Redesigning services

Sexual health in the UK is getting worse, with the number of diagnosed cases of sexually transmitted infections (STIs) and HIV increasing, high levels of teenage pregnancy and uneven access to contraception services. In addition, access to genito-urinary medicine (GUM) services has worsened over the past five years.

THT believes that there is a case for sexual health services to be redesigned. So we have set out some key resources to support sexual health managers and commissioners undertaking this redesign. These have been prepared specifically to support Primary Care Trust (PCT) and Strategic Health Authority (SHA) sexual health leads as well as managers in National Health Service (NHS) and voluntary and community organisations.

A review of STI and HIV levels is contained in Focus on Prevention, published by the Health Protection Agency (HPA), 2004. The HPA can also provide more information on local STI and HIV levels from local public health departments. A review of GUM waiting times by PCT area in England is also available from the HPA.

Targets

To combat worsening sexual health and service access, in 2004 the Department of Health in England set the following targets:

• halt the rise of sexually transmitted infections over the next two years, followed by a decrease in the number of new diagnoses
• an increase in the proportion of 15 to 24-year-olds screened for Chlamydia with coverage of the whole of England by 2007
• 48-hour access for everyone using GUM services by 2008
• a 50% reduction in the numbers of teenage pregnancies by 2010

These targets are drawn from the Choosing Health White paper published in 2004 and are informed by the Department of Health's Better prevention, better services, better sexual health - The national strategy for sexual health and HIV. For more information download the Department of Health's Summary of Intelligence on Sexual Health.

Investment

To achieve its targets for better sexual health, the Department of Health has made extra funding available for PCTs during 2006/07 and 2007/08. This funding is included within PCT baseline allocations.

Although this funding is not ring-fenced for use in sexual health, there is a clear expectation by the Department of Health that it will be used for this purpose, and invested in frontline services. Download Revenue allocations by PCT.

How to meet the HIV challenge

The HIV epidemic in the UK is growing at an unprecedented level, and more rapidly that at any stage since it began. The report Meeting the rising challenge describes and explains the growth and changes in the UK HIV epidemic. It also sets out the principal issues PCTs need to address and suggests action plans for PCT-led work to let the NHS strengthen its work in public health and social care.

To achieve the targets set by the Department of Health, many PCTs will be intending to redesign the way in which sexual health services are delivered. Suggestions for how STI and HIV services might be redesigned are contained in our list of related THT publications.