The National Sexual Health and HIV

Strategy

Cathy Hamlyn

Head of Sexual Health and Substance Misuse

Department of Health

Aims

• Reduce HIV and STIs

• Reduce prevalence of undiagnosed HIV and STIs

• Reduce unintended pregnancy rates

• Improve health and social care for people living with HIV.

• Reduce stigma associated with HIV and STIs

Better Prevention

• New national safer sex campaign• Targeted local prevention campaigns • More responsive national helplines• Evidence base for HIV/STI prevention• High priority to HIV prevention gay men• African Communities strategic framework• Needle exchange schemes• Sexual health of people living with HIV• Role of service providers in prevention

Better Services• Widen the role of primary care• Improve access to GUM services• HIV Standards ( sexual health standards)• Managed clinical networks• One Stop Shops• Chlamydia screening from 2002• Range of contraceptive services• Abortion address disparities/RCOG • Guidelines/info re counselling and TOP • Expand HIV testing• Increase hepatitis B vaccination

Model of Services

Level 1 All primary care teams/GU service/family planning clinicsLevel 2 Primary care teams with extra skills/GUM/family planningLevel 3 Specialist servicesGUM/FP/TOP

Levels of Service

1• Sexual history, STI/HIV testing,pregnancy

testing/referral,contraception,assessment of men with STI symptoms,cervical cytology screening, HepB immunisation

• IUDs,testing/treatingSTIs,implants,partner notification, invasive testing/men,vasectomy2

• Sexual health needs assessment, clinical governance, outreach , partner notification co-ordination, specialist contraception, specialist HIV treatment and care

3

Commissioning

• From April 2002 PCTs to commission

sexual health services.

• Specialised services for HIV

treatment at appropriate level.

• Local multi-agency group

• Sexual health plan in HIMP

• Reducing inequalities

• User views

• Performance Indicators

What Does the Strategy Say About Sexual Health Advisers ?

• Development of the role of health advisers

• Defining the role and responsibilities

• Increasing the numbers of sexual health advisers

• Improving partner notification

• Development of a health advising qualification by 2005

Responses to Strategy

• Agreement re issues and proposals• Action to achieve change• Lack of cross-Government support• Status of strategy• Need for more joined-up-ness • Medical model ;support;role of LAs• Capacity to reduce stigma• Capacity of PCTs to commission HIV• Concern re mainstreaming • Performance indicators/service standards• Commissioning toolkit• Increasing capacity of services• Service model/clinical govern./HIV testing• Training, training,training!

Next Steps

• Response to consultation Spring 2002

• Action plan Spring 2002

• Business plan for work cross-Government

• Base-line assessment received Mar 2002

• Consider capacity for delivery

• Consider mechanisms for local implementation

• Priorities for resources Spring 2002

National Implementationxxx

• Monitoring of HIV investment(May)• Mechanisms for user involvement• Commissioning toolkit (July)• National advisory arrangements (Summer)• Review data availability• Indicators and targets (October)• Set of standards end of 2002/3• First plans due for implementation April 03

Actions-Health Promotion

• Evidence on HIV and STI prevention (April)• Contraception and abortion evidence• HIV prejudice advertising campaign• Addressing stigma and discrimination• Pro-HIV testing campaign(Autumn)• Targeted prevention-gay men CHAPS and

African Prevention Framework• Health Promotion Toolkit ( August)• Role of Helplines• Sexual Health Public Information review• Role of schools and further education

Safer Sex Campaign

• Limited radio and TV campaign ( running)

• Review of evidence( March)

• Information about services

• Commission campaign ( June)

• Brief local areas of plans ( Summer)

• Campaign starts( October)

• Evaluation

Actions -Services

• Model of service description ( May)• Chlamydia screening roll-out ( May)• One Stop Shops pilots (Spring)• Health Advisers action plan ( Spring) • HIV testing briefing ( July)• African Communities Framework( June)• Contraception inc EC,Condoms• Abortion -addressing disparities• GUM waiting times• Managed service networks ( March 03)• Targeted services good practice (2003)

Actions-Support

• Commission report on support needs of adults living with HIV( September)

• Commission report on support needs of children living with HIV( September)

• Review Aids Support Grant(October)

• Support needs of people with STIs

• Skills development for people living with HIV-good practice( late 2002)

Supporting Change

• Mapping of skills and other professional training July

• Training strategy Summer 2002

• Workforce projections

• Review Aids Control Act- data requirements Summer 2002

• Research gaps/priorities-literature review

Issues and Challenges• Limited resources• NHS reorganisation• Finding a Local lead and champions• Many other priorities in NHS Plan• Primary Care under pressure• Engaging PCTs• Shortage of skilled staff• Existing services under pressure• Need to address access and standards• Need to address inequality• Emotional and Social support

How Do We Ensure Effective Implementation

• Leadership and Champions• Partnership and Participation• Raising the Profile• Linkage to other agendas• General and Targeted approach• Cross-cutting agenda • Levers-Indicators and targets• Monitoring of progress and outcomes • Guidance, support and direction• A little bit of money helps!