‘Oversubscribed’ Sexual Health Clinics In London Are Turning People Away

At the start of 2018 27-year-old Fraser (not his real name) tried to go for a routine STI test. He had had unprotected sex just before Christmas and wanted to get checked. He arrived at the Clifden Centre Sexual Health Clinic, which is attached to Homerton University Hospital in Hackney, just before 9.30 am and was told he could expect a 9-hour wait.

When Fraser did eventually go back for an appointment, he recalls ‘every seat in the waiting being taken with people standing’ and says ‘I think I was seen quickly because [what I needed] was routine and straightforward…but the backup of people was so so big’.

Across London, people are reporting similar experiences. If you try and book an appointment via the website of the Dean Street Express clinic (which falls under the Chelsea and Westminster NHS Trust), the following message appears:

According to a report by the BBC’s Shelley Phelps, last year the following London sexual health clinics closed:

Clare Simpson Clinic, Barnet Hospital, Barnet, June 2017

Lloyd Clinic, Guys Hospital, Southwark, March 2017

Marlborough Clinic, Royal Free Hospital, Camden, June 2017

St Ann's Sexual Health Clinic, Haringey, July 2017

St George's Court Yard Clinic, St George's Hospital, Wandsworth, October 2017

Vauxhall Riverside Sexual Health Centre, Lambeth, March 2017

Last summer, in the midst of these closures, the Guardian obtained a letter which had been written and signed by a group of expert senior doctors. In it, they warned that £531m cuts to local public health budgets had left sexual health services struggling to copewith a 25% rise in patients seeking help over the past 5 years. In addition, the King’s Fund published a report in March 2017 in which they warned that cuts to sexual health services across the country were placing the care of patients at risk.

A little over 6 months later and clinics are turning patients away because of what they call ‘increased pressures on services’.

You might argue that the name ‘sexual health’ doesn’t quite do justice to what these clinics actually do. The work they carry out is more than just routine STI testing, their staff are often the ones who are tasked with spotting the signs of abuse, trafficking and offering specialist counselling services for survivors of sexual assault and child exploitation as the experts who co-signed last summer’s letterpoint out. And, for those clinics which haven’t been shut down, staff numbers have been cut which puts further pressure on them.

One young woman, who wished to remain anonymous, told The Debrief of how she recently struggled to access sexual health serviceswhich were crucial to her emotional and physical health.

It all started, she says, when she was ‘experiencing burning and pain during sex’. She was sure that she did not have an STI because she had been in a relationship for some time but, still, ‘wanted to be sure’. It was then that she realised just how difficult it is to get an appointment with a sexual health specialist. ‘it’s really hard to get a gynae appointment at the moment’ she explains ‘there is a 3-month waiting list and, if you see a GP, which I did, they just tell you to go to an STI clinic so you end up feeling very alone in the problem’.

After her initial decision to try and find out what was going on, this young woman says she ‘spent two weeks chasing appointments’ only to find out ‘they were all booked up at central London clinics’. Because she had to work she ‘kept not getting through or missing out’. She explained to the The Debrief ‘I could have taken a morning of work and gone to a walk in, but I have a super stressful job and it wasn’t an “emergency” so I didn’t really want to do that’.

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The back and forth ‘turned into a much more stressful ordeal than it could have been’ this young woman says, she felt like saying ‘fuck it’ and giving up. She says, it’s ‘awful’ if loads of people experience this and also decide not to get checked out. The whole ordeal experience, she adds, put stress on her relationship - ‘I’d told my boyfriend I was experience and then had to wait two weeks to be seen. Going [to a clinic] and showing your vagina to someone is already uncomfortable enough, especially if you think you might have an embarrassing or scary illness…I just think [having to wait or being turned away] is going to make people really stressed and anxious about it and [decide not to go at all]’.

The BBC reportsthat Guy’s and St Thomas’ NHS Foundation published an impact report following the closure of three of its six clinics last year. This shows that they had to ‘turn away’ 11,447 patients on their day of attendance across the three sites between April and September 2017 alone.

The emotional impact of not being able to get a sexual health appointmentwhen you need one can be very serious. The young women who had to wait weeks before she was seen expressed her bewilderment to The Debrief, ‘I just find it weird that these cuts are being made to be honest' she said, 'the message I grew up with is that you should go and get checked out after every sexual partner to be safe. I don’t think people are going to be able to do that now’. As she sees it, the problems with these services are part of a bigger problem. ‘I feel like it plays into the message that [sexual health problems] are something that you as an individual should have control over, but they aren’t. Mental health trauma can cause sexual pain, herpes can lay dormant and arrive when you’re stressed, loads of STIs can get transmitted even if you’re using condoms or have had the same partner since you were a teenager…' In response to reports about extended waiting times and problems accessing sexual health services, Dr Olwen Williams OBE, President of the British Association for Sexual Health and HIV, told The Debrief:

'There is growing evidence to show that patients are being turned away from sexual health services in London due to the closure of clinics across the capital, the huge pressures clinics are facing and the delayed roll out of online testing services. This isn’t just a situation that is confined to London, but is something that is being felt across the country.'

She went on to say that 'people attend sexual health clinics for a number of reasons and it is vital that there are a blend of services available, from face-to-face appointments to online components. Sexual ill health arising from failure of diagnosing and treating STIs can have a devastating impact on a woman’s sexual and reproductive health. There should be access to timely high-quality sexual healthcare for all who need it, and this must be a key priority for policymakers and commissioners.'

Finally, Dr Williams explained to The Debrief 'unfortunately in recent years the Government has made persistent and damaging cuts to public health budgets from which sexual health services are funded, with a new cut of £170m (5%) that was announced in December and which will be delivered over the next two years. Government needs to provide the funding that sexual health services so desperately need and failure to do so represents the falsest of false economies, with the consequences being felt for years to come'.

As the young women who wished to remain anonymous put it 'sexual illnesses can have a massive impact on your relationships, mental health and work life so having a system that means you can get checked out as easily as you’d see your GP is hugely important for a healthy society.’

Have you struggled to get an appointment at a sexual health clinic? Let us know @TheDebrief

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This article originally appeared on The Debrief.