Community sexual and reproductive health

Community sexual and reproductive health (CSRH) is a specialty concerned with caring for the sexual health needs of men and women. Services include contraception, treatment of sexually transmitted infections and the menopause, sexual assault and unplanned pregnancies.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

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Nature of the work

CSRH evolved from the obstetrics and gynaecology sub-specialty of sexual and reproductive health. It was set up in an effort to improve leadership and skills in community based services and to reduce health inequalities.

Consultants in CSRH provide clinical expertise and leadership and bring a broad range of clinical skills to the workplace.

Consultants in CSRH work in a variety of settings and every consultant post is different.  They may be hospital or community based but the services delivered are in multiple community settings.  Some SRH consultants will work in large centres with a team of consultants and others will be single- handed in smaller centres.

Many centres now run integrated services where CSRH consultants work with consultant colleagues in genitourinary medicine (GUM) and patients attend combined general clinics offering a full range of expertise in contraceptive and sexually transmitted infections.

CSRH consultants will typically oversee the work of the community sexual health clinics and their governance.  They will work as part of a multidisciplinary team to improve the sexual health of the community, often as a lead for the diverse team of professionals involved.

Consultants will undertake specialist clinics, receive referrals and oversee training within the specialty.  Training will be for their own team and other providers, both statutory and voluntary, and vary in level from simple to complex sexual health care.

CSRH offers an opportunity to work with a wide variety of male and female patients often particularly caring for vulnerable groups eg young people, sex workers, prisoners, victims of sexual assault.

Consultants will undertake specialist clinics, receive referrals and oversee training within the specialty. Training will be for their own team and other providers, both statutory and voluntary, and vary in level from simple to complex sexual health care.

Female and male patients of a wide age range from 13 year olds (occasionally younger) to postmenopausal women and older men.  The patients are generally without life threatening disorders and can be managed in an outpatient setting.  Most people will consult about sexual health related issues at some time in their lives and most women suffer gynaecological problems which, if not life threatening, significantly affect their quality of life and as a consequence, that of their family.

Common procedures/interventions

Procedures within contraception include:

Consultants will be referred complex cases eg where intrauterine device (IUD) fittings have previously failed or where subdermal implants are deep.

Many CSRH consultants run abortion services and undertake surgical procedures in a theatre or outpatient setting.

Procedures within medical gynaecology include:

Given the increasing number of procedures that are becoming ‘office based’ and hence deliverable outside a hospital setting, this range of procedures is expected to increase.

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