SHRINE
SHRINE: was a five-year programme, which launched in May 2016 and was funded by Guy’s and St Thomas’ Charity and worked in partnership with Mind and Body to join up mental and physical healthcare.
SHRINE was a service improvement programme that used a human-rights based approach to deliver and evaluate sexual and reproductive healthcare for specific communities in Lambeth and Southwark:
- people who use drugs problematically.
- people with serious mental illness.
- people with intellectual disabilities.
Background
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 an intellectual disability.
Many do not use traditional sexual and reproductive health services. There is a high prevalence of Sexually Transmitted Infections (STIs) and HIV, unmet contraceptive needs, late recognition and medically complicated pregnancies. Some are vulnerable and likely to be a victim of sexual violence.
How SHRINE worked
SHRINE tested and evaluated two innovative care delivery models to understand the best way to provide care:
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Pathway one: looked at in-reach clinics and assertive outreach (also known as “clinic in a backpack”). This involved seeing patients where they were located, such as addictions services psychiatric inpatient wards, community mental health teams, postnatal ward, mother and baby units, homeless hostels, using charities to work with vulnerable people and if necessary, occasional home visits.
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Pathway two: the second looked at priority access appointments and fast track pathways. This involved providing last minute and flexible appointments within an established, complex clinic at the mainstream Camberwell Sexual Health Clinic in south London.