Busy lives and busy services

I recently spoke to a user of sexual and reproductive health services in London who had some difficulties finding and accessing services. It is a story about a woman seeking help about a coil she had fitted.

SH:24 currently only delivers sexual health services but our next phases involve the development of user support options and elements of reproductive health (emergency hormonal contraception (EHC) and oral contraception). The user’s story highlights some of the difficulties that can be experienced when looking for and trying to access services, but the high quality care and professionalism that is delivered when you do.

User story

I had a coil fitted as means of contraception over a year ago and recently wanted to have it checked because of a problem I’d identified. I subsequently looked at the clinic times where I’d had it fitted: appointments only available on Saturday mornings (but all booked for the next two weeks); drop-in clinics throughout the week. 

I have two small children, who are with me most of the time, and I also work part-time. A drop-in clinic wasn’t therefore any ideal option but I was keen to have the coil checked as soon as possible rather than have to wait weeks for an appointment.

I looked again online at the services available in my area, and after a fair amount of searching, found a drop-in clinic near my place of employment that opened at 8am. Perfect, I thought – I can see someone before I have to be in the office at 9am. I arrived at 7.45am and was told that I would have a considerable wait. The helpful receptionist staff did suggest, however, that I go into work and then return following a call from them when the patient before me was being seen.

The call came at 11am so I headed back during an early lunchbreak, but I was finally seen at 1.30pm - after saying at 1pm that I would have to go back to work soon. The doctor was extremely proficient, apologised for the delay, and resolved the problem. The reason for such a long delay (despite turning up before the clinic opened) was because contraception issues are dealt with on a Tuesday afternoon – when I am at work and thus unable to attend; I was assigned to the slowest stream as a result.

I experienced a further problem with the coil some weeks later and attended another clinic near my workplace. I arrived 90 minutes before the clinic commenced to ensure that I would be able to be seen before 9am – I was second in the queue. Again, the clinician was extremely professional and faultless care was delivered. Having had the coil checked, I asked for it to be removed as I was concerned that if I had another problem I would have more difficulties accessing services.

The clinical care I experienced was first class, but it shouldn’t be so difficult to access it! Anything that can be done to facilitate the provision of accessible contraception services would be a step forward.

What were our ‘take-homes’ from this story?

- People have busy lives which can make accessing busy services particularly difficult. Digital services and clear signposting can be a helpful extension of clinic services to get people to the most appropriate service

- There are many places people can go to get support regarding sexual and reproductive health but it can be difficult to locate the most convenient services. As part of our user support work we are looking to test simple online mapping of services that could help users find the service that they need when they need it

- Demand for sexual and reproductive health services in London is high and reinforces our belief that a blend of online and offline services can help. Moving some of the more straightforward STI testing online can free-up clinics to focus on cases where face-to-face support is needed the most.

- Building EHC and oral contraception into online STI testing services (as SH:24 plans to do) should provide more capacity for clinics to deal with more complex reproductive health cases

- ‘First class’ clinical care provides an excellent opportunity to create integrated pathways between online services and clinics. We are assured that when people with positive results are referred to local clinics they will receive the services they need

- There is much opportunity for digital and clinic sexual and reproductive health services to work together to create added convenience for the user (as our new animation shows - bit.ly/howitworksSH24)