Sexual Health Performance improvement – The Story So Far!

1. Sexual Health Performance improvement – The Story So Far!

3. Public health outcomes in London London has some of the worst health outcomes in the country in some key areas (including SH), and poor performance in prevention activity. Gross inequalities exist across the capital, both in the quality of preventive services and in health outcomes. NHS London prevention strategy, June 09 • Five public health priorities identified for focused improvement: - Childhood immunisations - Tobacco control and smoking cessation - Screening - Sexual health - Vascular Health

4. Sexual Health Sexual health is a particularly demanding public health and financial challenge for London. It affects the majority of the population, is linked increasingly with poverty and inequality, and is still associated with stigma. In London, we face the highest rates of sexual ill-health in the country. London Sex & Our City report 2008

5. London Sexual Health Improvement programme 2010/11 Sexual health providers will develop integrated services across primary, community and secondary care using London Sexual Health tariffs to enable equity of access to integrated Sexual Health services. This will be under a Clinical Director providing leadership to the network of service providers, and with particular responsibility for clinical governance and training. • Prioritise the delivery of Standard 5: • Focus on : - Improving access to and awareness of Long Acting Reversible Contraception (LARC) - Improving access to and awareness of Emergency Hormonal Contraception (EHC) - Reducing repeat terminations - Aim for universal minimum standard of: the offer of a comprehensive and accessible contraceptive service to Londoners.

8. Performance Improvement Approach Tried and tested approach Self assessment developed with the LSHP, clinicians and commissioners Robust review of sexual health commissioning in your PCT through self assessment with partners • Action plans to meet any gaps identified • Challenge meetings to review draft action plans • Finalised action plans signed off by PCT CE

9. Benefits of approach • Secures senior level buy-in for sexual health. • QIPP Quick Win • Maintains focus during period of transition • Galvanises expert support from sexual health clinicians, commissioners and academics. • Pan London funding to support themes identified.

10. Key themes and challenges • Good examples of progress on service integration and delivery • Lack of trained LARC fitters, especially in PC • Young people focused • Fragmented commissioning • Informal referral pathways • Reducing commissioning capacity • Varied levels of engagement with PC • Wealth of good practice examples • Enthusiasm and can-do, will do and inspirational attitude

11. What next • Dashboard development • Programme of support to include: • LARC train the trainer programme to include exploring the role of practice nursing and pharmacists • LARC champions • Showcase good practice/case studies • Sexual Health and QIPP • Explore options for pan-London commissioning and standardisation • Next Steps workshop this afternoon

13. Workshop – Sustaining Improvements in Sexual Health • What can we do at Borough, Sector and Pan London levels to: • Sustain sexual health improvements through the organisational changes in the NHS? • Maximise opportunities of QIPP to improve Sexual Health?