Study C - Pathway

Some NHS services in England and Scotland provide free condoms. You can also get a wide range of condoms at incredibly low prices, online, at the freedoms shop.

To find a sexual health clinic, click this NHS link if you live in England or click this Sexual Health Scotland link if you live in Scotland.

For more information about STIs, click this NHS link if you live in England or click this Sexual Health Scotland link if you live in Scotland.

‍Collaborate with us

Our Research Voice Advisory Group encouraged us to do this research, particularly to take the Online Chlamydia Pathway within the eSexual Health Clinic forward. They’re involved in design, planning and delivery; one member is on the research team.

Our inclusive approach to SEQUENCE Digital means that we are growing a network of community members, community-based organisations and sexual health organisations. Together, we hope to develop best practice for patient and public involvement in sexual health and to set a high standard for collaborative, inclusive research which provides the evidence to improve sexual health for all, in a digital NHS.
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Work with us

Our team is highly interdisciplinary with human computer interaction specialists, psychologists, sociologist, epidemiologists and clinicians, working together on innovative ways to improve sexual health for all, in a digital NHS.

We will advertise any vacancies here. If you are interested in work experience, please do get in touch with your CV and areas of interest.

Our research team are currently finalising the optimisation of the eSexual Health Clinic and preparing for the clinical trial in which we will test the eSexual Health Clinic.

Through five interlinking ‘Work Packages’ the SEQUENCE Digital research team will:

1.         Determine which groups of people are currently using online sexual healthcare services compared with physical(face-to-face) sexual health services (Work Package 1)

As we want to design an eSexual Health Clinic that is accessible to as wide a range of people as possible, we will interview a wide range of people to explore their experiences. This to help us identify some of the factors which are likely to influence whether and how different types of people use online sexual healthcare services.

This will help to reduce inequalities in accessing digital sexual healthcare services.
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‍2.         Improve the content and design of the eSexual Health Clinic to make it suitable for different groups of people ahead of a future trial (Work Package 2)

We will use what we learn from Work Package 1 to improve the design of a prototype eSexual Health Clinic.
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3.         Test the eSexual Health Clinic in atrial to determine its effectiveness in successfully managing people diagnosed with chlamydia compared with routine care (Work Package 3)
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4.         Assess the efficiency and cost-effectiveness of eSexual Health Clinic compared with routine care in physical sexual health clinics and explore the potential impact on health inequalities (Work Package 4)
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5.         Take an inclusive approach to our research by working with patients, and the public, as well as representatives from key national organisations, throughout the programme (Work Package 5)
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Together, we will co-produce appropriate, inclusive, and engaging strategies and materials to support recruitment of participants, data collection, and dissemination of our research findings.

During the SEQUENCE Digital programme of research, we’ll talk to service users and staff, and use routinely collected data to learn about the pros/ cons of online and other pathways for testing/treatment/prevention. We’ll use this information to further develop some of the Online Chlamydia Pathway within the eSexual Health Clinic and we’ll make them as inclusive as possible and measure their effectiveness, value for money, and who does and doesn’t use them in a clinical trial. We’ll look at services for contacts of people with STIs too.  

Through SEQUENCE Digital, we will provide robust scientific advice to guide national and local policy makers, commissioners, service developers, clinicians and care providers. This will include:

• A robust scientific explanation of who is and is not using current online sexual health services and some reasons why.
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• Recommendations to help improve access to STI self-sampling and online sexual healthcare services more broadly.
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• Recommendations to help make Online Chlamydia Pathway within the eSexual Health Clinic as easy as possible to use and accessible to everyone who wants to use it. This will include recommendations for how people can receive care after being diagnosed with an STI, how they can notify their sex contacts that they may have an STI and need testing and treatment, and how sex contacts receive care.
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• A new and improved, evidence-based and widely accessible eSexual Health Clinic which can be used to provide STI results, offer STI treatment, and contact, test, and treat the partners people diagnosed with STIs.  
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• A comprehensive evaluation of the eSexual Health Clinic which includes large scale use of an automated clinical decision making and prescribing algorithm for the first time in the NHS

We will collaborate with key national organisations, patients, and the public to ensure our research methods align with what people think is important and to support the rapid translation of research evidence into everyday clinical practice.

The eSexual Health Clinic has won:

2015    Cathy Harman Innovation Award, British Association for Sexual Health & HIV(BASHH), (eSexual Health)

2015    Queen Mary University of London Engagement and Entrepreneurship Award: Proof of Concept Study winner, (eSexual Health)

2016    Rosalind Franklin Appathon Challenge 2 Winner: eSexual Health Clinic, UK

2016    Royal Society for Public Health Award: Health Innovation & Technology: eSexualHealth Clinic, UK

2016    Royal Society for Public Health, Public Health Minister’s Commendation, UK

Aim

Within a digital NHS, sexual healthcare systems need ways of helping people get into the right care pathway for their needs. For some, ideal pathways to appropriate care are online, for others face-to-face, or a combination of both. Currently people are getting less or no choice in available care pathways. This could make things worse and cost more. Some people with the poorest sexual health already find it hard to engage with existing services; we need to make sure nobody is left behind as NHS care shifts online.    

We aim to improve health outcomes for people with sexually transmitted infections (STIs) and their sex partners by creating clinical care pathways fit for a digital NHS, and measuring how well they work in getting people the care they need.  We believe we are tackling the problems important to people in the groups most affected by STIs by securing safe and equitable care for all.

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Background

STI rates are rising. They can have a huge impact on people’s lives and are very costly for the NHS. Sexual health funding has been cut; online STI testing (self-sampling) is replacing face-to-face care.  This could help many people, but others might find it difficult to use, particularly people at greater risk of STIs. We need to understand what hinders/helps people at high risk and how we can best engage them with a range of options for testing, treating and preventing STIs, within inclusive, good-value-for-money services.

We’ll take advantage of our new technology, the Online Chlamydia Pathway within an eSexual Health Clinic, the first NHS service to offer an online automated consultation and ePrescribing in a web-app. It was very successful in treating people with chlamydia in early studies. But it isn’t the finished product yet, hasn’t been tested out large-scale and we don’t know if it suits the people at highest risk of STIs.

SEQUENCE Digital builds on previous research, where our researchers developed a new technology, the eSexual Health Clinic, which people access online.
Links to our team's scientific publications, relating to the SEQUENCE Digital programme are listed here.

SEQUENCE Digital is funded by the National Institute of Health Research (NIHR) under its Programme Grants for Applied Research. NIHR is a national funding body supported by the Department of Health and Social Care. NIHR aims to improve the health and wealth of the nation through research.

SEQUENCE Digital is led from Central and North West London NHS Foundation Trust in collaboration with:

• Barts Health NHS Foundation Trust
• Glasgow Caledonian University
• Islington Council
• NHS Greater Glasgow & Clyde
• University Hospital Birmingham NHS Foundation Trust
• University of Birmingham
• University College London
• University of Strathclyde
• University Hospitals Sussex NHS Foundation Trust