Adapting sexual and reproductive health services in response to COVID-19: examples of practice

During the COVID-19 response sexual and reproductive health services have adapted swiftly to ensure continued provision of essential services. This has included, for example, the scale up of online triaging and delivery, and prioritising face-to-face consultations for less well served groups, clinically complex cases and to address safeguarding concerns.

Public Health England is collating practice examples to capture how sexual and reproductive health services have adapted during the COVID-19 response with a particular focus on changes put in place to meet the needs of less well served populations. The practice examples below have been collected and published with no assumption or evidence of effectiveness at this stage. They are intended to briefly capture what has been done locally for the purpose of rapid knowledge translation. The practice examples were collected by PHE from local sexual and reproductive health providers and commissioners. PHE is collecting examples on an ongoing basis. If you are interested in submitting an example please contact Faye.Callaghan@phe.gov.uk.

The practice examples are also published on the national Sexual Health, Reproductive Health and HIV Knowledge Hub hosted by PHE, alongside emerging developments and updated sexual reproductive health guidance relating to COVID-19. This is an open group for those interested in sexual health, reproductive health and/or HIV in England. You can request to join the open group here.

Click on the title of the practice example in the table below to view the full text.

Title of practice exampleSummary
Adapting sexual health outreach to youth during the COVID-19 response in Dorset
(July 2020)
Sexual health outreach activities for youth in Dorset have been adapted during the COVID-19 response, with support offers assessed on an individual case-by-case basis and delivered primarily via telephone and video calls. Face-to-face clinic appointments to fit long-acting reversible contraception (LARC) or emergency contraception are offered to young people under the age of 16 years and any vulnerable young people following telephone triage.
Cohorted Bloodborne Virus and STI testing (CBBVs) testing for people who are homeless during COVID-19
(August 2020)
CBBV and STI testing was offered to all people temporarily housed in hotels across London as part of the COVID-19 Homeless Health Response.
Commercial Sex Worker support during Covid-19 lockdown
(October 2020)
Supporting Commercial Sex Workers with their sexual health, COVID-19 security and wellbeing during lockdown. Providing
information on hygiene practices, links to social support and condoms and lube.
Delivery of antiretroviral therapy (ART) during Covid-19 to people living with HIV
(September 2020)
We supported our local HIV clinics by delivering ART to people
living with HIV. This enabled people to continue taking this
essential medication whilst not being exposed to the risk of COVID-19.
Gateshead Sexual Health online community condom and lube distribution scheme: home delivery and remote access to barrier forms of contraception
(September 2020)
• Some community Long Acting Reversible Contraception (LARC) provision had temporarily been suspended due to COVID-19 lockdown, reducing access for many young women in Gateshead.
• Concerns were raised this may lead to an increase in unwanted pregnancy and potential future pressures on the social care system.
• In response, Gateshead sexual health service developed an online scheme enabling barrier forms of contraception to be remotely ordered.
• Access to contraceptive provision in selected community settings was also made available.
• Recognising potential inequalities regarding online access, 37 key public health services were supplied with grab kits.
• This totalled 28,512 condoms each containing, condoms, lube, demonstration and condom failure information and local service information.
Increasing visibility and access to sexual health and contraceptive services for young or vulnerable people during the COVID-19 lockdown
(July 2020)
At a time when many sexual health services and contraception clinics had closed, Sexual Health Services 4 Herefordshire redirected our resources to provide booked appointments and an expanded walk-in service for young people, service users at risk and those with previously identified vulnerabilities.
Innovation through a digital response to Relationship, Sex and Health (RSHE) Education: online learning and specialist support during the COVID-19 response
(July 2020)
Spectrum adapted their preventative RSHE programme to ensure continued access to high quality support and information for young people during COVID-19 school closures.
Learning from approach to safeguarding before and during the COVID-19 pandemic from the perspective of a community based, integrated sexual health clinic in East Berkshire
(August 2020)
