The concluding chapter in this section of the book provides a comprehensive review of the
evolution of the Scottish sexual health patient information system - NaSH, and its eventual
implementation. With all NHS Health Boards, at the time of writing, either using or about to introduce
NaSH, this is a significant achievement, given the previous patchy nature of sexual health patient records
in Scotland as the chapter describes. Dr Winter, a GUM consultant and expert in sexual health
information management, was part of the group behind the NaSH system, and conveys the multiple
strands that NaSH needed to incorporate, and the internal and external challenges that needed to be
overcome.
The NaSH system was funded by the Scottish Government to support increased access to services and to
bring all sexual health services in Scotland into the 21st century in IT terms in line with the inception of
the Sexual Health Strategy. It needed to meet the needs of national governance and local commissioners
for robust information about client uptake, service efficiency and sexual health demographics; of
clinicians and NHS managers for a workable and efficient system that maximised client outcomes; and
of clients for a system that made services increasingly accessible yet protected confidentiality in a highly
sensitive clinical area. The commissioning and tendering process for the NaSH system is described, and
a range of tables and documents drawn from the development process included that illuminate the
complexity of the system, and the issues that had to be addressed.