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Keep our sexual health services confidential

Yusef Azad

Sexual health remains for most people a sensitive and private matter – if we go to a sexual health clinic we expect the information they record about our sexual behaviour, about the tests we have, any STIs diagnosed and the treatment provided, to be kept confidential.

And this has meant not just confidential in relation to other members of the public, but also confidential in relation to other parts of the NHS.  If you go to a sexual health clinic that information is kept secure to that clinic.  It is not shared with other parts of the same hospital.  It is not shared with your GP.  The sexual health clinic would have to discuss with you any proposal to share some of your clinic records with another part of the NHS and you would have to agree for them to do so. 

To that extent sexual health clinics have operated to a particularly high standard of confidentiality.  If they did not do so, people would be afraid to go to the clinic, worrying about who would find out.  People don’t want their local hospital A&E to know they got gonorrhoea on holiday in Ibiza last year.  Or their family doctor to know about their recent fling.  If people are deterred from going to sexual health clinics that would mean less testing, less diagnosis, less treatment, more STIs spreading in the community with serious implications for our health. 

It is so obvious that we need to keep our sexual health services confidential, that it may come as a surprise to learn we may be on the brink of losing this vital protection.  But that is the case.  Since the early 20th century Regulations have been in place which have provided a legal basis for the robust confidentiality culture of our sexual health clinics.  As the NHS has gone through yet another reorganisation, the health bodies cited in the Regulations have ceased to exist.  But instead of agreeing new Regulations to maintain confidentiality, the Department of Health is planning to revoke the current Regulations and not replace them. Sexual health clinics would then be subject to the general rules of confidentiality which apply to the whole of the NHS, with no additional protections. 

Why would that be so bad?  After all, the Department of Health points out, the NHS has come forward in leaps and bounds in its understanding of the importance of confidentiality for sensitive medical information.  That is certainly true.  Healthcare workers are careful to get the consent of the patient before sending on information to other parts of the NHS and must heed any patient objections.  But the sexual health Regulations not only affect communication, they also affect record-keeping, and that is where, in the absence of such Regulations, confidentiality will be undermined. 

Currently a sexual health clinic keeps its own records, whether paper or electronic, strictly separate from the wider records system of the hospital within which they operate.  If they acted like every other clinic in the hospital and put onto the hospital records system their sexual health information, then whenever their patients went to the hospital for some other kind of care the other hospital healthcare worker would see their sexual health records, even though wholly irrelevant to the sprained ankle, or whatever the patient has come in for.  It would also make it far more likely that their GP would see the patient’s sexual health record.

It is the Regulations which have provided the legal basis for such a separate records system despite the additional costs possibly involved.  Without the Regulations, sexual health clinics will come under immense pressure to integrate their records with that of their hospital trust.  Precisely the sort of outcome which will deter people from accessing a sexual health clinic.

Of course in London you can try to attend a sexual health clinic in one hospital and go for all other aspects of your care to a completely different hospital where they would not see your sexual health records even if they were integrated with the sexual health clinic’s hospital records system.  But that choice is not available to people in most other parts of the country. 

NAT is calling for our sexual health services to be kept confidential.  This means some legal basis to justify sexual health clinics maintaining completely separate records systems.  Without such protection, many people will be deterred from going to a sexual health clinic until their health is in a real crisis and they have no choice.  But by then many others may well have been infected.  The sexual health of this country is being put at risk.  That cannot be right.

NAT Topic

Sep 7, 2016 By hugo