1. Sexual Health Services Concept Day 2 December 2015

2. Welcome, Introductions & Housekeeping Lisa Andrews, Senior Public Health Lead Surrey County Council

3. Programme 9.30Registration & refreshments 10.00Welcome and Introduction 10.15Presentation and discussion: Sexual Health Needs Assessment and the National Integrated Service specification 12.00Lunch 12.45Presentation and discussion: Service Delivery Models 2.45Summary and next Steps 3.00Close

4. Public Health: Sexual health services Locally Commissioned Services Emergency Contraception Dual STI testing: Chlamydia and Gonorrhoea Condom Distribution Scheme (Get It On) GUM Clinics Contraception and Sexual Health Clinics (CASH)

6. Sexual Health Needs Assessment Aims To gather information from a comprehensive range of sources in order to build a picture of levels of need and current service provision with respect to the sexual health of the population of Surrey. To use the resulting needs assessment report to inform and guide future commissioning and service provision to promote and improve the sexual health of people in Surrey.

7. SHNA: Key Messages Runnymede and Spelthorne have higher than the national average rates of teenage conceptions Over 60% of teenage conceptions result in termination Woking has a higher than the national rate of HIV Through engagement work it was identified that both adults and young people wanted better access to services, this included more flexible opening times such as evenings and weekends Both adults and young people felt that sexual health services could be promoted more effectively To improve patient experience by ensuring pathways are joined up There are variations gaps in service provision across the county. Meaning that resources could be more effectively targeted to needs. This is to be addressed through the re-procurement of services. Integration of services to allow holistic needs to be met. GUM and CASH services to be delivered by same clinicians.

8. SHNA: Recommendations Relationship and Sex Education (RSE) School Nurse role Missing out on education Positive relationships Further education/ Colleges/ Universities Termination of Pregnancy Young ParentsHIV PharmoutcomesPatient Choice Looked After Children Services for under 25s

9. Integrated Service Specification Department of Health 2013 Aims to improve sexual health: by providing easy access to services through open access ‘one stop shops’, where the majority of sexual health and contraceptive needs can be met at one site, usually by one health professional, services with extended opening hours and accessible locations. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/210726/Service_Specification _with_covering_note.pdf

10. Strategic leadership & accountability SRE in schools and colleges Young people friendly contraceptive & SH services Clear and consistent messages to young people, parents and practitioners Workforce training on SRE SRE & access to contraception in youth services Targeted SRE and contraception/ SH support for young people at risk Strong use of data for commissionin g & local performance management Dedicated support for teenage parents – including SRE and contraception Supporting parents to discuss sex & relationships Family Nurse Partnership Taken from; Teenage Pregnancy Engagement Day: building on success, presented by Alison Hadley, Director, Teenage Pregnancy Knowledge Exchange, University of Bedfordshire ‘Whole systems’ approach: ten factors for an effective local strategy.

11. Discussion & Task

12. Task: Instructions For your own organisation or sector: 1.What do you think your priorities from the SHNA are? For Surrey: 2.What is working well? 3.What can be improved?

13. Task Feedback

14. Programme 9.30Registration & refreshments 10.00Welcome and Introduction 10.15Presentation and discussion: Sexual Health Needs Assessment and the National Integrated Service specification 12.00Lunch 12.45Presentation and discussion: Service Delivery Models 2.45Summary and next Steps 3.00Close

15. Integrated Services An Integrated Sexual Health service includes the following: Contraception (including LARC) STI Testing and Treatment Psychosexual Counselling HIV Prevention Young People’s Sexual Health and Teenage Pregnancy Sexual Health Promotion Chlamydia screening An integrated sexual health service model aims to improve sexual health by providing easy access to services through open access ‘one stop shops’, where the majority of sexual health and contraceptive needs can be met at one site, usually by one health professional, in services with extended opening hours and accessible locations.

16. Model 1: Integrated Delivery (SCC commissioned) With individual contracts for Primary Care providers. NHSE contract separately. Integrated delivery by 1 lead provider (with or without sub-contracting) on a countywide basis for Surrey County Council services. Surrey Sexual Health Services Integrated Services (SCC) HIV Treatme nt & Care (NHSE) Primary Care Informal Relationship Sub- contracts

17. Model 2: Integrated Delivery (complete pathway) With individual contracts for Primary Care. Integrated delivery by 1 lead provider (with or without sub-contracts) on a countywide basis with underpinning Section 75. Surrey Sexual Health Services Integrated Services (complete pathway including NHS commissioned elements) Primary Care Section 75 Sub- contracts

18. Model 3: Integrated delivery model at geographical lot level (example with 2 lots) With 1 or more lead providers (with or without sub-contracting) Primary Care Integrated Services (complete pathway including NHS commissioned elements) Surrey Sexual Health Services – Lot 1 Surrey Sexual Health Services – Lot 2 Section 75

19. Discussion & Task

20. Task: Part A Debate the positives and challenges of: 1.procuring at geographical lot level 2.the use of sub-contracting arrangements 3.joint or separate contract with NHSE 4.the integrated model ‘v’; what is currently in place For each, write positives and challenges on post it notes

21. Task: Part B 1.Which of the models is best suited to the current market environment? 2.How can both larger and smaller organisations take a role in service delivery – is sub-contracting the best approach or could the service be delivered by a Special Purpose Vehicle (SPV) or a consortium? 3.Are there any models not presented that you feel are worth considering? Groups will feedback their answers to the room

22. Task Feedback

23. Summary and Timeline Preparation Present – January 2016 December: Concept Day January: Delivery Model defined Invitation to tender February – July 2016 End of February: Market Engagement Tender Evaluations July 2016 Contract Award October 2016 Contract Start Date 1 April 2017

24. Thought of something? Surrey Says (live from 4 December): https://www.surreysays.co.uk/public-health-health-improvement/sexual- health-concept-day https://www.surreysays.co.uk/public-health-health-improvement/sexual- health-concept-day Presentations, Sexual Health Needs Assessment and other useful documents will be made available from Surrey Says page.