How budget cuts are affecting our ability to deliver online STI testing services

For the first time since we launched last March, we are faced with having to limit access to people trying to get tested for STIs in Southwark and Lambeth, Telford & Wrekin and Shropshire.

This is a decision that has been made with our partners at Lambeth and Southwark Councils, Shropshire Council, Telford & Wrekin Council, Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust and South Staffordshire and Shropshire Healthcare NHS Foundation Trust. From now onwards, once fixed numbers of daily orders are hit in certain postcode areas, our website will not accept any more orders in that area until the following day. We know that might cause concern for people who use our services, and so wanted to explain the circumstances surrounding this decision and how we intend to support people in light of it.

SH:24 was founded to make it easier for people to access sexual health services, to reduce queues at overcrowded clinics and give clinicians more capacity to work with more complex cases. Restricting access to the service is the last thing we would want to do.

Sexual health services are commissioned by local authorities who receive their budget from the Department of Health. While it’s ringfenced until 2017/18 to only be spent on public health interventions, £200m has been cut from the money allocated to the local authorities in 2015/16. Public Health England’s Spending Review in late 2015 informed local authority chief executives of a further real terms cut averaging 3.9% each year to 2020/21. This means local authorities have even less funds with which to deliver public health services despite the fact that demand for these services remains the same or higher.

For people that don’t have any symptoms but would like to be tested, online testing is the most cost effective option - less than half the cost of testing in clinics. SH:24 has tested around 26,000 people since March 2015. We have not only had fantastic feedback from service users but have an average 4.92 overall satisfaction rating from over 1000 users surveyed.

Besides leaving some service users unable to order a test on some days, it’s difficult to predict the full extent of the impact this could have on the sexual health of the local communities affected. Sexual health and HIV doctor, Verity Sullivan warned earlier this year in the Guardian that cuts to sexual health fundings could have huge consequences for the health of the population. Based on our current chlamydia diagnosis rate of 5.5%*, we have calculated we could miss around 242 positive diagnoses between now and 31 March, 2017. The number of additional days the undiagnosed infection might be left in the community, at risk of being passed on to other people, is 2265 days.

What are you doing to ensure people continue to get support?

If the same numbers of people in Lambeth, Southwark, Telford & Wrekin and Shropshire continue to try to access the service at the rate they currently do, there will be a small number of people who won’t be able to access the test every day. If they don’t have any symptoms we’d encourage them to return to our website to try to order a test another day. If someone does have symptoms, we’d recommend going to see a local clinic - you can find one using NHS Choices. We will update our Facebook and Twitter profiles when we are close to meeting our orders for the day and again when there are no more kits left - people can check these pages before attempting to order a test.   

Sometimes, it might not even be the right time to order a test, all the infections we test for can take between 2 and 6 weeks to be detected after unprotected sex. We’d advise anyone thinking of taking a test to check our STI testing window periods information to see if it’s the right time. The best protections against infection are condoms and honest conversations with your partners about your sexual activity - here’s our top 10 tips for a safe and sexy time.

As with everything else about SH:24, we’re keen to hear how our service users feel about this change. You can get in contact by leaving a comment on this blog or emailing us at communications@sh24.org.uk

*based on data from tests performed in Lambeth, Southwark Telford & Wrekin and Shropshire between 1 March 2015 to 29 September 2016 time period