Downloaded from http://sti.bmj.com/ on March 18, 2015 - Published by group.bmj.com
BASHH column
The BASHH Public Health Special Interest Group Shamela de Silva,1 Gavin Dabrera,2 Helen Ward3 There are few medical specialties as closely allied to public health as genitourinary medicine (GUM). From their earliest beginnings, when clinics were established to tackle the burden of sexually transmitted infections (STI) in the population,1 GUM physicians have been at the forefront of improving health at the population level. While at the point of care STI are principally treated at an individual level, public health issues of transmission risk and contact tracing are routinely considered during consultations. Conversely, the prevalence of sexually transmitted diseases directly affects decisions on screening, treatment, postexposure prophylaxis, education and health promotion interventions for individual patients. This has created a unique interdependence between GUM and public health. Following the Health and Social Care Bill in 2012,2 we are entering a new era of sexual health provision in the National Health Service (NHS) in England, with the commissioning of genitourinary and contraceptive services sitting within public health at local authority level, while the Health Protection Agency has become part of a new organisation, Public Health England (PHE). Furthermore, NHS England will be commissioning HIV treatment and care and therefore be separate from genitourinary medicine. In contrast, sexual health is commissioned by local health boards in Wales, regional NHS boards in Scotland and the Health and Social Care Board in Northern Ireland, producing a mixed picture across the UK. This will result in major changes in the day-to-day practice of sexual health medicine. The new structures present opportunities for integrating sexual health with other council services for the benefit of the local population, but there are clearly also threats to existing models of provision and relationships with the rest of the NHS. British Association of Sexual Health and HIV (BASHH) members need knowledge
1
West Middlesex Hospital, London, UK; 2UK Field Epidemiology Training Programme, Public Health England, London, UK; 3Department of Infectious Disease Epidemiology, Imperial College London, London, UK Correspondence to Dr Shamela de Silva, West Middlesex Hospital, Twickenham Rd, London TW7 6AF, UK; [email protected]
2
and skills in public health both to lead and deliver the core functions of sexual health and HIV services, but also to be proactive and provide leadership in the new commissioning environment. The importance of public health was recognised in a 2006 article coauthored by leading BASHH members, in which they highlighted the relevance and importance of education in public health for GUM specialists managing STI services.3 Specific public health competencies were then incorporated into specialist training in GUM, supported by the inclusion of more epidemiology, statistics and public health in the BASHH STI and HIV course for trainees. The sexual health and HIV sections of the Department of Health Electronic Learning for Health (eLFH) programme also include modules covering key public health competencies. In 2011, the BASHH Board agreed to establish a special interest group (SIG) in public health to build on this work. Chaired by Professor Helen Ward, the multidisciplinary group includes clinicians, public health specialists, epidemiologists and health advisors. Since its founding, the group has continued to guide education in public health for members of BASHH as well as developing advice on working with public health structures in the new commissioning landscape. BASHH already has a history of public health activities such as the BASHH/PHE Fellowship ( previously BASHH/HPA). This popular programme, first established by the Medical Society for the study of Venereal Diseases and Communicable Disease Surveillance Centre over 10 years ago, has given many GUM registrars a hands-on opportunity to get involved with different aspects of public health work in terms of laboratory experience, analytical epidemiology or outbreak investigation. We have organised ordinary general meetings (OGMs) with public health presentations ranging from development of sexual health services to molecular epidemiology and improving HIV testing. Early next year we are planning an evening OGM with presentations and discussions of the key findings from Natsal 2012,4 which are due to be published later this year. We are adding to these initiatives by offering more opportunities to consultants,
non-consultant career grade doctors and doctors in training to improve and update their skills and knowledge, including a new course for BASHH members on public health. The course aims to equip colleagues to manage the public health aspects of their everyday work and the challenge of the move to commissioning by local authority public health in England. It will also cover key skills relating to surveillance and needs assessment of local populations and advice on outbreak response and preventive interventions. Details of the course will be announced in the coming months, and we are keen to hear from BASHH members who have ideas about particular areas they would like us to cover. If you want more information on the SIG, or to be kept informed of our work, then please contact us via the BASHH website or email [email protected].
