialty Committee - a group supported by BASHH and RCP London. The new format document aims to be an online resource for commissioners and service planners. A more interactive format is planned, with scope to reflect the varied care pathways and interactions between specialties in modern healthcare. I worked with our officers to recruit and brief a small working group to begin to write our chapter.

A final highlight of the month was the 10th joint BASHH/FRSH meeting at the RSM. The theme this year was “Challenging Issues in Sexual Health” and the packed hall heard some excellent presentations. I was intrigued by the prospect of intra-uterine balls and electronic chip controlled implants (!) as contraception methods. The audience was clearly shocked by some of the data in David Stuart’s talk about chemsex. I was made uncomfortably aware of my vintage when the feminism movement of the seventies was presented as a point in history of female emancipation. I started medical school in 1975 and lived through the time as a teenager when equal pay, equal employment and educational opportunities and free contraception for women were only aspirations. Even today, access to contraception and abortion services for women throughout their reproductive years remains patchy across the UK.

I wound up the meeting by reflecting that 10 years ago we had very few integrated services and hardly any community STI testing. Now, with many SRH and GUM services integrated and 2 million chlamydia tests with 150,000 cases treated outside of specialist services, the case for integrated meetings like this seems stronger than ever.

Apart from all the meetings listed, the email trails included discussions on workforce planning, consultations on sexual abuse and hepatitis C treatment, directing commissioners to GUM advisors for their procurement exercises, getting details from clinicians troubled by proposed funding cuts, and sorting out a date for the next public panel meeting.

So, the end of the month and my first blog is complete! This first attempt needs feedback, so please give me your comments by filling in the form below.

See you next month.

Jan Clarke

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