1. Improving Sexual Health in London: achievements and challenges Hong Tan London Sexual Health Programme Director London Sexual Health Forum 7 th December 2011 Hong Tan London Sexual Health Programme Director London Sexual Health Forum 7 th December 2011

2. Structure PolicyPerformanceChallenges Opportunities

3. Policy £1 in contraception = £11 savings in NHS Costs If 9% choose LARC= c£106 Savings If 9% use oral contraceptives = c£94m savings If 9% use condoms – c£93m savings Unintended Pregnancies cost NHS in London £105m: Sexual Health =QUIPP =in-year savings =open access to treatment as prevention Sexual Health =QUIPP =in-year savings =open access to treatment as prevention The total cost of sexual violence has fallen from 22.8bn in 2001 to 15.7bn in 2008

4. £££ police health and social care Big Society ??? education Policy

5. London Sexual Health Programme London Sexual Health Programme Pan London Procurement * Chlamydia Screening Strategic Network Chlamydia Screening Strategic Network London Contraception and Abortion Group, London LARC Network London Contraception and Abortion Group, London LARC Network Commissioning Network Commissioning Network 2012 Planning Group * 2012 Planning Group * Teen Pregnancy Leads NCSP- London Pan London HIV Prevention Group Sexual Health Network Subgroups Sexual Health Network Subgroups London Sexual Health Commissioning Board - Leading and Strengthening Sexual Health Commissioning in London Cluster PCT Directors of Commissioning/ MDs Cluster PCT Directors of Commissioning/ MDs London Specialised Commissioning Board London Specialised Commissioning Board London Sexual Health Commissioning Board London Sexual Health Commissioning Board London Sexual Health Programme. 16th Floor, Portland House, Stag Place. London, SW1E 5RS. simon.mercer@londonscg.nhs.uk London Havens Strategic Board London Havens Strategic Board London Sexual Health Improvement - NHS London* London Sexual Health Improvement - NHS London* FESHproNET: Further Education Sexual Health Network* FESHproNET: Further Education Sexual Health Network* Tariffs* London Sexual Health forum London Sexual Health forum *Time limited DPHs

6. London Firsts Implementing London's Sexual Health Strategic Framework: Vision to improve Sexual Health with integrated Sexual Health services: FIRSTS Reducing late diagnosis of HIV – proposed as 1 of 3 national Sexual Health outcomes in the Public Health outcomes Framework Award –winning Where is your line? Cannes Bronze Lion, 4 Blue Arrows British Advertising awards 2012 Olympic and Paralympic Games – focus on Sexual Health and Young People: Sex Factor Workforce- Higher Education Institutions, London PGDs

7. London Firsts FIRSTS Improving uptake and access to LARC – more fitters trained than any SHA PPE toolkit London needs assessment for Sexual Assault (paediatric, adult reviews) London needs assessment on HIV prevention London C-card scheme and sponsored condoms London young Peoples Sexual Health showcases MANY OTHERS!

8. Under 18 Conceptions 2009 first quarter 39.3 per 1000 2010 first quarter 37.9 per 1000 3.6% Lower Abortion rate for women under 18 2009 first quarter – 17.7 per 1000 2010 first quarter 16.6 per 1000 6.2% Decrease Chlamydia Tests -15-24 years 2009/2010 – 29.84% tests pa 2010/2011 – 32.53% tests pa 2.69% Increase HIV late Diagnosis 2008 53% late diagnosis (C4 Count <350) 2009 51% late diagnosis 2% Decrease LARC Uptake 2009/2010 – c46k prescribed 2010/2011 – c51k prescribed 10.8% Increase Performance

9. Change: Challenges and Opportunities Liberating the NHS, Revised operating framework for NHS- prioritised tariffs, localism, QIPP, New commissioning structures (GP commissioning consortia, Public Health Service, NHS Commissioning Board) Public Health White paper Social Care White paper Others- Policies into the 21 st Century

10. Change: Challenges and Opportunities £20 billion savings- Sexual Health delivers QIPP in-year Local authority commissioning- political drivers? Priority?- Engage Local Authorities, wider determinants of health now Capped budget vs open access? Lets work with DPHS, Local Authority Councillors on Health Improvement Board Now. No mandatory use of NHS tariffs – Lets make tariffs live in 2012-2013 and show they are robust and improve Sexual Health Fragmentation of commissioning – NHS Commissioning Board (CCGs, specialised commissioning) vs PH England, Local Authorities – Lets drive governance agenda in 2012-2013 London Sexual Health Commissioning Board Report to London SCG

11. Priorities for London Sexual Health Programme and Commissioning Board in 2012-2013 Implement Sexual Health Tariffs Strategic commissioning of the Havens Focus on reducing late diagnosis of HIV – HIV testing standard in Primary Care Opportunities for procurement efficiencies 2012 Olympic and Paralympic Games - Legacy Shaping transition

12. Conclusion 2012: focus on London for Sexual Health Many achievements and firsts because of YOU, US ALL Shape change – address challenges and opportunities LETS SIEZE THE DAY LETS BE BOLD!

13. THANK YOU