Consultation on Sexual Health Services Re-Tender

Consultation on Sexual Health Services Re-tender

Introduction

Sexual health services include the provision of sexual health advice and specialist services for contraception and sexually transmitted infections (STIs), including HIV. These services fall within local authorities’ mandatory responsibilities for commissioning public health services.

Bolton Council and Salford City Council are proposing to jointly re-tender these contraception and sexual health services and we are asking a number of questions to help us to decide how this should be organised and delivered.

Background

Bolton Council and Salford City Council both commission specialist contraception and sexual health services for their populations. These services include genitourinary medicine clinics, community contraception clinics and outreach programmes for young people.

In Bolton dedicated sexual health advice and contraception services for young people have recently been re-tendered as part of the integrated service for 5-19 year olds, and are therefore not included within this contraception and sexual health services re-tender.

What are we proposing?

Salford City Council and Bolton Council are proposing to re-tender and combine their sexual health services so that they will be delivered by a single lead provider from July 2016. This will be an integrated contraception and sexual health service, providing level 1, 2 and 3 services[1], for people of all ages in Salford and Bolton. This means that Salford and Bolton residents will be able to access all methods of contraception, screening for sexually transmitted infections and treatment from the integrated service.

For Salford residents the service will also include dedicated contraception and sexual health clinics, and community outreach programmes for young people. In Bolton dedicated contraception and sexual health services (levels 1 and 2[2]) are included in the integrated service for 5-19 year olds and are not part of this re-tender. We recognise that some young people may need access to level 3 services[3], or may choose to access services primarily designed for adults; this is why we are proposing that the integrated contraception and sexual health service is available to people of ‘all ages’.

The current locations of adult and young people’s sexual health clinics may be reconfigured to meet the needs of the population, but this will be subject to a review of existing estates and the provisions held by the successful tendering organisation.Whilst this may not include all existing buildings we expect that a hub and spoke model will be adopted, covering the identified areas of need within Salford and Bolton. The successful organisation will be required to provide the service from locations within Salford AND Bolton which will take into account levels of need, accessibility, current locations and co-location with other services that link to sexual health.

We are proposing that the contraception and sexual health services in Salford and Bolton:

Ensure that residents can obtain information and advice about contraception and sexual health
Promote the use of reliable methods of contraception
Promote the use of condoms
Ensure that residents can continue to obtain all methods of contraception
Ensure that residents can continue to obtain emergency contraception
Ensure that residents can continue to obtain screening for sexually transmitted infections including HIV
Ensure that residents can continue to obtain treatment for sexually transmitted infections.
Provide support for residents living with long-term conditions such as HIV

Why are we proposing it?

The proposed contraception and sexual health services will contribute to achieving:

Reduction in the transmission of HIV and other sexually transmitted infections
Reduction in the number of residents diagnosed with HIV at a late stage of infection
Reduction in the number of unintended conceptions among women of all ages
Reduction in the number of conceptions among young women aged under-18

We believe these proposals will:

Deliver efficiencies and closer integration of services across the two areas as we recognise that patients already choose to access services from each other’s areas;
Provide services that have a shared standard and quality for testing, treatment and care;
Facilitate patient flow across the areas (and in Greater Manchester) as we recognise the need for the services to be open access for all regardless of area of residency.

We are also working towards a shared service specification across Greater Manchester. This means that sexual health testing and treatment will have shared standards across the region, thus supporting the ethos of the recent devolution agreement of Health and Social Care funding to the Greater Manchester Clinical Commissioning Groups and Local Authorities.

These proposals also support the Public Health England “Making it Work” guidance on the commissioning of sexual health services in that:

Reconfiguration should be carried out based on assessed need not current service provision
A larger commissioning footprint will make the best use of limited resources to improve outcomes.
The economic climate requires new thinking and innovation – doing more or less of the same will not radically change outcomes or provide better value.

From our recent Sexual Health Needs Assessment in Salford, we have noted an overlap of provision and location of services for young people. We believe our new proposals of creating an ‘all age’ service will deliver efficiencies in service provision and therefore will cost less. Savings can then be invested back into the local authority to allow other areas to contribute to the city council’s budget challenge proposals for 2016/17.

What are we asking from you?

We are looking for feedback on the proposals, from the following groups/people/organisations:

Healthcare professionals
Staff and volunteers working in sexual health services
Commissioners and strategic leads
Others with a professional interest in sexual and reproductive health services
Customers of contraception and sexual health services, their carers and/or families
Customers of sexual health prevention and support services, their carers and/or families

Please provide your feedback via this online survey.The survey will be available until 21st September 2015.

[1] As described in ‘Integrated sexual health services: national service specification’ (DH, 2013)

[2]Basic and intermediate provision

[3]Complex service provision