SHRINE

Sexual and Reproductive Health Rights, Inclusion and Empowerment

SHRINE: Sexual and Reproductive Health Rights, Inclusion and SHRINEEmpowerment, is a four-year Mind and Body project launched on 16 May 2016 and funded by Guy’s and St Thomas’ Charity

SHRINE delivers and evaluates sexual and reproductive healthcare (SRH) for three specific communities in Lambeth and Southwark:

  • People who use drugs problematically
  • People with Serious Mental Illness (SMI)
  • People with Intellectual Disabilities (ID).  

What's the problem?

According to the Lambeth, Southwark and Lewisham Sexual Health Strategy 2014, approximately 10,000 people across Lambeth and Southwark either use drugs problematically, have a serious mental illness or have an intellectual disability.

The reality for these people is they do not use traditional sexual and reproductive health services and therefore have a high prevalence of Sexually Transmitted Infections (STIs) and HIV, unmet contraceptive needs, late recognition and medically complicated pregnancies, are often vulnerable and likely to be a victim of sexual violence and are often not given the possibility of having pleasurable and safe sexual experiences.

How SHRINE workPatient 2

SHRINE is a multi-disciplinary team, made up of experts from Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts. SHRINE has two consultants providing frontline services offering a full SRH service for people with complex needs.

SHRINE work creatively and flexibly to reach their target groups, including offering:

  1. Priority Access Appointments at Camberwell Sexual Health Clinic
  2. Assertive Outreach – ability to visit homeless hostels and day centres, community mental health teams, social services (Sunshine House, etc), mental health inpatient wards at Lambeth Hospital and Bethlem Hospital and etc.
  3. Weekly Clinics at Drug Treatment Services – Change.Grow.Live (CGL) at Cambridge House (Camberwell) and Lorraine Hewitt House (Brixton)
  4. Weekly clinic at Maudsley Hospital – Thursday afternoons between 1.30 to 4.30pm in the ECT suite on the Ground Floor. Available to both inpatients and outpatients accessing any SLAM service.

A Human Rights-Based Approach

SHRINE aim to develop a human rights-based approach (HRBA) to providing SRH services. SHRINE has started a literature review to understand the different definitions of HRBA and how it can be introduced into SRH care, with engagement from key human rights experts.

What SHRINE offer

SHRINE offer a full sexual and reproductive health service for people with complex needs including:

  • STI testing and treatmentHIV rapid test
  • Advice about contraception options and provision of contraceptive methods
  • Lumps and bumps
  • Pregnancy Testing
  • HIV testing, facilitate link with treatment and support services
  • Smear testing
  • Gynaecological Care (i.e. period problems).

Training

SHRINE has developed a suite of training programmes to increase the SRH capacity of health and social care professionals. The training programmes focus on the basics and essentials of SRH care and pathways, as well as practical clinical skills-based learning.  SHRINE developed and piloted a very successful contraception training course for the midwives at St Thomas Hospital that trained them to provide Progestogen-only methods of contraception during the 6-week postnatal following delivery. This training won the Burdett Trust’s Maternal Health Award 2018. We have extended this pilot to the Lambeth, Southwark and Lewisham Health Inclusion Team who are nurses working with homelessness, addictions, refugee and asylum seekers and vulnerable young people. Lastly, in collaboration with the Maudsley Simulation Centre we developed a one-day immersive experiential course called ‘How to Start the Conversation’ to support mental health professionals to develop their skills and confidence to discuss SRH with their patients.  

Evaluation and research

SHRINE will evaluate two models of care to ascertain the best way to provide a human rights-based approach to SRH services:

  1. Increasing access for people who use drugs problematically, have a serious mental illness and an intellectual disability to use existing mainstream SRH services through a dedicated appointment clinic at a mainstream SRH clinic
  2. Designated sexual health practitioners providing assertive outreach in the community and embedded SRH clinics within substance treatment centres, mental health and intellectual disability services.

SHRINE will also develop an evidence base around how to provide a human rights-based approach to SRH for vulnerable communities and will produce several research papers/projects on the topic as they progress.

Referring service users to SHRINE

To refer patients or service users to the SHRINE service please,

  • fill out a referral form 
  • email kch-tr.SHRINEReferral AT nhs.net
  • or phone 020 3299 5038.

For more detailed information about SHRINE please read their briefing notes.