Sexual Health Consultation Feedback April 2015

Outlines Sexual Health in Dudley Metropolitan Borough Council Consultation Rationale and method Results Recommendations

Sexual Health commissioning responsibility As from 1 April 2013, Dudley MBC is now required by regulation to commission comprehensive sexual health services including: Contraception including implants and intrauterine contraception – but excluding non LARC contraception provided as an additional service under the GP contract STI testing and treatment, including post-exposure prophylaxis after sexual exposure, Chlamydia Screening Programme and HIV testing Sexual health aspects of psychosexual counselling Any sexual health specialist services, including young people's sexual health and teenage pregnancy services, outreach, HIV prevention and sexual health promotion work, services in schools, colleges and pharmacies

Sexual Health Service Provision in Dudley Borough Contraception and Sexual Health (CASH) services are based at Brierley Hill Health and Social Care Centre with two community clinics at Central Clinic, Dudley town centre and Halesowen Health Centre. ( level 1,2&3) Genito- Urinary Medicine (GUM) service is based at Russells Hall Hospital.( level 1,2&3) Under 25s service is provided by Dudley Brook and is based in Dudley town centre with outreach clinics in colleges and the What? Centre, Stourbridge. Service offers sexual health advice and access to contraception, pregnancy testing and STI testing.

Other sexual health services offered in Dudley Borough Chlamydia Screening Programme which is commissioned in partnership with Wolverhampton and Sandwell and delivered by Brook. Service is offered in mainstream sexual health services, pharmacies and GP practices Emergency Hormonal Contraception (EHC or “morning after pill”) are available at 60% of our pharmacies HIV prevention and support for people is offered through Summit House Support. The service also offers HIV point of care testing (POCT) and is particularly targeted at people who are in “at risk groups”

Other sexual health services offered in Dudley Borough IUCDs and Sub-dermal implants are provided in the majority of our GP practices Condom Distribution Scheme enables young people to access free condoms Point of Care HIV Testing pilot scheme is offered in 12 pharmacies, Dudley Brook and contraception and sexual health (CASH) clinics. Respect Yourself Team provides holistic support to prevent teenage pregnancy and support teenage parents, this includes domiciliary sexual health services funded by PH Abortion services which are commissioned by the CCG, PH monitor early access on behalf of the CCG

Our vision – What we want to achieve … To have the best sexual health and sexual health services in the country Our objectives are: Ensuring sexual health is everyone’s business and it is in everyone’s agenda Ensuring we commission according to the evidence base and needs of our local communities Effective partnership and collaborative working The strategic and operational directions of sexual health are determined by service users

How we will achieve our objectives Have efficient, effective and accessible sexual health services that meet the need of our population, particularly amongst those at highest risk of sexual ill health Reduction in sexual health inequalities amongst those more at risk of poor sexual health Ensure high quality, confidential service provision Increased opportunities for diagnosis and effective management of STIs, and preventing re-infection Increased uptake of HIV testing and rapid referral to HIV care services Increase uptake of Chlamydia testing, diagnosis and treatment Increased uptake of effective methods of contraception, including access to LARC for all age groups Continued reduction in teenage conception rates Reduction in repeat abortions

Consultation Method & Activity 28 th Jan to March 10 th 2015 Stakeholder Analysis/Stakeholder Discussion(s) Service User Questionnaire (GUM/CaSH/Brook n=707) On-line surveys…. On-line Young Persons Survey (n=68) On-line General Public Survey (n=88) On-line Stakeholder Survey (n=63) On-line Provider Survey (n= 15) Focus Groups/Targeted Work (DAWN, CfED, HIV clients, MSM, Young People, LD, NEET) Stakeholder Workshop (n=54 including young people and service users)

NEET DAWN Colleges CaSH Pharmacy CVS FIT Youth Service FNP Respect Yourself Learning Disability GUM YoS Connexions CFED What Centre GPs Brook Drug & Alcohol School Health Stakeholders…..

Pharmacy

Key Focus Areas Views on current provision Ease of access to contraception and STI testing and treatment Preference for a one-stop shop model Preference between 2 models; Service for all ages Dedicated young peoples service Preferred service location (including Dudley town centre)

Views on current provision Question asked via all activity/overwhelmingly positive

Gaps in Provision Psychosexual and menopause counselling Single point of access/self management options Branding & Marketing

Ease of Access …(YP/Contraception)

Ease of Access …(YP/STI testing and treatment)

One-Stop? All providers and stakeholders we spoke to preferred the possibility of a one-stop shop. In the on-line surveys and service user questionnaire we asked if participants would prefer to be able to access a one-stop shop providing contraception and STI testing in the same place. The responses indicated a clear preference for this option; 52% of young people preferred a one-stop shop (26% not bothered either way, 15% don’t know) 70% of the general public preferred a one stop shop (3.3% said no, 25% not bothered, 1% don’t know) 89% of service users preferred a one-stop shop (5% No and 6% don’t know) From this, the consultation supports one-stop provision wherever possible.

Service Model In the young person’s survey the majority of respondents preferred a separate dedicated service for young people or didn’t know;

Young people represented only 17% of the 707 service user respondents. However, of these 17%, 55% opted for a dedicated service for young people;

From a stakeholder perspective the preference was clearly for a separate service for young people with 70% choosing this option and only 23% option 1;

Recommendations The consultation activity actively supports a recommendation to expand one stop provision and provide comprehensive contraception and STI screening/testing/treatment in Dudley MBCs services. Services in Dudley town centre should be considered as part of the overall matrix of provision, but carefully consider aspects such as transport links and parking Young people’s dedicated services should be developed in addition to services for all ages as part of an overall matrix of provision. In particular these need to be locality based and in the main colleges. Commissioners should task potential providers to demonstrate how they would particularly cater for young people based on epidemiological data and local insight