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Letters to the editor calculated by the National Institute of Health and Care Excellence (NICE).3 As pointed out by Dr Britton, we did not include the cost of overheads as these were not included in the NICE cost-impact report. However, we acknowledge that the overhead costs in a community setting are likely to be different to those in a primary care setting and these would need to be taken into consideration when commissioning services. Louise Cook, MRCGP, MFSRH Associate Specialist in Sexual and Reproductive Health, Aneurin Bevan Health Board – Sexual and Reproductive Health, Newport, UK; [email protected] Charlotte Fleming, MD, MRCOG Consultant in Sexual and Reproductive Health, Aneurin Bevan Health Board – Sexual and Reproductive Health, Newport, UK; [email protected]
Competing interests None. J Fam Plann Reprod Health Care 2014;40:153–154. doi:10.1136/jfprhc-2014-100908
REFERENCES 1
2
3
Britton A. Comment on ‘What is the actual cost of providing the intrauterine system for contraception in a UK community sexual and reproductive health setting?’ J Fam Plann Reprod Health Care 2014;40:153. Cook L, Fleming C. What is the actual cost of providing the intrauterine system for contraception in a UK community sexual and reproductive health setting? J Fam Plann Reprod Health Care 2014;40:46–53. National Institute for Health and Clinical Excellence. National Cost-Impact Report. Implementing the NICE Clinical Guideline on Long-acting Reversible Contraception (Clinical Guideline CG30). 2005. http://www.nice.org. uk/nicemedia/live/10974/29916/29916.pdf [accessed 12 February 2014].
Comment on ‘Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals’
been running such a service for some years originally delivered by BPAS and now delivered, for the last 12 months, by the integrated Torbay Sexual Medicine Service (tSMS), hosted by South Devon Healthcare Foundation Trust (SDHCFT). The pre-abortion counselling, the medical assessment, the ultrasound scan and the early medical abortion (EMA) service are all delivered from a community-based health centre. The staff and the patients felt that this was a natural extension of the integrated sexual medicine service, which also includes sexually transmitted infection (STI) management, contraception, a chlamydia screening service, HIV care and an outreach service. The only part of the abortion service that requires hospital care is the surgical termination of pregnancy service, which is delivered by the gynaecologists of SDHCFTand our colleagues from BPAS. The third key message from the article was about the improvement in contraceptive and STI management. Since the service has been taken into the integrated service the rates of STI diagnosis, the rates of patients having long-acting reversible contraception post-procedure, and the rates of the use of EMA compared with surgery have all significantly increased. In conclusion, we hope the above information confirms the notion of the Michie et al. article that not only is a community-based service desirable, it is also feasible and practical. Philip Kell, FRCOG, FRCP(L) Consultant Physician, Torbay Sexual Medicine Service, Department of Genitourinary Medicine, Castle Circus Health Centre, Torquay, UK; [email protected]
sexual and reproductive health setting: views of health care professionals. J Fam Plann Reprod Health Care 2013;39:270–275.
Comment on ‘Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals’: authors’ response We thank Dr Kell and Ms McMahon for their comments1 on our article2 and for sharing their experience of running an abortion service from a community setting. It is reassuring to learn that both staff and patients welcomed this service and that both contraceptive provision and sexually transmitted infection diagnosis have improved as a result. We hope other clinicians providing abortion care services may be encouraged to consider the potential benefits of providing such services from a community setting.
Lucy Michie, MRCOG, DFSRH Specialty Trainee in Sexual and Reproductive Health, Sandyford Initiative, Glasgow, UK; [email protected] Sharon Cameron, MRCOG, MFSRH Consultant Gynaecologist, Chalmers Sexual and Reproductive Health Centre, Edinburgh, UK; [email protected] Anna Glasier, FRCOG, FFSRH Honorary Professor, Department of Reproductive and Developmental Sciences, University of Edinburgh, Edinburgh, UK; [email protected]
Competing interests None.
Karen McMahon, RN Matron, Torbay Sexual Medicine Service, Department of Genitourinary Medicine, Castle Circus Health Centre, Torquay, UK; [email protected]
Competing interests None.
▸ http://dx.doi.org/10.1136/jfprhc-2013-100863 J Fam Plann Reprod Health Care 2014;40:154. doi:10.1136/jfprhc-2014-100881
REFERENCES 1
We read with interest the article by Michie et al. in the October 2013 Journal.1 We are delighted that our colleagues at a sexual and reproductive health care meeting are supportive of the concept of running an abortion service from a community setting. In Torbay we have
154
▸ http://dx.doi.org/10.1136/jfprhc-2014-100881 J Fam Plann Reprod Health Care 2014;40:154. doi:10.1136/jfprhc-2013-100863
REFERENCE 1
Michie L, Cameron ST, Glasier A. Abortion care services delivered from a community
2
Kell P, McMahon K. Comment on ‘Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals’. J Fam Plann Reprod Health Care 2014;40:154. Michie L, Cameron ST, Glasier A. Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals. J Fam Plann Reprod Health Care 2013;39:270–275.
