Nurses have reported having to turn patients away from short-staffed sexual health clinics, leading to fears over a drop in infection testing.

Overstretched resources in the field mean that the public are being left unprotected, according to the Royal College of Nursing (RCN), which launches a report on Monday as sexual health experts warn that services are at “tipping point” due to budget cuts.



It found that the number of 18- to 24-year-olds being tested for chlamydia, the most common disease, has fallen by close to half a million in the five years since the government moved public health services into local authorities. Despite a 25% fall in tests, recent figures recorded a higher level of positive diagnoses, now at 128,000 cases a year.



The past five years coincided with what the RCN described as detrimental changes to commissioning of services, funding reductions and a “dangerous” recruitment freeze.



An RCN survey of more than 600 nurses working in sexual health found services severely understaffed, with few registered nurses, a mix of skills that the body described as inadequate and little access to training.

Nurses reported having to turn patients away, a lack of clinics, low morale and a “tick box” culture. Six in 10 said there had been a reduction in the number of registered nurses where they work, with the majority pointing to recruitment freezes as the reason behind shortages.

The report also found that while the introduction of the human papilloma virus (HPV) vaccine for teenage girls had contributed to a 74% reduction in genital warts in 15- to 17-year-old girls, access to cervical screening for HPV has been affected by confusion in commissioning and provision.

The impact of sexually transmitted infections remains greatest in heterosexuals aged 15 to 24, black ethnic minorities and gay, bisexual and other men who have sex with men (MSM).

Teenage patient receives the HPV vaccine. Photograph: Burger/Phanie/REX

Helen Donovan, professional lead for public health at the RCN, said: “This is a worrying picture of understaffed services going to extreme lengths to try to cope, even turning people away – the last thing a health professional ever wants to do.



“If people are not able to access services then serious STIs could go undiagnosed and untreated – it is a major risk to public health.”

Olwen Williams, president of the British Association for Sexual Health and HIV, said that the findings provided more evidence that sexual health services had reached tipping point: “With the recent emergence of multidrug-resistant gonorrhoea and record levels of syphilis, these cuts have come at the worst possible time.”

The Department of Health said: “This government has a strong track record on public health—teenage pregnancies are at an all-time low and sexually transmitted infections continue to fall overall. Local areas are best placed to understand their own needs, so over the current spending period, we will invest more than £16bn to help them deliver the right services for their communities.”