Sexual Health, Reproductive Health And HIV: A Review Of Commissioning

This report outlines the findings of a 2016 survey, carried out jointly with the Association of Directors of Public Health, which aimed to gain a clear picture of the commissioning arrangements for sexual health, reproductive health and HIV services | PHE

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The survey found that whilst there has been progress in improving services and the development of collaborative approaches there is also evidence of structural concerns which have the potential to impede effective commissioning. Key findings from the survey highlight the fragmentation of commissioning, barriers to access for those at greatest risk, increasing financial pressures and patient demand, and workforce concerns.

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Sexual health, reproductive health and HIV: commissioning review

Findings and action plan from a national survey of commissioning arrangements for sexual health, reproductive health and HIV. | Public Health England

In 2016 Public Health England (PHE) and the Association of Directors of Public Health (ADPH), supported by NHS England and NHS Clinical Commissioners, carried out a survey of local authorities, NHS England and Clinical Commissioning Groups (CCGs) to highlight areas of challenge within the commissioning framework.

The survey findings form the basis of an action plan published within the review. Appendix 1 provides a detailed analysis of the survey responses and appendix 2 details the action plan to respond to the challenges identified.

Full report: Sexual health, reproductive health and HIV: commissioning review

Sexual health at risk of becoming ‘Cinderella’ service, say GPs

Sexual and reproductive health is at risk of becoming a ‘Cinderella’ service thanks to red tape, and financial and training hurdles facing GPs and their practice teams, the Royal College of GPs (RCGP) has warned.

These issues risk undoing years of improvement in the quality of sexual and reproductive healthcare being delivered to patients – including a halving of teenage pregnancy rates over the past decade and steadily increasing uptake of long-acting reversible contraceptives (LARCs), it says.

The findings of a College consultation, published in a report, Time to Act, show that GPs fear rates of teenage pregnancy and transmission of sexually transmitted diseases will rise – reversing current trends – as vulnerable patients are being excluded from accessing the most appropriate forms of contraception, and widening  health inequalities as a result.

Full report: Sexual and Reproductive Health: Time to Act

Story via OnMedica

Sexual and reproductive health in England: local and national data

condom-538601_1280An updated version of Guidance to help health professionals including local government, service providers and commissioners understand the sexual health data that is available across England and how the data can be accessed. It includes data collected by
Public Health England (PHE) and other organisations.

This information provides an overview of the information available on sexually transmitted infection (STIs), HIV, contraception, conception and abortion and where to access it. It is divided into indicators (used for tracking progress), detailed local information (collation and interpretation of local intelligence) and national resources (tables and reports).

Access the full guidance: Sexual health, reproductive health and HIV in England: a guide to local and national data

Increasing the uptake of long-acting reversible contraception in general practice

Mazza, D. et al. (2016) BMJOpen. 6:e012491

Introduction: The increased use of long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, has the potential to reduce unintended pregnancy and abortion rates. However, use of LARCs in Australia is very low, despite clinical practice guidance and statements by national and international peak bodies advocating their increased use. This protocol paper describes the Australian Contraceptive ChOice pRojet (ACCORd), a cluster randomised control trial that aims to test whether an educational intervention targeting general practitioners (GPs) and establishing a rapid referral service are a cost-effective means of increasing LARC uptake.

Methods and analysis: The ACCORd intervention is adapted from the successful US Contraceptive CHOICE study and involves training GPs to provide ‘LARC First’ structured contraceptive counselling to women seeking contraception, and implementing rapid referral pathways for LARC insertion. Letters of invitation will be sent to 600 GPs in South-Eastern Melbourne. Using randomisation stratified by whether the GP inserts LARCs or not, a total of 54 groups will be allocated to the intervention (online ‘LARC First’ training and rapid referral pathways) or control arm (usual care). We aim to recruit 729 women from each arm. The primary outcome will be the number of LARCs inserted; secondary outcomes include the women’s choice of contraceptive method and quality of life (Short Form Health Survey, SF-36). The costs and outcomes of the intervention and control will be compared in a cost-effectiveness analysis.

Ethics and dissemination: The ACCORd study has been approved by the Monash University Human Research Ethics Committee: CF14/3990-2014002066 and CF16/188-2016000080. Any protocol modifications will be communicated to Ethics Committee and Trial Registration registry. The authors plan to disseminate trial outcomes through formal academic pathways comprising journal articles, nation and international conferences and reports, as well as using more ‘popular’ strategies including seminars, workshops and media engagements.

Read the article here