(P117) Ensuring quality patient care for sexually transmitted infections regardless of service type

Project:

The British Association for Sexual Health and HIV (BASHH) Bacterial Special Interest Group (BSIG) has developed a programme of work aimed at effecting long-term change in online sexually transmitted infection (STI) provision, to ensure appropriate patient care by all service types, whether they be face-to-face or online, public or private.

Issue:

Online STI care has increased in popularity because it overcomes barriers associated with face-to-face services and access has improved considerably. However, recent data show that the quality of care provided varies significantly between services, with for-profit providers often falling short of United Kingdom national recommended standards. In March 2021, BASHH released a position statement alerting regulatory and advisory bodies to some STI service providers’ practices which were inconsistent with national guidance, were detrimental to patient care and threatened antimicrobial stewardship.



Results:

Progress has been made in all workstreams (Table 1).



Lessons Learned:

For-profit services are difficult to engage with because of commercial sensitivities; they may also not change practices since “guidelines are not legislation”. Regulatory change is needed, which holds all services accountable to the same standards and penalises services that do not comply. Previous efforts to effect longer-term improvement from some providers have failed because of the vastness of the online testing sector and concerns around maintaining regulation of such “behind closed doors” practice. Despite this, we have generated interest from high-level National Health Service stakeholders and many medical, pharmaceutical and voluntary third-sector partner organisations. An ongoing commitment to collecting data and improving the evidence base is essential to maintaining engagement with these organisations.



Careful messaging is needed to frame the important issues: online provision of care is extremely varied and applying the same conclusion to all services is incorrect and damaging to those who do provide high standards of care. More work is needed to understand which patients choose to access which services and their reasons for doing so. A targeted information campaign with clear messaging aimed at educating the public around expected standards of care from providers, along with direct engagement with companies, are likely to offer the best hope in effecting longer-term change.