Sex and the City – Edinburgh’s Story

Thursday, 05 November 2015

Medico-Chirurgical Hall

Dr Ailsa Gebbie, Consultant Gynaecologist, Director Clinical Effectiveness Unit of the Faculty of Sexual and Reproductive Healthcare, NHS Lothian.

The new Chalmers Centre for integrated Sexual and Reproductive Health focuses on improving the sexual health of the people of Lothian. It has adopted innovative approaches to tackling high rates of teenage pregnancy and abortion, and reducing sexually transmitted infections. It offers rapid access for complex patients and 'one stop' visits to streamline care and reduce waiting times. Notable successes have been improving access to long acting reversible contraception, supporting primary care and developing services for vulnerable women and young people.

Dr Ailsa Gebbie is a consultant gynaecologist with NHS Lothian and Clinical Lead for Family Planning in Edinburgh. She is Chair of the Medicines and Women's Health Expert Advisory Group of the UK Medicines and Healthcare Regulatory Authority (MHRA) and is Co-Director of the UK Clinical Effectiveness Unit for the Faculty of Sexual and Reproductive Healthcare.


Notes for Society Meeting 5th Nov 2015

The President welcomed those attending the meeting and reminded those present of ongoing availability of places at the forthcoming Founders’ Commemorative Dinner.

He next introduced the award of the Strachan Bursary for the best student on the 4th Year Clinical Medicine Examinations and presented a cheque to Claire Wernham.

Dr Hamilton then welcomed Dr Ailsa Gebbie, the evening’s speaker and invited her to give her talk entitled ‘Sex and the City – Edinburgh’s Story’.  Dr Gebbie explained her professional evolution through Obstetrics and Gynaecology to Community Gynaecology which has now become embedded within the more recently established specialty of Sexual and Reproductive Health, combining a broad range of disciplines and specialists.

The main part of the talk consisted of a description of how the new specialty had come together and is currently working in Edinburgh with a specialist base at Chalmers Hospital and around 10 peripheral clinics, principally centred on areas of greatest social deprivation.  She described the important collaborative efforts across an extended team and the growing range of services provided including complex contraception, sexually transmitted infection, HIV management,  premenstrual syndrome, menopause, vasectomy, sexual assault, young persons’ services, colposcopy and gender reassignment.

Great emphasis was placed on the satisfactory functioning of the specialist centre being critically dependent on not seeing the more straightforward problems and cases, and how this in turn required commitment to development and support of colleagues working in primary care to enable management of routine family planning including device insertion, routine genitourinary medicine screening, management of genital warts and herpes simples infections all to be undertaken in general practice. Ongoing support is provided by the availability of an on-call specialist 12 hours per day, and an email advice line which is answered daily. Triage by experienced nursing staff facilitates regulation of appropriate cases in the centre with inappropriate cases being turned away and directed to appropriate pathways. There is also an automated results line which allows patients to access their information directly and the existence of a ‘rapid, no-talk testing pathway’ was another innovative strategy.

The establishment of an effective and updated website describing the services available and appropriate access criteria has greatly enhanced the ability of members of the public to gather the correct information on whether or not to self-refer to the centre and information films on, for example, termination of pregnancy, have gone a long way to managing patient expectations of what the service can provide and how this will be undertaken.

Dr Gebbie told the company that the success of the project to develop this combined diagnostic and treatment centre with its complex array of one-stop services and outreach facilities was attributable to the dedication and collaboration of staff and to support from Government, including substantial recurrent funding support .

There followed an extended session of questions from the audience which included the reassuring endorsement from our speaker of similar services, while organised differently, also being largely successfully provided in Grampian.

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