Review of the National Strategy for Sexual Health and HIV SSHA, Newcastle 26 September 2008.

Review of the National Strategy for Sexual Health and HIV

SSHA, Newcastle26 September 2008

SHHA Newcastle 26 September 2008 2

Desk research:

on the progress of implementation of the Strategy; the changing landscape and epidemiology

Expert Review Groups:

services; commissioning; prevention & inequalities; indicators

Meetings:

on strategy; with stakeholders; and with sexual health service users.

NATIONAL STRATEGY REVIEW METHODOLOGY


Changing context for sexual health

Progress in improving sexual health and implementing the Strategy

Key barriers to implementation

Action to drive forward the Strategy

Measuring further progress

REVIEW CONTENTS


CHANGING CONTEXT FOR SEXUAL HEALTH [I]

Policy developments

Devolved decision making

Local authority role and partnerships

Public health and tackling inequalities

Patient and public involvement

Darzi review – quality, health improvement/prevention Organisational change and NHS reforms

Restructuring – PCTs, SHAs, RDPH role

Commissioning reform

Market reform and patient choice

Financial reform – PbR, GMS contract


Clinical and service delivery developments

Service modernisation

Multidisciplinary teams, new roles (nurses, health trainers)

Self-management

Technological changes

Prevention, testing and treatment technology - rapid testing, HPV vaccination

Communications technology – internet, text messaging

CHANGING CONTEXT FOR SEXUAL HEALTH [II]


PROGRESS IN IMPROVING SEXUAL HEALTH AND IMPLEMENTING THE STRATEGY

Sexual health in 2008 HIV, STIs, unintended pregnancy, psychosexual problems,

sexual assault

Inequalities - BME, gay men, young people and older people

Implementing the strategy - achievements national priority, targets and support - GUM access, abortion

<10 weeks publication of standards and best practice guidance service modernisation and integration, innovation implementation action plan – most actions delivered (national

level)


KEY BARRIERS TO IMPLEMENTATION

Barriers

Prioritisation, targets and investment

Commissioning

Evidence base

Integration and workforce development

Funding mechanisms

Engaging GPs

Lack of strong voice, stigma

Locally variable implementation


improve access to the full range of contraceptive methods

reduce unintended pregnancy rates

improve care for women seeking abortion

reduce transmission of HIV and STIs

reduce prevalence of undiagnosed HIV and STIs

improve health and social care

reduce stigma [HIV and other aspects of sexual health]

improve sexual health and wellbeing

recognise psychosexual health as an integral part of sexual health

improve access to good quality services and care

STRATEGY AIMSFocus for further action


5 PRIORITY AREAS FOR ACTION:PRIORITY ACTION 1

Prioritise sexual health as a public health issue.Sustain high-level leadership locally, regionally and nationally.

Designate accountability for sexual health improvement at PCT/LA level

Strong public health base with regular sexual health needs assessment

Dedicated regional function to ‘support and challenge’ backed by sound leadership and performance management

Continued national support for local delivery via NST More effective mechanisms to foster evidence building and

knowledge transfer Build infrastructure and training


PRIORITY AREAS FOR ACTIONPRIORITY ACTION 2

Build strategic partnerships

Active engagement in joint planning mechanisms to ensure sexual health and HIV are prioritised

Ensure sexual health is represented in related health improvement plans (eg alcohol, staying healthy, mental health)

Acknowledge third sector as an equal partner and include in needs assessment and strategic planning

Closer working between SHAs and GOs More integrated cross-government approach to address

inequalities and wider determinants of sexual heath Fully engage professional bodies representing sexual health



Commission for improved sexual health

Holistic commissioning model

Commissioning at an appropriate level to ensure fair, effective best- value provision

Link service networks to the commissioning process and business agenda

Skill up sexual health commissioners to meet WCC requirements

Accelerate development of tariffs which allow for different service models and reflect the real cost of services

Develop strong multi-disciplinary teams



Invest in prevention

Ensure effective sexual health promotion and HIV prevention is commissioned according to local need and is adequately resourced

Make prevention an integral part of all sexual health service provision

Develop a national prevention framework for a more coordinated approach across government departments

Improve synergy between national and local prevention initiatives

Improve dissemination about what works and what is cost effective, particularly in relation to African communities, gay men and young people

Intensify efforts to tackle stigma Make PSHE Education and all elements of SRE a statutory

subject



Deliver modern sexual health services

Specify local quality standards and ensure performance of all those providing sexual health services is monitored

Establish and further develop sexual health and HIV networks to cover all areas of the country

Label services more clearly and maintain open access at all times

Increase level and quality of services provided by general practice and include sexual health in future development of QOF

Ensure sexual health and HIV services are included in local reconfiguration work (eg primary care centres/polyclinics)

Improve workforce planning and training at all levels and link to service development and changing models of care


A HIGH QUALITY WORKFORCE


KEY MESSAGES

Transmissible infections have no regard for geographical boundaries

There are potential dangers in leaving public health control of STIs and HIV to competing services without quality standards or a requirement for collaboration.

High quality and timely surveillance data are vital to identify need, determine the value of prevention programmes and optimise service configuration.

There has to be a shared understanding about why improving sexual health is priority why it matters to life outcomes and the wider community.

Review of the National Strategy for Sexual Health and HIV

Review of the National Strategy for Sexual Health and HIV SSHA, Newcastle 26 September 2008.

Documents

Transcript of Review of the National Strategy for Sexual Health and HIV SSHA, Newcastle 26 September 2008.