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How Closely do the CQC Look at Sexual and Reproductive Healthcare in my Practice?

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The importance placed upon mental healthcare in the current care environment may lead some outsiders to believe that other areas of need are deemed as less important. This isn’t the case, and when the CQC conducts its inspections it will want to ensure that care across all needs are provided suitably and substantively. One area of concern is the provision of sexual and reproductive healthcare (SRH).

GPs are an ever present in people’s sexual health

The GP practice plays a leading role in the provision of SRH throughout a patient’s life. It is important that the practice is non-discriminatory in its approach. There are some agreed principles and best practices that the CQC will expect to be evidenced. For example:

- All SRH services offered should be displayed on the practice’s website

- Process should be in place to ensure that patients under 16 years of age are assessed in line with their Fraser Competence.

- The practice should ensure that safeguarding issues are considered in the cases of vulnerable adults and under 18s

Dealing with requests for appointments

Requests for appointments should be dealt with on a timely basis. For example, where a request for emergency contraception is made, it should be dealt with on the same day. When a request has been made to discuss the termination of a pregnancy, this should be dealt with within a few days.

Other appointments – for example requests for contraceptives – should be dealt with in line with other factors such as expiry dates of devices and the need for continuity of contraception.

A special word about contraception

It is imperative that contraceptive choices are fully discussed with the patient. These discussions should include long acting reversible contraceptive methods (LARCS), and be repeated as necessary. Discussions are likely to evolve in line with a patient’s changing circumstances, which may include:

- When emergency contraception is requested

- Following a termination

- Following the birth of a baby

If medication is changed, or a patient’s health changes, the GP should take this opportunity to review and reiterate contraceptive advice.

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A special word about staff and premises

There may be occasions when certain employees make a conscientious objection to SRH, or part of it. The practice will need to ensure that these objections are taken into consideration and that other arrangements are available to ensure that patient care and safety is not harmed. The practice should have:

- Appropriate clinical facilities

- All necessary equipment available

- Only staff with up-to-date letters of competence undertaking IUD and implant fitting

- Clear referral pathways for difficult procedures

In addition to the above, the practice will need to show that it has an audit process in place that records for complications following LARCS procedures conducted in the practice.

Summarising what the CQC assesses

The provision of SRH crosses a number of CQC’s key lines of enquiry, including:

- Systems, processes, and practices that ensure safe care and safeguard patients from abuse

- Ensuring that patients’ needs are adequately assessed and the care and treatment offered are suitable and in line with current legislation and standards

- Ensuring that employees have the proper skills, training, experience, and qualifications to deliver the care they are expected to deliver

Have you ever had a difficult situation with regards to a patient’s sexual health? Do you have any tips on best practice within the practice? Let us know if you’d like to share your experience to benefit others.

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If you have any questions or feedback, please do not hesitate to contact me -alex.henman@esuppliesmedical.co.uk - 01865 261451

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