The British Association for Sexual Health & HIV (BASHH), the College of Sexual and Reproductive Healthcare (CoSRH), and Terrence Higgins Trust have called upon Public Health Wales (PHW) to act to assure the public and patients that the online testing service meets defined clinical and information governance standards.
Public Health Wales has today confirmed serious safeguarding and information governance issues that have been identified within their remote Sexually Transmitted Infection (STI) testing service. The online service forms a vital component of the Welsh STI and HIV testing provision, covering a significant proportion of asymptomatic STI testing and being critical to improving equity of access, particularly for rural communities and supporting Wales to achieve a goal of ending HIV transmissions by 2030.
BASHH, CoSRH, and Terrence Higgins Trust have met with Public Health Wales to ask for details of the issues identified and for urgent reassurance that measures have been put in place that ensure the safety and security of the service in the short term. This includes clear communication with the public so that confusion and unnecessary concern can be prevented and those affected can seek the further advice they need immediately.
The organisations (BASHH, CoSRH and Terrence Higgins Trust) have also written to the Chief Medical Officer for Wales calling for a full, transparent review process to understand and address why systemic weaknesses in the STI screening service occurred, to ensure that lessons are learned and that the service is supported to be optimised in the future.
Dr Cara Saxon, President of BASHH, said:
‘The reports today will inevitably be worrying for patients and the professionals working to support them. We have engaged with Public Health Wales to understand the actions taken so far. Our foremost concern is ensuring that the system is now safe, robust, and functioning to the standards expected with proper engagement with experts across the system in Wales. People must continue to be able to access this critical online STI testing service with confidence that safeguards and clinical oversight are operating as they should. Full transparency on what has happened, who may be affected and what is in place to give this confidence now is the least patients and the public deserve.
‘We are clear that there needs to be an external, fully independent review that is able to provide comprehensive answers on what went wrong, and provide learning and steps that can further be taken to rebuild trust across the system.
‘GUM and sexual health services across Wales bring exceptional expertise in safeguarding, clinical governance and risk management. Services must now be properly supported to manage the necessary follow-up. This should include a multi-disciplinary response with appropriate clinical governance and oversight and in line with BASHH standards of care.’
Dr Georgina Forbes, College of Sexual and Reproductive Healthcare Wales Committee Chair, said:
‘Public Health Wales has overseen a service that plays a crucial role in improving access to STI testing. The issues identified are therefore especially concerning, as patients must be able to trust that this service is safe and well‑governed. Safeguarding and reliable results management are fundamental to high‑quality care. The priority now must be for Public Health Wales to take transparent, timely action to strengthen systems and ensure that this much needed service can continue to support patients.’
Richard Angell OBE, Chief Executive of Terrence Higgins Trust, said:
‘We welcome the openness and candour from Public Health Wales and share their regret that they have fallen short of their own standards and the necessary safeguards that should have been in place. We are working with them on a whole series of remedial actions, some of which are now in place, a number of which are still to be made. We will keep a watchful eye on their developments and speak up for service users without fear or favour.
‘HIV and STI testing is a highly effective way to stay in control of your sexual health. The postal testing service in Wales is free, confidential and available 24/7 all year round. Everyone in Wales must be able to access an HIV and STI test with confidence, in a way that suits their needs.
‘Public Health Wales must take immediate action to learn from this, have third parties around the table so they are not marking their own homework, commit to the service being best in class going forward, and have the voice of service users central to the working of the service, a ‘look back’ review and next steps.’
BASHH, the College, and Terrence Higgins Trust also recognise these failures are likely to create additional pressures for already stretched local sexual health services, which will be supporting patients affected by errors or missed safeguarding opportunities.
BASHH, CoSRH and Terrence Higgins Trust are committed to continuing to work collaboratively with PHW and the Welsh Government to ensure the review process is transparent, independent, and focused on restoring public trust. It is essential that lessons are learned and that appropriate safeguarding, clinical governance and information governance standards are embedded going forward.
Notes to editors:
It is reported that a gap in the system meant that some children aged under 18 were incorrectly treated as adults. As a result, they missed out on thorough risk assessments for sexual exploitation that would typically be expected during a clinical consultation for their age group. Further, some people appear to have had their positive results sent to the wrong health board for treatment in error. Public Health Wales has reported these issues to the Information Commissioner’s Office (ICO).
BASHH standards reflect current, evidence-based, best practices in sexual health management. They are developed in collaboration with key voluntary sector organisations, professional associations and public health bodies and offer essential guidance for UK commissioners, providers and healthcare professionals in the field of Sexual Health and HIV.
The College of Sexual and Reproductive Healthcare (CoSRH) represents 14,000 professionals across the UK. As a multidisciplinary professional membership organisation, it sets clinical guidance and standards, provides training and lifelong education, and champions safe and effective sexual and reproductive healthcare across the life course for all.
Terrence Higgins Trust is the UK’s leading HIV charity, offering support, information and advice services for those living with HIV and affected by HIV or poor sexual health. Our vision is a future where HIV does not hold anyone back, where all people living with HIV are diagnosed, in treatment, supported, and free from stigma.