Sexual health follow up after visiting a paediatric SARC: Learning from survivor voice

Meyrick, Jane; Adams, Rachel; Michelle, Cutland; Hope, Barraclough

Abstract

Title: Sexual Health Follow Up after visiting a Paediatric SARC: learning from survivor voice

Aim We listened to children and young people, parents/carers and health professionals with experience sexual health follow up (SHFU) after visiting a paediatric SARC (pSARC). The learning was then used to redesign our SHFU service.

Background Our pSARC sees ~200 CYP per year and initiates SHFU across three counties. The existing SHFU pathway had limited choices, with CYP referred to the nearest provider to their home, usually sexual health clinics (>13s) or paediatricians/GPs. No telemedicine or postal testing services were offered. A regional audit identified that 1 in 5 CYP were lost to SHFU.

Methods We worked in collaboration with a health psychologist expert in patient and public involvement (PPI), CYP themselves, therapeutic support organisations and health care professionals.

We took a trauma-informed approach, and the project employed a dedicated clinical research fellow and paediatric SARC crisis worker for the duration of the project. We embedded our activities within existing safe spaces held by children’s therapeutic services. 4 CYP aged 16-18 took part in creative workshops over 5 hours, 2 parents participated in semi-structured interviews and 20 professionals took part in focus groups.

Results

Thematic analysis by group: Outcomes / opportunities for change A map of the SHFU journey Clear options including ‘no’ A place to ask questions child friendly resources

Overall

themes CYP workshops P/C interviews Professional

Confusion Bewilderment What is going to happen to me? unprepared isolated unable to be a guide for their child What is being asked of me? Inexperienced Unclear handover

Questions

Choice I had no choice Cannot provide choice Ask: “where is

Psychologically safe care Feeling exposed, no safe haven Parental trauma not acknowledged Unfriendly environments Complexity fear of causing harm safe for you” “who do you feel safe with” Maximise choice, familiarity and continuity

Figure 1: New SHFU pathway "patient passport"

Conclusion

SHFU after SARC attendance can present logistical and commissioning challenges for referrers, training and safeguarding concerns for providers, and may cause distress for CYP and carers. The biggest need expressed by service users was improving choice and reducing confusion. Our new SHFU pathway was designed in collaboration with our CYP participants to address this. Alongside a new clinical guideline, it includes a patient ‘passport’ to help guide and empower decision making through a range of follow up options, including returning to our SARC, a chosen alternative clinical service, telemedicine or supported postal testing.

Citation

Meyrick, J., Adams, R., Michelle, C., & Hope, B. (2023, April). Sexual health follow up after visiting a paediatric SARC: Learning from survivor voice. Presented at Protecting Children in the Digital Age - St Mary's Annual Conference 2023

• Presentation Conference Type: Keynote
• Conference Name: Protecting Children in the Digital Age - St Mary's Annual Conference 2023
• Start Date: Apr 25, 2023
• End Date: Apr 26, 2023
• Deposit Date: Sep 23, 2023
• Public URL: https://uwe-repository.worktribe.com/output/11132733