Transcript Slide 1

The London Sexual Health Programme
Sexual Health in Londonachievements and challenges
Hong Tan, London Sexual Health Programme Director
13 November 2009
The London Sexual Health Programme
1. Structure
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Context
Achievements since 2008
Challenges
Opportunities- Commissioning priorities for
2010-11
The London Sexual Health Programme
2. Context
• Sexual Health is a Public Health and Financial
priority across London
• London Sexual Health Framework 2004
• London Sexual Health Programme 2005strategic commissioning leadership
• London Sexual Health Chief Executive and
Commissioning Board, 2007
London Sexual Health Commissioning Board- Leading and
Strengthening Sexual Health Commissioning in London
London Specialized
Commissioning
Groups
London PCT CEs
Group
Lead PCT Chief
Executive
GOL - Teen Pregnancy
London Sexual Health
Commissioning Board
Pan London
Procurement
Chlamydia
Screening
Strategic
Network
Sexual Health
Network
Subgroups
PCT Directors of
Commissioning
/ SACU MDs
London Sexual Health
Programme
London
Contraception
and
Abortion Group
Pan London HIV
Prevention Group
London Sexual
Health Promotion
Framework
Commissioning
Network
London Sexual
Health forum
2012
Planning Group
London
Havens
Strategic
Board
London
Sexual
Health
Strategic
Framework
3. Achievements
Sex and Our City (2008)
- London Sexual Health Strategic
Framework (2009):
sets out Vision and standards…
London Sexual Health Strategic Framework
A. Reduces ill health and improves Londoners health
1. Commissioners clearly specify the health and wellbeing outcomes they are commissioning and
agree with providers the measures that will demonstrate service effectiveness
B. Provides everyone with high quality care that is comprehensive and accessible
2. A comprehensive range of sexual health services is commissioned to enable access at times and
places that meet individual need
C. Focuses healthcare on individual needs and choices to ensure a better patient
experience
3. Sexual health services involve users in their design and delivery and regularly measure the
experiences of service users
D. Resources, implements and plans improvements by integrating high quality
evidence with clinical and patient leadership
4. Commissioners and providers work together to identify innovative approaches to promotion, prevention and
care that will increase and improve health and wellbeing outcomes
5. Commissioners within each of the London sectors develop a sector framework for commissioning within the
London framework, agreeing standards for quality and productivity across the sector
6. Sexual health providers will develop integrated services across primary, community and secondary care, under a
Clinical Director providing leadership to the network of service providers, with particular responsibility for clinical
governance and training
4. Achievements (2)
Promoting good sexual health:
applying social marketing principles, and approaches relevant to different population
segments, providing a range of approaches and materials that support people to be
sexually healthy
Fewer teenage pregnancies:
addressing wider health determinants as well as service provision, and including risk
reduction, counselling, behaviour modification, and provision of post pregnancy
contraception including long acting methods.
Increased access to long acting methods of contraception:
encouraging and enabling use while taking account of the importance of patient choice,
with local agreement on how increased use of long acting methods will be measured
and agreeing a local target rate appropriate to the population age profile.
Easy access to emergency contraception:
including arrangements for free emergency hormonal contraception in pharmacies at
least for young people (age range agreed locally), and counselling about the different
methods and their effectiveness.
Early abortions and effective post abortion contraception:
More than 70% of abortions should take place earlier than 10 weeks gestation, and
where this target has been achieved further improvement should be agreed. Local
arrangements for measuring post abortion contraception should be agreed with
providers. A strategy for reducing repeat abortions and the role of sexual health and
abortion services in reducing repeat abortions should be agreed.
Access to Genito-Urinary Medicine Services:
Access to GUM services is an operational standard for the NHS.
5. Achievements (3)
Fewer Sexually Transmitted Infections:
achieved through sexual health promotion and speedy diagnosis to reduce spread
between partners, making full use of up to date screening technology and provision
for automated results, with easy arrangements for making appointments.
Chlamydia Screening:
increasing the uptake of Chlamydia screening by those at highest risk, those under the
age of 25.
Fewer late HIV diagnoses:
including testing in community contraceptive services and in primary care, with same day
testing and results. Testing in acute settings should also be agreed where population
prevalence is such for this to be appropriate (check level).
Better care for clients who are HIV positive:
Quality of life has improved for people living with HIV with the use of effective
antiretroviral therapy. High quality chronic disease management should be provided
to promote individual wellbeing, with effective support and education to prevent
onward transmission of infection and of unplanned pregnancy.
No undiagnosed antenatal patients with HIV, Hepatitis B and Syphilis.
Testing arrangements and systems in place to report any women undiagnosed at delivery
and actions to address and prevent future occurrences. Antenatal screening for
Rubella Antibody negative women should be promoted as part of the programme.
Prevention of Hepatitis B in MSM with a programme to ensure that MSM who are not
immune to Hepatitis B are immunised.
Patient Experience of sexual and reproductive health services:
Commissioners should ensure that all those in London have access to integrated local
specialist sexual health services that deliver a comprehensive range of services, and
should require providers to measure and improve people’s experience of their sexual
and reproductive health services.
6. Achievements (4)
Improved commissioning, supporting delivery and better value for money:
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Contracting tools: London service specifications GUM, contraception/SRH,
abortion guidance on GUM tariffs, PEPSE
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PbR development site for Sexual Health tariffs
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London procurement of condoms-> Chlamydia screening, Abortions
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Bimonthly Sexual Health Commissioning Learning sets- World Class
Commissioning, HIV late diagnosis, Chlamydia screening, Contraception and
abortion
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Increasing contraception training in Primary Care
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Going All the Way- FE Colleges
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London Assembly Progress Report on sexual health services for Young people
(2009)
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London Sexual Health Programme website- www.londonsexualhealth.org
7. Achievements (5)
Strengthening Strategic commissioningnew stakeholder engagement groups:
• London Contraception and Abortion subgroup
• London 2012 Sexual Health Planning GroupDH/IAG/LOCOG
• London Havens Strategic Board- Justice
Award 2009
8. Achievements (6)
Examples of best practice
• Contracting tools- DH Abortion specification
• Tariffs- Pricewaterhouse Coopers evaluation
• Local examples- checkurself Chlamydia screening website
- London C-card scheme and Medivend scheme
- Healthbytes- FE colleges
- Living Well Self Management Programme for Vulnerable
Young People
- New services; Dean St. Streatham Hill- Dr Ali Kubba
9. Challenges
• Sexual Health needs and demands increasing
• Economic climate- 20% savings:
- £2bn for NHS in London
- c£40m for Sexual Health services (excludes Primary Care)
- 200,000 GUM , 100 SRH attendances
- QIPIP agenda
- World Class Commissioning
- Tariffs policy
• Change:
- General Election- Policy, priorities, systems and structures
- Strategic changes?- National Sexual Health/HIV and
Teenage Pregnancy Strategies end in 2010
- Technology- IT/internet, patient access via
home/community services; self management
10. Challenges (2)
Commissioning priorities in 2010-11:
Focus on:
• Tariffs development and implementation
• Pan-London procurement- Chlamydia screening,
abortion and streamlining contracts
• London Sexual Health Strategic Framework- actions to
be developed in 2010-11 e.g. workforce strategy,
strengthening networks
• Strengthening Sexual Health commissioning- Learning
sets, contracting tools and templates, supporting
performance improvement and monitoring
11. Challenges (3)
• Change= Fear/opportunities
• Seize opportunities- Brave partnerships
• Achievements in 2010- Your commitment
The London Sexual Health Programme
THANK YOU