Warning over cuts to in-person STD appointments

Medical staff are concerned victims of domestic violence may slip through the net under plans to reduce face-to-face appointments for sexually transmitted diseases (STDs).

The council-funded Central Health Clinic in Bristol is significantly reducing the number of nurses on its payroll, meaning fewer in-person appointments will be available from Tuesday.

Dr Peter Greenhouse, a retired consultant in sexual health, believes the shift will make it more difficult to recognise whether patients are being abused at home.

Bristol City Council insists funding to sexual health services is not being slashed, and says the move is simply a response to increasing demand for online testing.

Dr Greenhouse's former colleagues revealed the number of staff at the clinic, which houses the Unity Sexual Health centre, will be cut by around a third under the plans.

The NHS clinic's union, the Royal College of Nursing, declined to comment.

However, a spokesperson added: "We are working closely with the employer and our members to ensure staff wellbeing and the ongoing future provision of vital services to the community."

Dr Greenhouse said the need for face-to-face consultations remained the same regardless.

"People have hidden problems that they will only reveal with a face-to-face consultation, such as a sexual assault or domestic violence," he explained.

Dr Greenhouse added that in recent years, a record number of people in England have been diagnosed with gonorrhoea.

He warned rates of the disease in this country are now higher than during World War Two, and the shift to online appointments may fuel the rise.

The digital consultations will be staffed by nurses working remotely across the country, with the results delivered via email or text.

However, staff fear the absence of local health workers creates a lack of knowledge around the client base, as well as a lack of knowledge of which areas experience more deprivation and therefore require more assistance.

The BBC has spoken to a number of nurses at the clinic in Bristol, who preferred to remain anonymous, who shared Dr Greenhouse's concerns.

"For some people it will be efficient, if you are well educated and competent," said one nurse.

"Who is going to suffer are people who will be less capable of accessing the service such as sexual violence victims."

Another nurse added: "Some people don't use the internet, and some people want to collect kits, they don't want kits posted to them."

Bristol City Council, which funds the service, was not able to confirm or deny the figures given to the BBC regarding staffing cuts.

Councillor Stephen Williams, chairman of the public health and communities committee, said there has been a 4% increase in funding for sexual health services.

"Citizens increasingly want to have more information up front to assess for themselves a concern they might have about their health. They can then apply for a test," he said.

"The advantage of doing that via a digital portal is that it can be turned round really quickly, often within four days.

"They can get the test result back and at that point, assess whether someone needs a face-to-face a clinical consultation."

Mr Williams added that if a patient receives a positive STD assessment online, they can expect a face-to-face consultation "pretty soon".

The NHS declined to comment on changes to job roles.

Follow BBC Bristol on Facebook, X and Instagram. Send your story ideas to us on email or via WhatsApp on 0800 313 4630.