London’s best-known sexual health clinic has tweeted it is cutting the number of people it can see at its Dean Street Express branch.
A tweet posted Tuesday evening revealed the size of the cut. A spokesperson for the Soho’s 56 Dean Street said: ‘We’re very sorry that some people are experiencing problems getting an appointment with us. Our new contract means we have had to reduce the number of bookable time slots at Express from 350 to 75 per day. Home test kits can be ordered from our site.’
GSN reached out to Dean Street to clarify the tweet. It is unknown if it will be accepting walk-in appointments to compensate for the drop in advance appointment slots. However, after we contacted them yesterday, the tweet was deleted. We are still awaiting a response.
‘No longer possible for all patients to be seen within 48 hours of contacting us’
Dean Street Express is situated in the heart of Soho. It has a large number of LGBTI clients and undertakes more HIV tests than any other clinic in the UK. Approximately one in nine HIV diagnosis in the UK is made at Dean Street.
However, over the last couple of years, it has become increasingly difficult to get an appointment. The clinic posted a message to its website last year warning that 1,500 people apply daily for 300 appointment slots.
Dean Street is managed by Chelsea and Westminster Hospital NHS Foundation Trust.
Its website states: ‘Sexual health services across London are under increasing pressure. These services are funded by Local Authorities, many of whom have experienced a budget reduction of more than 30%. Some areas in London have closed their sexual health clinics and as a result we are experiencing an increased demand for our appointments.
‘We aim to see everyone who wishes to uses our services—however, it is no longer possible for all patients to be seen within 48 hours of contacting us. Patients will be prioritised according to clinical need.’
Dean Street Express is now offering home-testing kits via Sexual Health London for those with no symptoms. The service aims to deliver results via text to patients approximately four days after samples are received.
Sexual health campaigners expressed alarm at the news of the cut back in appointments.
Ian Howley, Chief Executive of health organization LGBT Hero/GMFA, said, ‘I find it absolutely outrageous that in a time where we are pushing for those who are at high risk to test for HIV and STIs they are coming up against a limited service and further cuts.
‘Home testing is a great alternative system, but it’s not and will never be for everyone. Minors, people living with family and those in relationships are less likely to order a home testing kit.
‘We need to be increasing the numbers of people testing, not reducing them.’
His views were echoed by Matthew Hodson of HIV support organization, NAM.
‘Recently we’ve seen astonishing success in driving down the number of new HIV cases, with falls of up to 29% among gay and bisexual men in London in 2016. This success has been due to the ability for clinics to increase the number of tests that they give to gay men so that more gay men are testing and gay men are testing more frequently more often.
‘All of the success we’ve seen in recent years has been down to the availability of testing. Any progress to HIV reduction is vulnerable to these cuts. 56 Dean Street is recognised internationally as an innovator that if they’re not able to deliver their services to meet the need it will result in higher rates of HIV.’
Closure of sexual health services increases demand at remaining clinics
At least five sexual health clinics have closed in London over the past two years – partly due to cuts to NHS and local authority funding. These include Lloyd Clinic in Guy’s Hospital, Vauxhall Riverside Health Centre in Vauxhall and Artesian Health Centre in Bermondsey, among others.
On Monday, the Royal College of Nursing warned that sexual health services in the UK are at a ‘tipping point’ due to cutbacks in funding. It surveyed 600 nurses working in sexual health services and found low-morale and serious understaffing.
‘This is a worrying picture of understaffed services going to extreme lengths to try to cope, even turning people away – the last thing a health professional ever wants to do,’ Helen Donovan, professional lead for public health at the RCN told The Guardian on Monday.
‘If people are not able to access services then serious STIs could go undiagnosed and untreated – it is a major risk to public health.’
In the UK, funding for NHS sexual health services is partly derived from local authorities. The Borough of Westminster oversees some of the funding for Dean Street.
Approached for comment about a potential cut in services at Dean Street from 350 appointments to 75 each day, Westminister councillor Heather Acton, Cabinet Member for Family Services and Public Health, said she was aware of changes at Dean Street. However, she refuted this represented a cut in the delivery of frontline sexual health services in Westminster.
‘The clinicians at Dean Street have configured their services to deliver the best quality provision for people who are at high risk of contracting a sexually transmitted infection.
‘More people who are not at such a high risk can now access online services and home testing, ensuring that people who need direct consultation always receive it in a timely manner.’
A spokesperson for 56 Dean Street issued GSN with the following statement.
‘London’s sexual health services are commissioned by Local Authorities rather than the NHS. One aspect of the new contract is for people to use a new online home testing service rather than attend a clinic. Each clinic has a target for switching people from clinic to online over the next few years.’
‘In response, Dean Street Express has been redesigned. It now offers walk in services for people who have symptoms of an STI and all those who need treatment for gonorrhoea and chlamydia. It provides support and monitoring for people needing HIV PrEP prevention and follow up care for those taking post exposure prophylaxis. In addition we offer services not available online, such as Hepatitis and HPV immunisations.
‘The number of bookable slots for a routine check-up has been reduced significantly, as it is anticipated that over time more people will be using a home test kit and will only seek an appointment after receiving the results from their home test. There is a link on our website to order the home test kit.
‘Demand for our services is significantly higher than the number of appointments we are funded to offer. We’re aware of the frustration that some of our users are experiencing. We are really sorry about this and want to reassure the community that we are doing all we can to maintain access to those who need us the most and at the highest risk.”