USEFUL RESOURCES ▸ BASHH website: http://www.bashh.org/ BASHH/BASHH_Groups/Special_ Interest_Groups/Public_Health_SIG/ BASHH/BASHH_Groups/Special_ Interest_Groups/Public_Health_SIG. aspx?hkey=7007fe55-d40a-4f04-9ce0e6ae2fcc9e0c ▸ e-Learning for Healthcare: http:// portal.e-lfh.org.uk/ ▸ Public health in local government factsheets: https://www.gov.uk/government/ publications/public-health-inlocal-government ▸ Healthy lives, healthy people update: https://www.gov.uk/government/ publications/healthy-lives-healthypeople-update-and-way-forward Acknowledgements We thank Philip Veal and Dona Milnes for their insights into commissioning in Northern Ireland and Scotland. Handling editor Jackie Cassell Competing interests None. Patient consent Obtained. Provenance and peer review Commissioned; internally peer reviewed. To cite de Silva S, Dabrera G, Ward H. Sex Transm Infect 2014;90:2. Sex Transm Infect 2014;90:2. doi:10.1136/sextrans-2013-051260
REFERENCES 1 2 3 4
Royal Commission on Venereal Diseases Final report of the commissioners. London: HMSO, 1916. Health and Social Care Bill 2012. http://services. parliament.uk/bills/2010-12/healthandsocialcare.html Robinson AJ, Payne N, Ward H. Public health training in genitourinary medicine. Sex Trans Infect 2006;82:191–2. The National Survey of Sexual Attitudes and Lifestyles. http://www.natcen.ac.uk/study/natsal
de Silva S, et al. Sex Transm Infect February 2014 Vol 90 No 1
Downloaded from http://sti.bmj.com/ on March 18, 2015 - Published by group.bmj.com
The BASHH Public Health Special Interest Group Shamela de Silva, Gavin Dabrera and Helen Ward Sex Transm Infect 2014 90: 2
doi: 10.1136/sextrans-2013-051260 Updated information and services can be found at: http://sti.bmj.com/content/90/1/2
These include:
References Email alerting service
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This article cites 1 articles, 1 of which you can access for free at: http://sti.bmj.com/content/90/1/2#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.
Articles on similar topics can be found in the following collections Drugs: infectious diseases (2843) HIV / AIDS (2238) HIV infections (2238) HIV/AIDS (2238) Screening (epidemiology) (883) Screening (public health) (883) Contraception (217) Drugs: obstetrics and gynaecology (132) Reproductive medicine (1219)
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/
BASHH column
The BASHH Public Health Special Interest Group Shamela de Silva,1 Gavin Dabrera,2 Helen Ward3 There are few medical specialties as closely allied to public health as genitourinary medicine (GUM). From their earliest beginnings, when clinics were established to tackle the burden of sexually transmitted infections (STI) in the population,1 GUM physicians have been at the forefront of improving health at the population level. While at the point of care STI are principally treated at an individual level, public health issues of transmission risk and contact tracing are routinely considered during consultations. Conversely, the prevalence of sexually transmitted diseases directly affects decisions on screening, treatment, postexposure prophylaxis, education and health promotion interventions for individual patients. This has created a unique interdependence between GUM and public health. Following the Health and Social Care Bill in 2012,2 we are entering a new era of sexual health provision in the National Health Service (NHS) in England, with the commissioning of genitourinary and contraceptive services sitting within public health at local authority level, while the Health Protection Agency has become part of a new organisation, Public Health England (PHE). Furthermore, NHS England will be commissioning HIV treatment and care and therefore be separate from genitourinary medicine. In contrast, sexual health is commissioned by local health boards in Wales, regional NHS boards in Scotland and the Health and Social Care Board in Northern Ireland, producing a mixed picture across the UK. This will result in major changes in the day-to-day practice of sexual health medicine. The new structures present opportunities for integrating sexual health with other council services for the benefit of the local population, but there are clearly also threats to existing models of provision and relationships with the rest of the NHS. British Association of Sexual Health and HIV (BASHH) members need knowledge
1
West Middlesex Hospital, London, UK; 2UK Field Epidemiology Training Programme, Public Health England, London, UK; 3Department of Infectious Disease Epidemiology, Imperial College London, London, UK Correspondence to Dr Shamela de Silva, West Middlesex Hospital, Twickenham Rd, London TW7 6AF, UK; [email protected]
2
