1. www.hertsdirect.org Developing a 5 year Sexual Health Plan for Hertfordshire PH & Localism Cabinet Panel Louise Smith Deputy Director, Public Health 23 January 2014

2. www.hertsdirect.org 5 Year Plan Needs assessment Partnership & commissioning responsibilities Vision Implementation

3. www.hertsdirect.org 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

4. www.hertsdirect.org Commissioning responsibilities Figure 1: Sexual Health services commissioning arrangements from April 2013 Local authorities will commissionClinical 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

5. www.hertsdirect.org Sexually Transmitted Infections

6. www.hertsdirect.org <18 Conception Rates

7. www.hertsdirect.org HIV Prevalence by Locality

8. Sexual Health Clinics

9. www.hertsdirect.org Vulnerable Groups Information 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

10. www.hertsdirect.org Service User Views Accessibility –Making appointments and contacting services –Opening times –Turned away from drop-in Environment –Maintaining confidentiality

11. £ 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

12. www.hertsdirect.org 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