1. Sexual Health Update Community Pharmacy Sheffield
Amy Buddery, Health Improvement Principal
Public Health, Sheffield City Council

2. Questions What does good sexual health look like?
What role does/can Community Pharmacy have in improving sexual health?
What barriers exist?
2/3 actions to take away

3. Sexual Health & Community Pharmacy
A Framework for Sexual Health Improvement DH (2013)
NPA – Healthy Living Pharmacies: taking a pro active approach to health & health improvement
Important component of a well functioning sexual health system that support access, promotes choice and address inequalities

4. Contribution to Improving Sexual Health
Support access and rapid access to specialist services
Provide information and supports prevention
Earlier diagnosis of STIs and access to treatment
Protecting and safeguarding young people
Providing support to those most at risk
Supports wider determinants of sexual health
Forms part of care pathways

5. Public Health Outcome Indicators
Reduce the number of teenage conceptions (females aged per 1,000) (23.6 per 1,000)
Reduce the rate of late diagnosis of HIV (58%)
Increase the chlamydia detection rate (people age per 100,000) (1583 against a target of 2300)

6. Facts and Figures -STIs
Overall 3838 new sexually transmitted infections (STIs) were diagnosed in residents of Sheffield, a rate of per 100,000 residents (compared to per 100,000 in England).
In Sheffield, an estimated 6.1% of women and 8.1% of men presenting with a new STI at a specialist SHC during the 5 year period from 2010 to 2015 were re-infected with a new STI within 12 months.
Sheffield has the 55th highest rate (out of 326 local authorities in England) for gonorrhoea, which is a marker of high levels of risky sexual activity. The rate of gonorrhoea diagnoses per 100,000 in this local authority was 64.2 (compared to 70.7 per 100,000 in England).

7. Facts and Figures
There were 20 new late HIV diagnoses in Sheffield. The diagnosed HIV prevalence was 1.8 per 1,000 population aged years (compared to 2.26 per 1,000 in England).
In Sheffield, between 2013 and 2015, 57.5% (95% confidence interval [CI] ) of HIV diagnoses were made at a late stage of infection (CD4 count <350 cells/mm³ within 3 months of diagnosis) compared to 40.3% (95% CI ) in England.
58% of diagnoses of new STIs in Sheffield were in young people aged years (compared to 45% in England).

8. Proportion of new STIs by age group and gender in Sheffield: 2015

10. Reproductive Health
% of year olds prescribed user dependant oral contraceptives rather than long acting reversible methods
2015 – 1500 women in Sheffield were prescribed emergency hormonal contraception 13.4% - higher than the national average of 10%

11. Access to Emergency Hormonal Contraception (EHC)
Community Pharmacy Scheme ≤ age 17 via PGD
PGD for EHC in place at both University GP Practices
Available at GP Practices
Available at Sexual Health Service

12. EHC - levonorgestrel (Levonelle)
PGD in place ≤ age 17 – looking to expand upper age limit to 24 years
Self declaration of competence
Under review –following Faculty of Sexual and Reproductive Health Guidance (March 2017) on use for patients with a BMI over 26
Being discussed at Formulary Sub Group and APG (21st Sept)
Look out for amendments

13. EHC – ulipristal (EllaOne)
PGD ≤ age 17 currently suspended due to changes to reclassification from a POM to a Pmed
looking to expand upper age limit to 24 years
Local guidance being drafted to include agreed use of Levonelle following APG mtg 21st Sept
Look out for changes

14. Condoms & Chlamydia
Increased availability of self testing kits for chlamydia/gonorrhoea order from Sexual Health Sheffield Service
Condoms for EHC and NEX Pharmacies contact

15. Future Development of Provision
Level 1 – condoms, EHC, self testing kits
Level 2 – initiation and on going supply of oral contraceptives, injectable contraceptives, HIV testing
Introduction of Pharmoutcomes

16. Questions What does good sexual health look like?
What role does/can Community Pharmacy have in improving sexual health?
What barriers exist?
2/3 actions to take away