Nottinghamshire Insight

Joint strategic needs assessment

Sexual Health (2015)

This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.

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Topic title Sexual Health (2015)
Topic owner Sexual Health Strategic Commissioning Group
Topic author(s) Dawn Jenkin, Sally Handley, Libby Lomas
Topic quality reviewed February 2015
Topic endorsed by Sexual Health Strategic Commissioning Group 27th March
Topic approved by Approved 17th July 2015 HWIG
Current version Final AMENDED 15th March 2017
Replaces version Draft v1.2 20th April 2015
Linked JSNA topics

Executive summary

Introduction

Good sexual health is an important aspect of health and wellbeing, and it is vital that people have the information, the confidence and the means to make choices that are right for them, regardless of their age, gender, ethnicity, sexual orientation, religion or belief or disability. This helps people to develop positive relationships and enables them to protect themselves and their partners from infections and unintended pregnancy.

This chapter considers the need, evidence of effective interventions and current service provision for:

  • sexually transmitted infections, including HIV,
  • contraception,
  • terminations of pregnancy,
  • teenage conceptions,
  • child sexual exploitation and
  • sexual abuse.

The highest burden of sexually related ill-health is borne by groups who often experience other inequalities in health, including men who have sex with men, young people, black and minority ethnic groups, and socio-economically deprived groups.

Diagnosis of sexually transmitted infections (STIs) is rising nationally. These infections have a significant impact on the health of individuals and communities. STIs which remain undiagnosed or are not effectively treated can cause long term serious health consequences which include pelvic inflammatory disease (PID) and infertility.  The use of effective methods to prevent transmission, access to fast diagnosis and treatment, and good partner notification processes are all important in reducing STI prevalence and improving sexual health outcomes. Nationally, a large proportion of those with Human Immunodeficiency Virus (HIV) infection are diagnosed late, with serious consequences for individuals’ health and survival rates.

Availability and effective use of contraceptive methods is necessary to reduce STI transmission, unwanted pregnancies and termination of pregnancy. This depends on good access to contraception, information on available contraceptive methods, and skills and confidence to negotiate safer sex. Particular action is needed to support a reduction in teenage conceptions, as evidence clearly shows that having children at a young age can have negative impacts such as poor health and wellbeing, reduced education, poverty and social exclusion.

Sexual abuse is experienced by 19.1% of women and 2.7% of men over the course of their lives, but few people ever report or disclose this experience.  There has been a rise in reporting of historical abuse following high profile media coverage of historical sexual abuse cases. There is also increasing awareness amongst parents and educators of the risks of child sexual exploitation.

Unmet needs and gaps

Nottinghamshire County is similar to the rest of the country when considering key sexual health outcomes.  There is significant unmet need in terms of:

  • Sexually transmitted infections (STIs),
  • access to and effective use of contraceptives and
  • unplanned pregnancy, including teenage conceptions and terminations.

These are explored in more detail in section 8 of this report.  There is a clear evidence base presented for effective interventions to address population sexual health need. 

A sexual health needs assessment was completed for Nottinghamshire County in January 2014 the findings are summarised in this document.

Recommendations for consideration by commissioners

The recommendations below are summarised from section 10 and identify key changes needed to address the sexual health needs of people in Nottinghamshire County. 

It is essential that services are commissioned based on the needs of the local population and that feedback from service users informs the development of future service models. Integrated service pathways are essential to support access to a range of interventions that meet sexual health needs and in turn support the achievement of enhanced sexual health outcomes.

Summary Recommendations

Commissioning responsibility

Local

Authority

CCGs

NHSE Area Teams

Strategy & integrated commissioning

1

Promote system alignment of sexual health commissioning priorities.

x

x

x

2

Evaluate (following shadowing) the integrated sexual health tariff.

x

 

 

3

Work collaboratively to implement the interdependent priorities identified across key strategies.

x

x

x

Prevention

4

Improve access to up-to-date information about sexual health service provision.

x

x

x

5

Review and improve the provision of Sex and Relationships Education (SRE) in schools.

x

 

 

6

Ensure sexual health needs are addressed in the new school health model.

x

x

 

7

Review and improve the promotion of information about the full range of contraception and Sexual Health services by mainstream youth services and the Youth Offending Service (YOS)

x

 

 

8

Review and improve access and coverage to increase STI testing and uptake of LARC.

x

 

 

9

Review the effectiveness of the service model for Chlamydia screening.

x

 

 

10

Improve the promotion of preventative messages to high risk groups and young people concerning reinfection of STIs

x

 

 

11

Work with secondary care provider to offer additional HIV training and awareness within primary care.

x

 

 

Quality and Accessibility

12

Implement a rolling programme of engagement with local people. 

x

x

x

13

Work with providers to complete a health equity audit of all sexual health services.

x

 

 

14

Implement ‘You're Welcome’ accreditation in all secondary care services to improve quality and access for young people

x

 

 

15

Work with providers to improve integration of pathways for young people accessing Sexual Health services

x

 

 

16

Review sexual health pathways to increase access for young offenders and develop accordingly to ensure need is met.

x

 

 

17

Continue and develop, access to specialist services for prostitutes/sex workers to meet specific sexual health needs.

x

 

 

18

Ensure sexual health services are accessible and meet the needs of MSM and LGBT communities across the county.

x

x

x

19

Ensure that monitoring data reported by all Local Authority commissioned sexual health services meets commissioning needs.

x

 

 

Early Diagnosis and Treatment

20

Implement integrated pathways for sexual and reproductive health that reflect evidence based practice and deliver an improved patient journey that is equitable, accessible, high quality and reflects value for money

x

x

x

21

Establish the causes of the apparently high recorded rates of admission for pelvic inflammatory disease in Nottinghamshire.

x

x

 

22

Review the Termination of Pregnancy (TOP) pathway to identify any areas for improvement and ensure best practice.

 

x

 

23

Consider approaches to reduce the proportion of women undergoing repeat terminations.

 

x

 

24

Ensure best practice in HIV treatment completion by agreeing and communicating coherent patient pathways with commissioners in NHSE and CCGs

 

x

x

25

Promote earlier diagnosis of HIV by working with primary care.

x

 

 

26

Work collaboratively with NHSE Area Teams to ensure best practice, in effective and coordinated HIV treatment and care.

x

 

x

Key contacts

None provided.

This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.

Full report »