J Fam Plann Reprod Health Care 2014 April Vol 40 Issue 2
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Comment on 'Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals' Philip Kell and Karen McMahon J Fam Plann Reprod Health Care 2014 40: 154
doi: 10.1136/jfprhc-2013-100863 Updated information and services can be found at: http://jfprhc.bmj.com/content/40/2/154.1
These include:
References Email alerting service
This article cites 1 articles, 1 of which you can access for free at: http://jfprhc.bmj.com/content/40/2/154.1#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Letters to the editor calculated by the National Institute of Health and Care Excellence (NICE).3 As pointed out by Dr Britton, we did not include the cost of overheads as these were not included in the NICE cost-impact report. However, we acknowledge that the overhead costs in a community setting are likely to be different to those in a primary care setting and these would need to be taken into consideration when commissioning services. Louise Cook, MRCGP, MFSRH Associate Specialist in Sexual and Reproductive Health, Aneurin Bevan Health Board – Sexual and Reproductive Health, Newport, UK; [email protected] Charlotte Fleming, MD, MRCOG Consultant in Sexual and Reproductive Health, Aneurin Bevan Health Board – Sexual and Reproductive Health, Newport, UK; [email protected]
Competing interests None. J Fam Plann Reprod Health Care 2014;40:153–154. doi:10.1136/jfprhc-2014-100908
REFERENCES 1
2
3
Britton A. Comment on ‘What is the actual cost of providing the intrauterine system for contraception in a UK community sexual and reproductive health setting?’ J Fam Plann Reprod Health Care 2014;40:153. Cook L, Fleming C. What is the actual cost of providing the intrauterine system for contraception in a UK community sexual and reproductive health setting? J Fam Plann Reprod Health Care 2014;40:46–53. National Institute for Health and Clinical Excellence. National Cost-Impact Report. Implementing the NICE Clinical Guideline on Long-acting Reversible Contraception (Clinical Guideline CG30). 2005. http://www.nice.org. uk/nicemedia/live/10974/29916/29916.pdf [accessed 12 February 2014].
Comment on ‘Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals’
been running such a service for some years originally delivered by BPAS and now delivered, for the last 12 months, by the integrated Torbay Sexual Medicine Service (tSMS), hosted by South Devon Healthcare Foundation Trust (SDHCFT). The pre-abortion counselling, the medical assessment, the ultrasound scan and the early medical abortion (EMA) service are all delivered from a community-based health centre. The staff and the patients felt that this was a natural extension of the integrated sexual medicine service, which also includes sexually transmitted infection (STI) management, contraception, a chlamydia screening service, HIV care and an outreach service. The only part of the abortion service that requires hospital care is the surgical termination of pregnancy service, which is delivered by the gynaecologists of SDHCFTand our colleagues from BPAS. The third key message from the article was about the improvement in contraceptive and STI management. Since the service has been taken into the integrated service the rates of STI diagnosis, the rates of patients having long-acting reversible contraception post-procedure, and the rates of the use of EMA compared with surgery have all significantly increased. In conclusion, we hope the above information confirms the notion of the Michie et al. article that not only is a community-based service desirable, it is also feasible and practical. Philip Kell, FRCOG, FRCP(L) Consultant Physician, Torbay Sexual Medicine Service, Department of Genitourinary Medicine, Castle Circus Health Centre, Torquay, UK; [email protected]
sexual and reproductive health setting: views of health care professionals. J Fam Plann Reprod Health Care 2013;39:270–275.
Comment on ‘Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals’: authors’ response We thank Dr Kell and Ms McMahon for their comments1 on our article2 and for sharing their experience of running an abortion service from a community setting. It is reassuring to learn that both staff and patients welcomed this service and that both contraceptive provision and sexually transmitted infection diagnosis have improved as a result. We hope other clinicians providing abortion care services may be encouraged to consider the potential benefits of providing such services from a community setting.
Lucy Michie, MRCOG, DFSRH Specialty Trainee in Sexual and Reproductive Health, Sandyford Initiative, Glasgow, UK; [email protected] Sharon Cameron, MRCOG, MFSRH Consultant Gynaecologist, Chalmers Sexual and Reproductive Health Centre, Edinburgh, UK; [email protected] Anna Glasier, FRCOG, FFSRH Honorary Professor, Department of Reproductive and Developmental Sciences, University of Edinburgh, Edinburgh, UK; [email protected]
Competing interests None.
Karen McMahon, RN Matron, Torbay Sexual Medicine Service, Department of Genitourinary Medicine, Castle Circus Health Centre, Torquay, UK; [email protected]
Competing interests None.
▸ http://dx.doi.org/10.1136/jfprhc-2013-100863 J Fam Plann Reprod Health Care 2014;40:154. doi:10.1136/jfprhc-2014-100881
REFERENCES 1
We read with interest the article by Michie et al. in the October 2013 Journal.1 We are delighted that our colleagues at a sexual and reproductive health care meeting are supportive of the concept of running an abortion service from a community setting. In Torbay we have
154
▸ http://dx.doi.org/10.1136/jfprhc-2014-100881 J Fam Plann Reprod Health Care 2014;40:154. doi:10.1136/jfprhc-2013-100863
REFERENCE 1
Michie L, Cameron ST, Glasier A. Abortion care services delivered from a community
2
Kell P, McMahon K. Comment on ‘Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals’. J Fam Plann Reprod Health Care 2014;40:154. Michie L, Cameron ST, Glasier A. Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals. J Fam Plann Reprod Health Care 2013;39:270–275.
J Fam Plann Reprod Health Care 2014 April Vol 40 Issue 2
Downloaded from http://jfprhc.bmj.com/ on July 9, 2015 - Published by group.bmj.com
Comment on 'Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals' Philip Kell and Karen McMahon J Fam Plann Reprod Health Care 2014 40: 154
doi: 10.1136/jfprhc-2013-100863 Updated information and services can be found at: http://jfprhc.bmj.com/content/40/2/154.1
These include:
References Email alerting service
This article cites 1 articles, 1 of which you can access for free at: http://jfprhc.bmj.com/content/40/2/154.1#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
