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Digital sexual health: secure messaging helpline expanding into sexual health services

The Digital Health Transformation Service at Leicestershire Partnership NHS Trust is rolling out a secure healthcare messaging system to sexual health services at trusts across the country.

ChatHealth, which acts as a direct messaging helpline between patients and healthcare staff, enables people to get quick and easy access to confidential help and advice on a range of sexual health issues.

Although the Leicestershire-based team developed the system, the team now supports other services to use and adapt it for their own purposes. It has also created a community of digital nurses to share their learning and best practices.

The messaging function is able to be used by staff, fully-trained by ChatHealth’s central support team during implementation of the service. This means they can potentially interact with more service users and patients than when solely using face-to-face appointments, ensure that those most at-risk can be prioritised for help, and reduce the barriers to accessing care and support by enabling people to chat anonymously.

Demand for ChatHealth, which was launched in 2013 following a successful pilot, almost tripled in the last year during the COVID-19 pandemic, as health providers sought to keep clinics open digitally while face-to-face appointments were restricted. However, it’s expected that the need will continue with the use of technology allowing sexual health practitioners to reach out to younger audiences who may be put off by the stigma or time constraints of attending a clinic in person, preferring the privacy and ease of messaging on their mobiles, where applicable.

It’s also expected that hybrid services offering a combination of both digital and in-person access to healthcare professionals, at the patient’s discretion, will be increasingly important in the NHS’s future. ChatHealth’s monthly messaging reports can also be useful in terms of resource planning, anticipation of bottlenecks and staff rota scheduling, as they can reveal the busiest days and times, as well as the contact types and outcomes.

The Royal Wolverhampton NHS Trust’s Sexual Health Service, Embrace, was one of the services that adopted ChatHealth over the last year, launching it in September 2020, as part of its plan to adapt its model beyond the traditional walk-in clinic.

It was the desire to effectively triage people, so that those most in need got the swiftest access to services, as well as the problems posed by the pandemic, which gave the clinic the final push to add long-discussed digital routes to its care.

As well as increasing accessibility and allowing for prioritisation, it was used as a tool to promote safe sex and signpost people to find further support and treatments – from STI and HIV testing, to smear tests, emergency contraception, pregnancy advice, and counselling.

Kirsty Lewis, Matron of 0-19 Services and Sexual Health, outlined some of the reasons for the Wolverhampton adoption: “Anyone could turn up in the morning and come in to ask for an appointment. There was a big demand and we simply didn’t have enough appointments. Most days we would have a queue across the car park.

“This was a concern because the person at the front of queue would be guaranteed an appointment, but they could have been one of the ‘worried well’ and simply looking for reassurance. However, the person at the back of the queue could be the symptomatic patient who we didn’t get to see that day because we had run out of appointments. We realised we needed a triage system to identify those that needed urgent help from those that simply needed advice.”

Embrace had noted that ChatHealth had been rolled-out successfully by school nurses and that it would therefore meet their safety and information governance standards, so decided that now was the time to “give it a go” and “see if it had a place in sexual health services”, too.

As it had already been set up within the school nursing service, Kirsty’s team was “able to replicate and transfer many of the same standard operating procedures”, she said, and they also “found the system training to be quite straight forward in learning how to use it to respond to messages.”

ChatHealth’s Central Support Team assisted Embrace in deploying the messaging function and now, using a duty system, clinical staff can respond to messages that have been sent to the helpline number. The team uses the term ‘ChatSexualHealth’ to promote the service, which is available Monday to Friday, from 10am to 4pm.

On average, ChatSexualHealth now receives around 350 messages per month, with 85% of contacts completed through the messaging, which Embrace says has freed up more time for staff to do face-to-face and telephone consultations.

As for user feedback, the service cites those with autism and hearing impairments among those to have benefitted from the messaging option, with some finding it easier and more comfortable to text rather than talk or appreciating the lack of time spent travelling or waiting in the clinic.

One patient said: “Thank you so much. Have to say what a wonderful service this is. It’s not always easy to make outgoing calls from work and I had the fear of explaining myself! You’ve made this so easy!”

On the clinical feedback side, Kirsty explained that ChatHealth had “opened up a whole world of people that I’m not sure we were seeing before in any capacity.”

Discussing making the leap from consideration to implementation, she added: “I would say don’t be afraid of trying something different – if there is ever a time to do it, now’s the time. We sometimes get contacts from across the country, which shows that messaging is what people want. It really feels like other NHS trusts could benefit from a similar approach.”

Although the Digital Health Transformation Service’s current focus is on encouraging the spread of ChatHealth nationally to other interested trusts and sexual health services, it has so far predominantly been adopted in public health nursing.

The first and main area of growth has been in school nurse settings, with around 60% of the school nursing services across the country using the messaging platform, as well as around 35% of the nation’s health visiting services. For the former, its popularity is largely attributed to its discretion, while the latter services have been able to utilise it for new parents who may want to follow up on or ask questions that they forgot to mention in face-to-face appointments.

Interest from sexual health services across the country is now growing, too, and the team are keen to reach out and expand in this area by offering ChatHealth to trusts. Mental health and perinatal mental health services are others that can benefit from the use of direct but discreet messaging systems, while the team is also working with an autism team and weight management service.

To find out more about adopting ChatHealth, visit