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Introduction Public Health Network Cymru based within Public Health Wales provides a range of support to practitioners and researchers across all sectors that influence any aspect of public health and health improvement in Wales. Amongst the services they provide is an annual conference of which the members choose the theme. The topic of Sexual Health was a timely choice due to the recent Sexual Health Review. The Network arranged a planning group to aid in the shaping and contribution of the conference. This conference took place on the 22 March 2018 and was hosted at the All Nations Centre, Cardiff. The conference was chaired by Jan Williams, Chair at Public Health Wales. Jan welcomed everyone to the event and spoke about how much we have progressed over the last century to the point that we now have a comprehensive informed evidence review of sexual health need and provision in Wales. Jan explained that the day would include discussions around what could happen in the future, how technology might impact, what threats would need to be managed, educational opportunities, societal implications and how is the service going to provide the vision for the future of Wales.
Overview of presentations The day was opened by Dr. Frank Atherton, Chief Medical Officer, Welsh Government. Dr. Atherton spoke about his past experiences which provided an insight into the challenges around sexual and reproductive health and spoke highly of the excellent work currently being undertaken across Wales. He talked about the challenges that we face across Wales and how services are under pressure with the increasing demand. Prevention is very important and in particular how we support populations to prevent STIs, teenage pregnancies. Early diagnosis to get people in for treatment earlier is key and primary care and community care services are extremely important for people with sexual health needs. Communication is also critical and we need to think about how we can communicate better with the public to avoid stigma around diseases. Dr. Atherton concluded his presentation stating that not everything needs to be ‘gloomy’. We’ve come a long way, for example, antivirals are now working, HIV is now seen as a chronic disease rather than a fatal disease and access to services is much better. We still have challenges ahead but we need to build on our successes. This was followed by two presentations, Dr. Giri Shankar, Lead Consultant for Health Protection, Public Health Wales; and a joint presentation by Adam Jones, Public Health Practitioner (Policy), Public Health Wales and Dr. Rachel Drayton, Cardiff & Vale University Health Board. Dr. Shankar presented information regarding the recent Sexual Health Review including the objectives, methodology used, key findings and the next steps following this. Dr. Shankar thanked Welsh Government for approaching Public Health Wales to undertake the Sexual Health Review in Wales. In the context of the Review a number of services were being examined that provide sexual health services across various spectrums of care. Dr. Shankar advised that a final summary report has been submitted to Welsh Government. In addition to the report there are several documents which should be read in conjunction with the final report. Adam Jones presented on the Pre-exposure Prophylaxis (PrEP) review in the Welsh context which was introduced in July 2017. Adam explained the process followed for this review and how they looked at the last 6 reporting years (2010-2015) to give an average diagnosis of HIV in Wales. Adam spoke about the governance arrangements in Wales for overseeing PrEP in Wales and how an Outreach Programme is currently under development with Terrence Higgins Trust Cymru and colleagues. Dr. Rachel Drayton followed on with a clinical perspective on PrEP. Dr. Drayton opened her presentation with a case study of an individual to highlight where we were prior to PrEP. Following this Dr. Drayton updated delegates on how a specialist PrEP Clinic was set up in Cardiff where a Doctor and Specialist Nurse were identified to run 2 clinics per week and would receive patients via a referral process to discuss and administer PrEP to the suitable patients. There would be reviews following their initial appointment. It became apparent that the process worked well but there was no capacity to book follow up appointments as they were all filling up with new patients. Things were amended and a waiting list was created for new patients to allow for the follow up appointments. Dr. Drayton spoke about the challenges facing us with PrEP and what to consider going forward. Individual presentations are available by contacting publichealth.network@wales.nhs.uk or can be accessed on the Public Health Network Cymru website.
Parallel Sessions • Dry Swab Chlamydia / Gonorrhoea Testing in the Community Setting Zoe Couzens, Principal in Public Health - Health Protection • School Practices Important for Students’ Sexual Health: Analysis of the School Health Research Network Survey in Wales Dr. Honor Young, Lecturer in Quantitative Research Methods, Public Health Improvement Research Network (PHIRN) DECIPHer & Member of Healthy Relationships Panel • Delivering sexual health education programmes to vulnerable young people in education and community settings FPA Jiwsi, Sandra Peters, Project Officer, FPA and Corrina Williams, Project Officer, FPA. • Sex, Parenting and People with a Learning Disability Samantha Williams, Policy and Network Coordinator, Learning Disability Wales
Overview of the Afternoon Presentations The first of the afternoon presentations was about ‘Healthy Relationships in the Welsh Curriculum’ and was delivered by Dr. Honor Young, Lecturer in Quantitative Reseearch Methods at Public Health Improvement Research Network (PHIRN) DECIPHer and Member of Healthy Relationships Panel. Dr. Young spoke about the aim and remit of the expert panel, the current status and provision in Wales around Sex and Relationships Education, the future of Sex and Relationships Education in Wales focussing specifically on the recommendations from the expert panel and to conclude she spoke about the way forward. Dr. Young explained the background to the expert panel and how they were established by the Cabinet Secretary for Education in March 2017. The panel are required to provide recommendations to the Cabinet Secretary on how current Sex and Relationships Education practice might be improved. They are also required to provide recommendations to the Cabinet Secretary and pioneer schools on the future of Sex and Relationships Education in Wales as part of the Health and Wellbeing Area of Learning Experience (AoLE). The final presentation of the day was Dr. Laetitia Zeeman from University of Brighton. Dr. Zeeman presented the findings from the Health4LGBTI research which was commissioned by the European Commission. This was a pilot study that lasted 2 years and ends in March 2018. The aim is to reduce the health inequalities in LGBTI people. Dr. Zeeman provided some background to the project and how LGBTI people experience significant health inequalities that have an impact on health outcomes. Stigma and discrimination combined with social isolation and limited understanding of their lives by others, lead to significant barriers in terms of accessing health and social care services. She also provided the findings from the scientific review and from a comprehensive scoping review. Individual presentations are available by contacting publichealth.network@wales.nhs.uk or can be accessed on the Public Health Network Cymru website.