Following a visit from the Care Quality Commission (CQC) in summer 2019, Sexual Health’s Garden Clinic, part of Berkshire Healthcare NHS Foundation Trust, introduced several measures to improve the safety and welfare of vulnerable populations.
The measures included:
• identifying and monitoring individuals at risk of sexual exploitation;
• ensuring clinicians adhered to best practice;
• and conducting ongoing audits to measure success and adherence to national guidelines.
Following the start of the COVID-19 pandemic, practices were transformed to ensure the service was responsive to the needs of vulnerable populations.
Meeting the sexual and reproductive health needs of homeless individuals accommodated in Northampton hotels during lockdown
(July 2020)
The Northamptonshire Healthcare NHS Foundation Trust (NHFT) Sexual Health Outreach Team partnered with the Hope Centre to continue outreach services to homeless individuals temporarily accommodated in hotels during the COVID-19 lockdown.
Men who have sex with men (MSM) support during Covid-19 lockdown
(September 2020)
Supporting MSM with their sexual health, well-being and safety during COVID-19 lockdown using online outreach.
Outreach at Public Sex Environments (PSEs) during the COVID-19 lockdown
(September 2020)
• During the COVID-19 lockdown an active PSE was identified with sexual contact taking place.
• Service provision to this site prior to lockdown included the distribution of condom packs.
• In the interest of public health, the decision to resume condom provision at the site during lockdown was taken.
Professional Online Training and My Life 1:1 Wellbeing support for Young People during COVID-19 (Brook)
(August 2020)
During the COVID-19 response Brook in Essex has converted professional training sessions for delivery via an online platform. We have also adapted support provided for young people, enabling continued provision of services via telephone appointments as opposed to face-to-face delivery. During this time, Brook has sought provisions for a secure online platform for 1:1 delivery.
Providing C-Card condoms through Youth Service Outreach and the post during COVID-19
(August 2020)
Young people who hold an existing C-Card membership ID are being provided condoms through Youth Work outreach activity during COVID-19. Alternatively, C-Card members could order condoms online to be posted to their home address, free of charge.
Sexual health care of remote and rural populations during COVID-19
(July 2020)
Sexual health services for remote and rural populations were adapted during COVID-19, with 99% of consultations carried out via telephone and video calls and the introduction of a drive by service to support delivery of STI testing and treatment services.
Sexual health outreach delivery for MSM clients during COVID-19
(June 2020)
During COVID-19 our Sexual Health Outreach Services were restricted to digital provision. Once lockdown restrictions were lifted, we began offering the service once again, engaging with men who have sex with men (MSM) clients in public sex environments (PSE).
Sexual health services for sex workers – SAFE project, Birmingham & Solihull
(October 2020)
Due to COVID-19 sexual health services have had to adapt and change making it more difficult to reach this group. The SAFE project sees both male and female sex workers. Despite the lockdown a large number of sex workers have continued to work as they are not eligible to claim any of the financial measures put in place for loss of income during COVID-19.
Supporting women in West Yorkshire and Harrogate to access postnatal contraception before discharge from maternity services during COVID-19
(June 2020)
A group had recently been established (pre-COVID) to make a series of recommendations about Preconception and Reproductive Health to the Local Maternity System (LMS). Because these relationships had already been formed, when COVID-19 started impacting on service delivery one of the Contraceptive Leads for Sexual Health suggested we could put something together collectively to support and encourage maternity providers to offer postnatal contraception more systematically. The West Yorkshire and Harrogate LMS Prevention Lead facilitated a conversation between relevant commissioners, providers and the public health system to improve access to postnatal contraception during COVID-19. The group worked together to develop resources and a tiered offer for delivery through maternity services.
Teenage pregnancy outreach support during COVID-19: enabling contraceptive choice for under 19s who have already had a pregnancy
(July 2020)
We aimed to continue providing an accessible contraceptive service to teenagers who have become pregnant despite the temporary reduction in services due to COVID-19 pandemic. Contact and follow-up was carried out by 2 named Band 7 Contraceptive Nurse Specialists.
YC Hertfordshire: Sexual Health Text Service
(July 2020)
A confidential and free text service for young people to be able to get accurate and timely information on sexual health and relationships during COVID-19.

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