At the start of a new decade, it is increasingly apparent that health care has to interface with society in the broadest sense as well as with the physiology of the individual. Sexual health is at the boundary between health and society. It reflects the outcomes of human behaviour, is assisted by increasingly sophisticated technology and treatments, and is influenced by legislation and policy making that shifts over time
This collection takes sexual health as the subject for investigation, and addresses it through reviewing the experience of Scotland in the United Kingdom. The editors and contributors make a strong case for suggesting that the governance and policy context, coupled with Scotland’s poor health record, have allowed creative responses to occur to address poor sexual health and to challenge some of the longstanding societal mores.
Chapters are written by experts in the field – from clinical, health improvement, policy and management – many of whom have been active players in the developments and changes that the book sets out. The approaches taken in the chapters vary depending on the aspect of sexual health being covered, and this makes the collection of wide interest. It demonstrates the high levels of innovation, lateral thinking, clarity of purpose and genuine multi-agency working that characterises the successful approach that has been taken in Scotland.
Difficult challenges remain, but there is a lot here that will benefit those elsewhere in the UK and more widely afield, and I am delighted to recommend this collection.
Dr Christine RobinsonMA FRCOG FFSRH
President, Faculty of Sexual and Reproductive Healthcare
Royal College of Obstetricians and Gynaecologists
In October 2008, a conference took place in Glasgow, Scotland attended by those who are part of the sexual health family – government Ministers, civil servants, clinicians, managers, policy-makers, researchers, academics, commissioners, health improvement specialists, public health experts, community activists, educationalists, voluntary organisations and many others. They had come together to recognise the work that has taken place across Scotland and in other parts of the UK since the development of the first national sexual health strategy - Respect and Responsibility - and its UK counterparts. The conference was over-subscribed and due to demand has now become an annual event.
The conference showed how far we have travelled in the last few decades in sexual health as, what was once a stigmatised clinical and health issue, has now become more open and less invisible. There are better and more accessible services, improved diagnosis and treatments, higher numbers of trained staff, wider understandings of the links between sexual health and other aspects of collective and individual experience, and a commitment from all UK national governments to improve the poor sexual health outcomes of the population.
This collection arose from the experience of organising and attending that October conference. We felt that the buzz in the room needed to be harnessed and disseminated, and that the creative activities, innovative services and insightful thinking happening across Scotland concerning sexual health should be more widely represented. Both to shed some light on the different political, cultural and structural structures in Scotland, and why that matters in a field like sexual health; as well as to share our experiences as a small nation in tackling challenging poor sexual health in the context of inequalities that are far-reaching.
This collection brings to wider attention some of the main themes that were discussed that day, with papers rewritten by their original presenters, alongside newly commissioned pieces that provide other insights. We hope that this collection appeals to those already in the sexual health family, and to all those friends and neighbours who will find something of interest here. Thanks to all the contributors and those who have provided ideas and support, especially Kelda McLean, Programme Administrator at the Glasgow Centre for Population Health.
Dr Rosie Ilett
Deputy Director, Glasgow Centre for Population Health
Formerly Head of Planning and Partnerships, Sandyford
Dr Alison Bigrigg
Lead Clinician, West of Scotland Sexual Health Managed Clinical Network
Lead Clinician for Sexual Health, NHS Greater Glasgow and Clyde
Director of Sandyford
List of Contributors
Glasgow Centre for Population Health
West of Scotland Sexual Health Managed Clinical Network
ALISON BIGRIGG FRCOG, MFFP, FRCS, FRCP, MD, MBA
NHS Greater Glasgow &Clyde
West of Scotland Sexual Health Managed Clinical Network Sandyford
URSZULA BANKOWSKA MB CHB, FFSRH
JAMES CHALMERS MBChB, MSc, MRCGP, FFPH
NHS National Services Scotland
PHIL EAGLESHAM MSc
NHS Health Scotland, Glasgow
The Open University in Scotland,
LORRAINE FORSTER RGN, RM, BSc Hons, MPC
SHIRLEY M. FRASER MSc, MA Joint Hons
NHS Health Scotland
ANDREW GARDINER BA (Hons), CQSW
ANNA GLASIER BSc, MD, DSc, FRCOG, FFSRH, OBE
Sexual Health NHS Lothian, NHS Lothian Family Planning Service
Edinburgh University of Edinburgh, University of London
PHIL HANLON BSc, MD, FRCP, FFPH
University of Glasgow
ROSIE ILETT BA (Hons), MSc, PhD
Glasgow Centre for Population Health, Formerly Sandyford
MARTIN MURCHIE BSc, MPH
RAK NANDWANI FRCP (Glasgow), FRCP (London)
Formerly NHS Quality Improvement Scotland, Edinburgh. University of Glasgow
FELICITY NAUGHTON MA (Hons)
Public Health &Substance Misuse Division
Scottish Government, Edinburgh Formerly NHS National Services Scotland,
ANDREW J. WINTER Ph.D, FRCP
Sandyford, Glasgow University of Glasgow