Evaluation Form 103 people registered via Eventbrite for the event and 86 attended on the day. The seminar was also live streamed via Twitter and a total of 103 people viewed the seminar. An evaluation form was given to all delegates at the end of the event and 35 forms were returned. An email was sent to all delegates following the event asking for the completion of evaluation forms but none were returned.
Quantitative Results The first question asks delegates whether or not they were members of Public Health Network Cymru. The majority of delegates were members of the Network (60%) however, there were still delegates at the event who were not existing members (40%). Following on from this event the Network had 5 new member registrations the following week. The next question on the evaluation form asks delegates to rank from one to five, (where one is not at all useful and five is very useful) how useful did you find the seminar. As can be seen the majority of people answered 4 or 5 (97.1%) to this question with 2.9% (1 person) providing the answer of 3. Following a closer look at the evaluation forms there was nothing to indicate why this person gave the answer they did.
How useful did you find the event ?
4
60%
5 (Very Useful)
37% 3
3%
Qualitative Results What was your main motivation for attending this event? The majority of delegates attended the event to as they had an interest in sexual health within their professional role. However, there were still a wide variety of responses in addition to that. Promoting service and gaining information of the sexual health review. Always a good networking event too :) To understand / find out about the current state of sexual health provision in Wales and what is upcoming. To understand public health priorities for Wales Content of presentations and parallel session Was there anything that was of notable interest? A number of people mentioned Dr. Honor Young’s presentation on the healthy relationships in the Welsh curriculum as being one of the highlights of the day. Other speakers were also mentioned as being an interesting aspect of the day. The PrEP presentation and Dry Swab parallel session also received a lot of interest. Dr. H. Young’s presentation and Dr. L. Zeeman’s were incredibly interesting. Presentation 1 and Presentation 3 were the most beneficial and informative for me. All was very engaging - all topics discussed were delivered excellent. How do you plan to utilise the learning gained at this event? As is often the case on evaluation forms, many of the delegates said that they would share the information gained at the event with colleagues and would use the information in their everyday practice. To take back to my place of work and disseminate to colleagues I attended the dry swab test session and will be part of the trial. Pass information to my colleagues absent from conference. Do more research and get more information on how to better deliver SH info to people with learning disabilities Look at how a local public health team can work towards reducing STIs
What seminar / conference topics would you like to see delivered in the future? The topic areas that delegates said they would like to see covered in future events were varied. The Network wouldn’t be able to provide events on some of the topic areas stated as they are too specific but would be able to direct delegates to other more relevant organisations: • • • • • •
Something which is young person led about experiences of SRE in schools Problems facing Refugees and Asylum Seekers in Sexual Health Services access Child Sexual Exploitation Air Pollution Effect of the internet on young people over the last 2 decades More sexual health!!
Other comments Delegates had an opportunity to provide any further comments they had about the event. There were only 2 negative comments from the day and these were in relation to a disappointing range of poster presentations which unfortunately was due to the lack of uptake by delegates and hosting two workshops in one room as the echo made it difficult to concentrate. Thank you for such a good day! Well worth travelling from North Wales! Excellent programme. Great to hear about direction of travel and impressed with public health priorities A very interesting, informative day, excellent presentations, convenient location / venue and delicious food/lunch! One word Participants were asked to give one word to sum up how they felt about the event. These words have been inputted into Wordle (www.wordle.net). Wordle generates word diagrams that give greater prominence to words that appear more frequently in the text. From this you can clearly see that informative, Excellent and Motivating were stated most frequently.
Further information All presentations are available on Public Health Network Cymru’s website Further information and a short video of the day is also available on the Public Health Network Cymru website or by contacting publichealth.network@wales.nhs.uk
Mentimeter Mentimeter is an easy to use web based presentation tool. It is a secure platform that can be used with different sized audiences to make presentations more interactive. We took the opportunity to use Mentimeter to interact with delegates and find out their views on the current situation. Participation was unfortunately quite poor by delegates and only 30 of the 86 delegates took part. The results are as follows:
Right now, what are your top three priorities for sexual health in Wales?
What do you think is the single most effective change that we could make to sexual health services in Wales?
What one change will result in value for money and prudent healthcare in a sexual health context?
What do you think are the greatest inequities affecting sexual health in Wales today?
By allocating points, in the next five years, which of the following would you result in the greatest impact to improve sexual health service delivery?
How can we best address risky behaviours in sexual health?
Thinking 20 years ahead, where do you think Sexual Health in Wales will be in relation to the following:
At what age should the following be discussed as part of relationships education?
What do you consider the wider benefits of providing early relationships education to the health of the population?
Vote for you poster of the day Delegates were asked to vote for their favourite poster from the selection presented at the conference.
Evaluation of the day