The Director of Public Health will give a verbal update to the commission on Leicester’s Sexual Health Service.
Minutes:
The Director of Public Health gave a presentation to update the commission on Sexual Health Services. It was noted that:
Public Health Sexual Health Portfolio:
Integrated Sexual Health Service (ISHS)
Long acting Reversible Contraception (LARC)
Emergency Hormonal Contraception (EHC)
HIV Self Sampling Service
HIV IAG Service
HIV Peer Support Service (New)
· The service covered testing, both complex and noncomplex contraception, sexual counselling, education in schools and colleges, work with the HPV team, community outreach and responses to HPV exposure.
· The service was reported to be functioning well, with high levels of walk in and online activity. For city residents in July there were 1680 contacts, including 1463 orders and 729 distributions of free condoms. Service users continued to express appreciation for the staff and the quality of care provided.
· Ongoing challenges remained around bookings and access to the service.
· There had been operational pressures over the summer. The city service was now delivered solely within Leicester as Leicestershire County Council and Rutland Council had moved to a different provider. Walk in access at the city site had been temporarily closed to encourage behaviour change among county residents. Staffing had now increased and walk in access had reopened. Demand from county residents to use the city service remained high. The previous condom distribution scheme had operated irrespective of where people lived, but county arrangements had since changed which reduced confusion. There remained a potential financial risk if a high number of county residents continued to use the city service.
· Work was underway with primary care to support the delivery of long acting reversible contraception. People requiring these procedures were directed to Haymarket Health, with a clear pathway for fitting and removal. Efforts were being made to make access as easy as possible and to support general practice with the associated costs.
· Emergency hormonal contraception had previously been commissioned locally and delivered through both the clinic and pharmacies. Most activity had taken place at the clinic. From 29th October the entire pharmacy provision transferred to the national NHS pharmacy contraception service. This made emergency contraception free for all age groups and increased reimbursement for pharmacies. Local contracts were therefore being decommissioned. Pharmacies could seek payment from the council or primary care networks during the transition period. Mystery shopper work had been undertaken to assess accessibility and findings had been shared with colleagues to support service improvement.
· HIV self-sampling kits were being used by around forty people in the first quarter through a provider called SH24. Future commissioning intentions were still to be confirmed.
· The HIV information, advice and guidance service based at the clinic supported people to access and engage in treatment, with case studies demonstrating positive outcomes.
· A HIV peer support pilot was in place. Under national policy people attending emergency departments were now routinely tested for blood borne viruses unless they opted out. Those identified with HIV were able to receive immediate support through the pilot.
The following was noted in Members discussions:
· Questions were asked about the financial risk associated with county residents using the city service and why arrangements had changed. It was noted that the issue remained a concern due to the open access nature of sexual health services. Work was underway with partners to understand data trends and encourage people to use services closer to where they lived.
· Concerns were raised about the wider NHS structure and the extent to which patients were required to work around service changes. It was acknowledged that the situation was complex and that regular discussions were taking place across the system.
AGREED:
That members note the update on Sexual Health Services.