developing a 5 year sexual health plan for hertfordshire ph & localism cabinet panel
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Developing a 5 year Sexual Health Plan for Hertfordshire PH & Localism Cabinet Panel. Louise Smith Deputy Director, Public Health 23 January 2014. 5 Year Plan. Needs assessment Partnership & commissioning responsibilities Vision Implementation. Outcomes. - PowerPoint PPT PresentationTRANSCRIPT
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Developing a 5 year Sexual Health Plan for HertfordshirePH & Localism Cabinet Panel Louise SmithDeputy Director, Public Health
23 January 2014
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5 Year Plan
• Needs assessment
• Partnership & commissioning responsibilities
• Vision
• Implementation
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Outcomes
• 3 indicators in Public Health Outcomes Framework:
• Under 18 conceptions
• Chlamydia diagnosis in the 15-24 age group
• Late diagnosis of HIV
• Improving patients’ experience of services
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Commissioning responsibilitiesFigure 1: Sexual Health services commissioning arrangements from April 2013
Local authorities will commission Clinical Commissioning Groups (CCGs) will commission
The NHS Commissioning Board will commission
Comprehensive sexual health services. These include:
Most abortion services (but there will be a further consultation about the best commissioning arrangements in the longer term)
Contraception provided as an additional service under the GP contract HIV treatment and care (including drug costs for post-exposure prophylaxis after sexual exposure)
- contraception, including LESs (implants) and NESs (intra-uterine contraception) and all prescribing costs, but excluding contraception provided as an additional service under the GP contract;
Sterilisation
- sexually transmitted infection (STI) testing and treatment, chlamydia screening as part of the National Chlamydia Screening Programme (NCSP) and HIV testing;
Vasectomy
Promotion of opportunistic testing and treatment for STIs, and patient-requested testing by GPs
Non-sexual health elements of psychosexual health services
- sexual health aspects of psychosexual counselling; and
Gynaecology, including any use of contraception for non-contraceptive purposes. Sexual health elements of prison
health services Sexual Assault Referral
- any sexual health specialist services, including young people’s sexual health and teenage pregnancy services, outreach, HIV prevention and sexual health promotion, services in schools, colleges and pharmacies.
Centres
Cervical screening
Specialist fetal medicine services
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Sexually Transmitted Infections
Overall rate of key 5 STIs, Hertfordshire, 2011
0
100
200
300
400
500
600
700
Engla
nd
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s & E
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atfie
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ford
Area of residence
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GUMCAD &Community data2011
Community data2011
GUMCAD 2011
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Conception rate in women under 18 across Hertfordshire, 1998 - 2011
05
101520253035404550
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Year
Co
nce
pti
on
rat
e p
er 1
000
wo
men
Overall rate for England
Overall rate for Hertfordshire
Average rate for WestHertfordshire
Average rate of East/NorthHertfordshire
<18 Conception Rates
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HIV Prevalence by Locality
Local Authority
Diagnosed HIV prevalence per
1,000 (2012)% late diagnosis
(2009/11)England 50.00%Broxbourne 1.22 60.00%Dacorum 1.09 55.60%East Hertfordshire 0.82 37.50%Hertsmere 1.64 63.60%North Hertfordshire 1.03 54.50%St. Albans 0.98 61.90%Stevenage 2.14 57.10%Three Rivers 0.91 81.30%Watford 2.84 50.00%Welwyn Hatfield 1.97 44.70%
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Sexual Health Clinics
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Vulnerable GroupsInformation concerning vulnerable groups is extremely
limited but some data has been sourced on the following groups:
– Looked after young people– Young People NEET– Commercial sex workers– People with disabilities– Prisoners
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Service User Views
• Accessibility
– Making appointments and contacting services
– Opening times
– Turned away from drop-in
• Environment
– Maintaining confidentiality
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• £ Efficiencies
• Centralised booking
• Single point of GUM & FP access across Herts
• Increased testing provision in community clinics
• Better opening times: evenings, weekends
• Improve equity of access East vs West
• Increase HIV testing in wider settings
• Target support for vulnerable groups
Vision
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Recommendations:
1. Re-tender a single integrated sexual health service
2. Establish a provider training network
3. Establish a sexual health partnership across Hertfordshire
4. Commission research into the health needs of groups with high risk sexual health behaviours
5. Develop an integrated strategy for sexual health promotion & harm reduction, targeting vulnerable groups