Presentation on theme: "SEXUAL HEALTH STRATEGY An Update Nick Payne Sexual Health Team, Department of Health, London."— Presentation transcript:
SEXUAL HEALTH STRATEGY An Update Nick Payne Sexual Health Team, Department of Health, London
22 Daily Star National Survey of Sexual Attitudes and Lifestyles
33 Sexual Behaviour Changes Age of first intercourse reduced in last 10 years Increase in unprotected sex - associated with alcohol and binge drinking Number of lifetime partners increased in the last 10 years Concurrent relationships increased Condom usage increased, but offset by number of sexual partners 44% of HIV+ men have sex with new partners in the last month of whom 40% reported no or inconsistent condom use.
Part of physical and mental health and well-being Inequality, poverty and social exclusion Infertility,ectopic pregnancy, premature delivery Chronic conditions e.g.Cancer, hepatitis Unintended pregnancies/abortion HIV Stigma and discrimination Consequences of Poor Sexual Health
55 New diagnoses of selected STIs/HIV in GUM clinics England, Wales & Northern Ireland STI Cases in 2004 % Change 2001 to 2002 % Change 2002 to 2003 % Change 2003 to 2004 Chlamydia 97,027 14%9%8% Genital Warts 73,350 2% 4% Gonorrhoea 21,567 9%-3%-13% Genital Herpes 17,640 3%-2% Syphilis 2,088 63%28%32%
November 2004 Public Health White Paper - Choosing Health
77 Summary of Sexual Health Topics in Public Health White Paper A new national STI advertising/media campaign. New capital and revenue funding for modernisation of the whole range of NHS sexual health services. A national chlamydia screening programme, covering all of England by March 2007.
88 Audit of contraceptive service provision in early 2005 and investment centrally to meet gaps in local services. National review of treatment services to provide advice and support on service modernisation for both commissioners and service providers. By 2008 everyone referred to a GUM clinic should be able to have an appointment within 48 hours.
99 Funding announced - over 3 years Advertising Campaign £50m Treatment Services (Capital and Revenue) £130m Chlamydia Screening £80m Contraceptive Services £40m
10 New national campaign Targeting younger men and women Risks of unprotected sex in terms of STIs and unintended pregnancies Promoting benefits of condoms Engaging support of stakeholders
Chlamydia screening Accelerated roll-out of national screening programme by March 2007, backed by £80 million investment Piloting screening in pharmacies across London and Cornwall
Contraceptive Services Audit Comprehensive audit of contraceptive service provision will include specialist providers, general practice, outreach services etc – Audit should be used at local level to support service development and identify gaps – Investment of £40 million to improve services in line with results of audit
13 Newer DoH Initiatives GUM Development Pilots GUM Services Review Cost-effectiveness of Sexual Health Services
Warrington West Dorset North Cumbria Waltham Forest Weston & Bristol Northumberland North of Tees Swindon Telford & Wrekin Salford & Manchester GUM Development Pilots
15 GUM Development Pilots Ten in England Invitations for Local Bids BASHH involved with Department of Health in prioritising Each gets about £250,000 over 2 years What general lessons can we learn?
16 Main Issues arising from GUM Development Pilots Recruitment and staffing Accommodation
17 GUM Services Review
18 GUM Services Review Being conducted for DoH by MEDFASH – Medical Foundation for AIDS and Sexual Health Pre-visit questionnaire Aim to visit all ~ 200 GUM Clinics in England Local Sexual Health Economy also part of Review Process Results should inform investment
19 Health Economics of Interventions in Sexual Health Limited literature Not well presented to NHS – especially with Finance and Commissioning Leads Some interventions are cost-saving, others are very cost-effective Consensus meeting Dissemination of “Solid Facts”
20 The Economic Case for Investment Average lifetime treatment costs of each HIV +ve patient £180,000 Each case HIV infection prevented saves £1/2-1 million in terms of individual health benefits and treatment costs Cost of infertility due to chlamydia - 20% + of infertility treated by IVF
21 Example of Results Cost-saving Condom provision for high risk groups Condom subsidy schemes Outreach health promotion and safe sex programmes for high risk groups and hard to reach groups High quality integrated Sex & Relationships Education Outstandingly cost-effective Wide variety of routes for condom distribution Short access times for GUM services Averagely cost-effective Highly Active Antiretroviral Therapy (HAART) Routine HIV screening for STD clinic attenders Not very cost-effective but within current NHS range Screening and suppressive therapy for genital herpes
22 The Times National Survey of Sexual Attitudes and Lifestyles