and skills in public health both to lead and deliver the core functions of sexual health and HIV services, but also to be proactive and provide leadership in the new commissioning environment. The importance of public health was recognised in a 2006 article coauthored by leading BASHH members, in which they highlighted the relevance and importance of education in public health for GUM specialists managing STI services.3 Specific public health competencies were then incorporated into specialist training in GUM, supported by the inclusion of more epidemiology, statistics and public health in the BASHH STI and HIV course for trainees. The sexual health and HIV sections of the Department of Health Electronic Learning for Health (eLFH) programme also include modules covering key public health competencies. In 2011, the BASHH Board agreed to establish a special interest group (SIG) in public health to build on this work. Chaired by Professor Helen Ward, the multidisciplinary group includes clinicians, public health specialists, epidemiologists and health advisors. Since its founding, the group has continued to guide education in public health for members of BASHH as well as developing advice on working with public health structures in the new commissioning landscape. BASHH already has a history of public health activities such as the BASHH/PHE Fellowship ( previously BASHH/HPA). This popular programme, first established by the Medical Society for the study of Venereal Diseases and Communicable Disease Surveillance Centre over 10 years ago, has given many GUM registrars a hands-on opportunity to get involved with different aspects of public health work in terms of laboratory experience, analytical epidemiology or outbreak investigation. We have organised ordinary general meetings (OGMs) with public health presentations ranging from development of sexual health services to molecular epidemiology and improving HIV testing. Early next year we are planning an evening OGM with presentations and discussions of the key findings from Natsal 2012,4 which are due to be published later this year. We are adding to these initiatives by offering more opportunities to consultants,
non-consultant career grade doctors and doctors in training to improve and update their skills and knowledge, including a new course for BASHH members on public health. The course aims to equip colleagues to manage the public health aspects of their everyday work and the challenge of the move to commissioning by local authority public health in England. It will also cover key skills relating to surveillance and needs assessment of local populations and advice on outbreak response and preventive interventions. Details of the course will be announced in the coming months, and we are keen to hear from BASHH members who have ideas about particular areas they would like us to cover. If you want more information on the SIG, or to be kept informed of our work, then please contact us via the BASHH website or email [email protected].
USEFUL RESOURCES ▸ BASHH website: http://www.bashh.org/ BASHH/BASHH_Groups/Special_ Interest_Groups/Public_Health_SIG/ BASHH/BASHH_Groups/Special_ Interest_Groups/Public_Health_SIG. aspx?hkey=7007fe55-d40a-4f04-9ce0e6ae2fcc9e0c ▸ e-Learning for Healthcare: http:// portal.e-lfh.org.uk/ ▸ Public health in local government factsheets: https://www.gov.uk/government/ publications/public-health-inlocal-government ▸ Healthy lives, healthy people update: https://www.gov.uk/government/ publications/healthy-lives-healthypeople-update-and-way-forward Acknowledgements We thank Philip Veal and Dona Milnes for their insights into commissioning in Northern Ireland and Scotland. Handling editor Jackie Cassell Competing interests None. Patient consent Obtained. Provenance and peer review Commissioned; internally peer reviewed. To cite de Silva S, Dabrera G, Ward H. Sex Transm Infect 2014;90:2. Sex Transm Infect 2014;90:2. doi:10.1136/sextrans-2013-051260
REFERENCES 1 2 3 4
Royal Commission on Venereal Diseases Final report of the commissioners. London: HMSO, 1916. Health and Social Care Bill 2012. http://services. parliament.uk/bills/2010-12/healthandsocialcare.html Robinson AJ, Payne N, Ward H. Public health training in genitourinary medicine. Sex Trans Infect 2006;82:191–2. The National Survey of Sexual Attitudes and Lifestyles. http://www.natcen.ac.uk/study/natsal
de Silva S, et al. Sex Transm Infect February 2014 Vol 90 No 1
Downloaded from http://sti.bmj.com/ on March 18, 2015 - Published by group.bmj.com
The BASHH Public Health Special Interest Group Shamela de Silva, Gavin Dabrera and Helen Ward Sex Transm Infect 2014 90: 2
doi: 10.1136/sextrans-2013-051260 Updated information and services can be found at: http://sti.bmj.com/content/90/1/2
These include:
References Email alerting service
Topic Collections
This article cites 1 articles, 1 of which you can access for free at: http://sti.bmj.com/content/90/1/2#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.
Articles on similar topics can be found in the following collections Drugs: infectious diseases (2843) HIV / AIDS (2238) HIV infections (2238) HIV/AIDS (2238) Screening (epidemiology) (883) Screening (public health) (883) Contraception (217) Drugs: obstetrics and gynaecology (132) Reproductive medicine (1219)
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/
