The London Sexual Health Programme is a partnership of London boroughs who have worked together over the last three years to deliver a new collaborative commissioning model for open access sexual health services.
These include services for the screening and treatment of Sexually Transmitted Infections (STIs), including HIV testing and diagnosis, and the full range of contraception. The programme was set up to lead the transformation of the service model to deliver improved public health outcomes, meet the increasing demand and deliver better cost effectiveness. In 2018 the programme activities are transitioning to a new team being hosted by the City Of London Corporation.
The scale of the problem
- London has the highest rate of STIs in England. Of the top 20 local authorities in England with the highest rates of new STIs, 17 were in London
- In 2016, more than 117,500 new STIs were diagnosed in London
- The number of cases of syphilis increased by 2 per cent in 2016, more than double the number in 2012
- STIs disproportionately affects young people in London, those aged between 15 and 24 years represent 37 per cent of all new diagnoses in 2016
- Rates of new STI cases are more prevalent in men (1,623 per 100,000) and women (1.069 per 100,00)
- Men who have sex with men (MSM) are disproportionately represented, accounting for 27 per cent of London residents visiting a specialist sexual health clinic
London boroughs spent almost £140m on sexual health services in 2015, including Genito-Urinary Medicine, Contraception and other related services. There is recent evidence that some STIs are beginning to reduce following several years of growth. In 2016, new diagnoses of HIV fell for the first time in London since the start of the epidemic in the 1980s. However, the demand for sexual health services in London continues to increase and indeed are a vital part of driving improvements in sexual health. There are also noticeable variations in access and activity across boroughs, with residents across London accessing services in central London.
What has been achieved so far?
The London Sexual Health Transformation Programme ended in March 2017 with the programme activities transitioning to a new team being hosted by the City Of London Corporation. The programme has:
- worked collaboratively to agree a new model for sexual health services. From 2018 this will include a new online (self-sampling) service that will deliver improved resident access and experience. Clinic access will still be open to all, but streamlined with those able to use the online service supported to do so.
- Across London, clinics will be providing integrated sexual health services, bringing together services for infections and for contraception. This combination is popular with service users, especially young people and young adults, helps to meet both needs together and is efficient, helping to make better use of resources.
- built and maintained partnerships across London. The Programme has been a unique collaboration in terms of scale and complexity, working across 32 councils and many services.
- The Programme’s focus is on supporting long term, financially and clinically sustainable open access sexual health services across the capital, based on shared clinical standards and outcomes.
- led a detailed and complex procurement process for the online service element of the programme, and agreed a contract with Preventx to deliver the e service from January 2018. Preventx lead a consortium including Chelsea and Westminster NHS Foundation Trust, LloydsPharmacy and Zesty.
- The Programme’s focus is on a free, confidential online service which will bring convenience for service users, designed around the changing ways people now access services, and delivers increased cost effectiveness for commissioners. As the service rolls out and develops, it has the potential to reach groups not currently in contact with services.
What happens next?
The first clinic offering the e-service will go live in January 2018, with further mobilisations across clinics in the participating boroughs over the first few months of 2018. Self-sampling kits will be available through clinics allowing patients to order a kit to be delivered to their home address.
As part of the planned roll out of the service, from May 2018 self-sampling kits will also become available in clinics to be given out to eligible service users to use in clinic or elsewhere.
The programme has issued regular briefings to stakeholders.