MPs suggest sexual health screening be offered by school nurses

Sexual health screening should be introduced during school nurse interactions and at GP registration, a committee of MPs has said.

The recommendation from the Health and Social Care Committee follows an evidence session which found fragmented provision of sexual health services with inconsistent access, gaps in services and poor co-ordination.

There is an ‘urgent’ need for a ‘single coherent vision’ for sexual and reproductive health services, supported by sustainable funding, the committee said in a letter to the Department of Health and Social Care earlier this month.

This national strategy, first promised in 2019, is vital to clear up the ‘confusing picture’ of what services are offered by different parts of the health service or local authorities, the committee said.

Among a series of issues discussed by the committee was how sexual health screening could be incorporated into wider health services.

‘We recommend the commission explore options for integrating sexual health screening into wider healthcare interactions, such as GP registration, A&E visits, and school nurse interactions, to improve access, reduce stigma, and reach underserved populations,’ the committee said.

One initiative put forward was that individuals registering with a GP could be offered a postal kit for chlamydia, gonorrhoea, syphilis, and HIV.

‘This approach would effectively reach younger people, students, migrants, and those from lower socioeconomic backgrounds, who are more likely to move frequently and less likely to access traditional sexual health services,’ the committee added.

Related Article: Vulval skin conditions – the essentials for nurses in primary care

It is similar to a model tried in Wales where kits were available in community settings that could be returned discreetly ‘reducing stigma and increasing uptake’, the committee said.

The role of school nurses 

Speaking to the committee, Laura Domegan, head of nursing at the sexual health charity Brook, stressed the pressures faced by sexual health clinics and the decline in sexual health provision by school nurses and other community health professionals.

‘There is pressure on the clinics’ finances. We used to provide condoms to chemists and school nurses; we used to give them out across all areas where we have clinics.

‘We have had to restrict that because of the costs,’ Ms Domegan said.

She added that more sexual health tests should be ‘more readily available’, especially in school settings.

‘It is about having testing more readily available – in A&E and with GPs,’ said Ms Domegan.

‘We do not see school nurses much any more, either. Support the school nurses back in and give them the test kits.

‘It is just about having the kits and testing more readily available in areas where people do not have to come to a sexual health service.’

Patients facing long delays 

Another issue flagged by the committee was patients facing long delays, with one example given of a woman being unable to receive a hormonal coil fitting in a sexual health clinic due to ‘commissioning limitations’, despite the clinic having the capacity and expertise to do it.

Instead, she was passed between providers, facing potential delays of up to two years.

‘Commissioning must follow the patient, ensuring that services are responsive to need rather than constrained by administrative boundaries,’ the committee added.

Those giving evidence to the committee also raised the issue of scarcity of postal testing kits, and a lack of click-and-collect options for individuals who require discretion.

Dr. Zara Haider, president of the College of Sexual and Reproductive Healthcare (CoSRH), told the committee that she regularly trains senior nurses to fit coils in her consultant role, ‘and we have a lot of appointments’, she noted.

Related Article: Teenage pregnancy rates and STIs starting to rise

In response, the committee called for a national coordination of online platforms that test kits can be ordered from.

To help tackle stigma, DHSC should develop a public information campaign and social media strategy on sexual health, it said.

This should be developed with organisations working with young people and marginalised groups who are less likely to access services, to build trust and ensure that messaging is inclusive and culturally sensitive.

Better data is also needed on emerging sexual health challenges including chemsex-related harm, the committee said.

In a report published in summer, officials warned of a ‘concerning acceleration’ in cases of antibiotic-resistant gonorrhoea in England.

Figures also showed that syphilis, including late-stage syphilis or complications from the infection, increased 5% from 12,456 in 2023 to 13,030 in 2024.

Cases of chlamydia fell 13%, but among women aged 15 to 24 who eligible for the National Chlamydia Screening Programme, there was a 10.7% decrease in the number of tests carried out.

Health and social care committee chair Layla Moran MP said: ‘Despite having a dedicated and passionate workforce, we heard that sexual health services can feel like an overlooked and undervalued part of the health service for those on the front line.

Related Article: Pharmacies launch NHS emergency contraception service

‘And the fact that no policy review has been carried out for over a decade is an inexcusable oversight.

‘This government must now take a panoramic view of the confusing landscape of sexual health and reproductive services.

‘It should come up with a comprehensive strategy to take the anxiety out of accessing care, and make sure services are patient-centred and sustainably resourced.’

A version of this article was first published in our sister title, Pulse.