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Sexual Health

Supporting collaboration in London to improve sexual health outcomes

London faces some of the most significant levels of sexual ill-health and wider sexual and reproductive issues in the country, including

  • nearly half of all people living with HIV live in London. Fifty-seven per cent of new HIV diagnoses are in London and the trend is rising. One in 12 men who have sex with men (MSM) in London have HIV, with one in five undiagnosed
  • increases in sexually transmitted infections (STIs) in London, accounting for one in every four diagnoses in England. New syphilis diagnoses rose by 40% in 2014 with Londoners accounting for 55% of all syphilis diagnoses in England. New gonorrhoea diagnoses rose by 23% in London in 2014, with Londoners accounting for 47% of all cases in England
  • 44,810 diagnoses of chlamydia were made in London GUM clinics in 2014
  • very high STI rates in under 25 year olds - 37% of new infections in London were in those aged between 15 and 24 years
  • a significantly higher rate of repeat abortions in women under 25 at 33 per cent. This compares to a national average of 26.9 per cent
  • men who have sex with men (MSM) represent 69% of all gonorrhoea cases in 2014 (a rise of 31% since 2013) and 90% of all syphilis cases in 2014 (a rise of 54% since 2013), despite representing less than two per cent of the London adult population

Maps, charts and tables showing snapshots and trends by local authority can be found in Public Health England's sexual and reproductive health profiles (link to an external website).

From April 2013, local authorities have had responsibility for commissioning a range of sexual health services, including comprehensive open access sexual health services. Spending on sexual health accounted for 34 per cent of London councils' public health budgets in 2013/14, or £188 million.

The 32 Clinical Commissioning Groups (CCGs) and NHS England also have some sexual health commissioning responsibilities.  

Sexual health services are provided in a range of ways and places, including by GPs, acute hospitals (GUM clinics), community services, pharmacies and the voluntary sector.  The commissioning and delivery of sexual health services is therefore a complex picture.

We are working with the Directors of Public Health in London and other key partners to support collaboration between boroughs, improve sexual health outcomes and secure efficient and effective services in the capital.  

Our current priorities include:

  • supporting a London Sexual Health Group to provide a forum for strategic information-sharing and collaboration
  • supporting collaboration between boroughs, including the London HIV Prevention Programme and work being developed to collaborate on commissioning GUM services and to consider the case for a sexual health tariff
  • developing an understanding of the future budget implications of London's sexual health service needs
  • supporting the London Sexual Health Transformation Project
  • working with Directors of Public Health in London and NHS England on PrEP, which is the use of anti-retroviral drugs to prevent people at risk of contracting HIV from becoming infected
  • working with NHSE, PHE and sexual health commissioners and providers on a pilot to offer the HPV vaccine to men who have sex with men, to prevent genital warts and certain cancers.

 

Valerie Solomon, Policy and Projects Manager, Health and Adult Services

Valerie.Solomon@londoncouncils.gov.uk 

 

The split of commissioning responsibilities for sexual health

 

Local Authorities

  • Comprehensive sexual health services including most contraceptive services and all prescription costs, but excluding GP additionally- provided contraception
  • Sexually transmitted infections (STI) testing and treatment
  • Chlamydia Screening and HIV testing
  • Specialist services, including: young people's sexual health, teenage pregnancy      services, outreach, HIV prevention, sexual health promotion, services in schools, colleges and pharmacies

 

Clinical
Commissioning
Groups

 

  • Most abortion services
  • Sterilisation
  • Vasectomy
  • Non- sexual- health elements of phychosexual health services
  • Gynaecology including any use of contraception for non- contraceptive purposes

NHS England

 

 

 

  • Contraception provided as an additional service under the GP contract
  • HIV treatment and care (including drug costs for (PEPSE)
  • Promotion of opportunistic testing and treatment for STIs and patient- requested testing by GPs
  • Sexual health elements of prison health services
  • sexual assault referral centres
  • Cervical Screening
  • Specialist  fetal medicine services

Sexual health FAQs

The Local Government Association, Public Health England and Association of Directors of Public Health published FAQs on sexual health in February 2013.