Why I Got Involved in the London Sexual Health Programme

I’ve always been drawn to innovation, especially in digital health. Throughout my career, I’ve pushed to modernise services, which is why I got involved with the London Sexual Health Programme..

Before COVID, our face-to-face clinics in Cardiff were overwhelmed. People kept turning up to walk-in services, even when we were at capacity. Sometimes, individuals with urgent but undisclosed needs had to be turned away. The pandemic forced us to rethink how we deliver care. It gave us breathing space to assess what people truly needed, and how we could innovate to meet that demand more effectively.

What stood out about LSHP was its genuine appetite for doing things differently, paired with a commitment to learning, evaluating, and scaling. This wasn’t just lip service, it was a real shift in how sexual health services could operate. Online testing for STIs and HIV, for instance, is now widely accepted. It empowers people to manage their own health, rather than rely solely on overstretched in-person services. The debate has moved on from whether to offer online testing to how and what we offer, while ensuring those most in need still receive the best care and support.

What excites me most about digital sexual health is the autonomy it gives people. When users can choose when to test and how to engage, they’re empowered to take control of their health.

A bit about me: I grew up in northeast Wales, but like many young gay men at the time, I left. I moved to Manchester in the 90s, where I came of age both personally and professionally. I had friends diagnosed with HIV and saw how stigma shaped their lives, even within healthcare. As a medical student, I was drawn to HIV and sexual health, partly out of frustration, partly out of solidarity. Many of us in this field would say the best part of our job is the conversations we have with patients. They keep us sharp, and it’s a privilege to help people stay healthy and well.

After training as a specialist registrar in Manchester, I explored public health and spent a brief period with the local Strategic Health Authority and in Northamptonshire before settling in Cardiff as a Consultant. Over the past eight years, locally we’ve developed a hybrid model, combining face-to-face and digital services, encouraging self-management, and building resilience to shocks like COVID and Mpox (as much as we can).

London offered a different kind of opportunity. The scale, infrastructure, and energy made it the perfect place to test whether we could make something work at scale. London attracts ambitious, curious people who want to make a difference. If you can make a model succeed in London, you can make it work anywhere.

So, what’s next?

Technology is evolving fast. You can already buy a wide range of services and medications online, some credible, some not. Ideally, everyone would follow BASHH or NICE guidance, but that’s not always the case. That’s where NHS-branded, NHS-governed digital platforms come in.

Take gonorrhoea, for example. We’re approaching a crisis of antibiotic resistance. In clinics, we use injectable treatments as first-line, not tablets, because they’re more effective at reaching all parts of the body, especially the throat. If unregulated providers start handing out oral antibiotics, we risk unwittingly increasing resistance in the population. Strong governance and adherence to nationally agreed standards are essential to ensure people receive safe, effective care.

We’ve made huge strides in changing attitudes. Look at PrEP. Initially, many people said, “That’s not for me, I’m not the kind of person who needs it.” Today, it’s widely accepted and celebrated in the gay male community. But we need to extend that acceptance beyond this group, because HIV doesn’t discriminate, especially in a city like London.

In the years ahead, capacity will remain a major challenge. As long as people are having sex - and I hope they are - there will be demand for sexual health services. I believe safe, enjoyable sex is a human right. But we must also recognise that an STI diagnosis can be a gateway to uncovering deeper issues; coercion, alcohol misuse, obesity, poor mental health. Sexual health is often just the tip of the iceberg. We need to explore how services can help identify and support people facing complex life challenges.

Ultimately, our role isn’t necessarily to prescribe the solution, it’s to define the challenge. We have the tools, the data, and most importantly, the people: smart, committed professionals ready to collaborate. The London Sexual health Programme is a space to test ideas, challenge assumptions, and build something better.

We’re not done yet.