Case study: Using ChatHealth messaging for sexual health advice

In September 2020, The Royal Wolverhampton NHS Trust’s  Sexual Health Service, known as Embrace, launched the safe and secure messaging helpline, ChatHealth. This allows local people in Wolverhampton to quickly and easily contact a sexual health nurse for confidential advice about a range of sexual health issues.

Organisation: The Royal Wolverhampton NHS Trust
Service: Embrace, Wolverhampton Sexual Health Service


Embrace wanted to adapt their service model to offer more than the traditional walk-in clinic. They needed a more effective way to ensure that people most at risk could easily get help, whilst promoting safe sex universally and efficiently signposting people for sexual health treatments.

Matron of 0-19 Services and Sexual Health, Kirsty Lewis explains,

“Anyone could turn up in the morning and come in to ask for an appointment. There was a big demand and we simply didn’t have enough appointments. Most days we would have a queue across the car park.”

“This was a concern because the person at the front of queue would be guaranteed an appointment, but they could have been one of the ‘worried well’ and simply looking for reassurance. However, the person at the back of the queue could be the symptomatic patient who we didn’t get to see that day because we had run out of appointments. We realised we needed a triage system to identify those that needed urgent help from those that simply needed advice.”

Embrace also recognised that attending a clinic doesn’t suit everyone. For young people, in particular, the stigma attached to attending a sexual health clinic meant they worried about who they might bump into! Nevertheless, they understood that people wanted to take responsibility for their sexual health. Knowing younger people are very technologically advanced, Embrace saw the benefit of reaching this age group via their mobile phones.

In addition, the impact of the COVID-19 pandemic led to the reduction of face-to-face clinics. It became even more crucial to offer a more accessible, digital route into their sexual health service.

The solution

ChatHealth, a safe and secure healthcare messaging system, is widely used by NHS public health, mental health and community teams across the UK. Developed by Leicestershire Partnership NHS Trust, ChatHealth provides a way for service users to easily, anonymously if preferred, use messaging to get confidential help and advice from healthcare professionals.

Following the success of the Trust’s school nursing messaging service, the Embrace team felt reassured that ChatHealth met their criteria for clinical safety and information governance. Kirsty describes how they felt confident it would offer best value for money and work well with their IT set up and team capacity.

We felt that now was the time to give ChatHealth a go and see if it had a place in sexual health services. As it had just been set up by the school nursing service, we were able to replicate and transfer many of the same standard operating procedures. We found the system training to be quite straight forward in learning how to use it to respond to messages.”

Guided by the tried-and-tested deployment process and ongoing support of ChatHealth’s central support team, Embrace set up their messaging service in a safe and manageable way. Using a duty system, the clinical staff respond to messages sent to the dedicated messaging helpline number, offering advice on a range of sexual health issues including STI testing, safe sex, smear tests, pregnancy advice, counselling, HIV testing, emergency contraception as well as signposting to other local NHS or support services.

Promoted as ‘ChatSexualHealth’, the messaging service is available 10am to 4pm, Monday to Friday (except bank holidays), responding to messages within 48 hours. The promotional materials were designed to appeal to a wide range of ages and diverse population in Wolverhampton. Local communications specialists created a range of promotional materials and a robust communications plan, including posters put up across the organisation, email signatures on emails, regular social media posts, displayed on TV screens in GP practices and stickers on packs of condoms.

The results

Since setting up their ChatHealth messaging service, Embrace have received a consistent amount of messages from service users and it is helping them to work in a more efficient way.

  • An average of 350 messages from service users are received per month.
  • Around 85% of contacts are completed via the messaging conversation.
  • More time freed up for clinical staff to offer face-to-face or telephone consultations to people most in need.

Many barriers that some people face have been removed and this is encouraging more people to reach out. This was the case for a female user who had a hearing impairment; she found it easier to text than speak on the phone. In another case, an autistic male felt more comfortable seeking help from his own home than navigating difficult social situations, such as getting on a bus and sitting in a waiting room to be seen in clinic.

In recent feedback after a messaging conversation, one service user said:

“Thank you so much. Have to say what a wonderful service this is. It’s not always easy to make outgoing calls from work and I had the fear of explaining myself! You’ve made this so easy!

Key learnings

Embrace plans to continue delivering virtual contacts in this way. Clinical staff have found that they really like using ChatHealth to engage with service users. The Embrace team are now working in a more efficient way.

Kirsty explains how it has worked well for both staff and their service users,

“ChatHealth has opened up a whole world of people that I’m not sure we were seeing before in any capacity. The pandemic has given us permission to work in a different way and recognise that not everybody needs to be seen face-to-face.”

When on ChatHealth duty, clinical staff  respond to messages as part of their working day, often in between working on other tasks. Although some flexibility is required – on some days a few messages will come in and other days can be much busier. The monthly messaging reports from ChatHealth are useful to the team, showing the busiest days and times of contacts, contact types and outcomes.

Kirsty’s recommendation

“I would say don’t be afraid of trying something different – if there is ever a time to do it, now’s the time. We sometimes get contacts from across the country, which shows that messaging is what people want. It really feels like other NHS trusts could benefit from a similar approach.”

Kirsty Lewis, Matron of 0-19 Services and Sexual Health

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