Improving Sexual Health in London:
achievements and challenges
Hong Tan
London Sexual Health Programme Director
London Sexual Health Forum
7th December 2011
Structure
Policy
Performance
Opportunities
Challenges
Policy
Sexual Health
=QUIPP
=in-year savings
=open access to
treatment as
prevention
The total cost of
sexual violence has
fallen from 22.8bn
in 2001 to 15.7bn
in 2008
Unintended
Pregnancies cost
NHS in London
£105m:
If 9% choose
LARC= c£106
Savings
£1 in
contraception
=
If 9% use
condoms –
c£93m savings
£11 savings in
NHS Costs
If 9% use oral
contraceptives
= c£94m
savings
Policy
police
???
???
education
???
£££
Big Society
health
and social
care
???
London Sexual Health Commissioning Board - Leading and
Strengthening Sexual Health Commissioning in London
DPHs
London Specialised
Commissioning Board
Cluster PCT
Directors of
Commissioning/ MDs
London Sexual Health
Commissioning Board
Teen Pregnancy Leads
NCSP- London
London Sexual Health
Programme
London
Havens
Strategic
Board
Chlamydia
Screening
Strategic
Network
Sexual Health
Network
Subgroups
London
Contraception
and
Abortion Group,
London LARC
Network
Pan London
HIV Prevention
Group
London Sexual
Health forum
Commissioning
Network
Pan London
Procurement*
2012
Planning
Group *
FESHproNET:
Tariffs*
Further Education
Sexual Health
Network*
London Sexual Health Programme. 16th Floor, Portland House, Stag Place. London, SW1E 5RS.
*Time limited
simon.mercer@londonscg.nhs.uk
London
Sexual
Health
Improvement
- NHS London*
London Firsts
Implementing London's Sexual Health Strategic Framework: Vision to
improve Sexual Health with integrated Sexual Health services:
FIRSTS
• Reducing late diagnosis of HIV – proposed as 1 of 3 national
Sexual Health outcomes in the Public Health outcomes
Framework
• Award –winning “Where is your line?” Cannes Bronze Lion,
4 Blue Arrows British Advertising awards
• 2012 Olympic and Paralympic Games – focus on Sexual Health
and Young People: Sex Factor
• Workforce- Higher Education Institutions, London PGDs
London Firsts
•
•
•
•
•
•
•
FIRSTS
Improving uptake and access to LARC – more fitters
trained than any SHA
PPE toolkit
London needs assessment for Sexual Assault
(paediatric, adult reviews)
London needs assessment on HIV prevention
London C-card scheme and sponsored condoms
London young People’s Sexual Health showcases
MANY OTHERS!
Performance
Under 18 Conceptions
• 2009 first quarter 39.3 per 1000
• 2010 first quarter 37.9 per 1000 3.6% Lower
Abortion rate for women under 18
• 2009 first quarter – 17.7 per 1000
• 2010 first quarter 16.6 per 1000 6.2% Decrease
Chlamydia Tests -15-24 years
• 2009/2010 – 29.84% tests pa
• 2010/2011 – 32.53% tests pa 2.69% Increase
HIV late Diagnosis
• 2008 53% late diagnosis (C4 Count <350)
• 2009 51% late diagnosis 2% Decrease
LARC Uptake
• 2009/2010 – c46k prescribed
• 2010/2011 – c51k prescribed 10.8% Increase
Change: Challenges and Opportunities
• Liberating the NHS, Revised operating
framework for NHS- prioritised tariffs,
localism, QIPP, New commissioning
structures (GP commissioning
consortia, Public Health Service, NHS
Commissioning Board)
• Public Health White paper
• Social Care White paper
• Others- Policies into the 21st Century
Change: Challenges and Opportunities
• £20 billion savings- Sexual Health delivers QIPP in-year
• Local authority commissioning- political drivers? Priority?Engage Local Authorities, wider determinants of health now
• Capped budget vs open access? Lets work with DPHS, Local
Authority Councillors on Health Improvement Board Now.
• No mandatory use of NHS tariffs – Let’s make tariffs live in
2012-2013 and show they are robust and improve Sexual
Health
• Fragmentation of commissioning – NHS Commissioning Board
(CCGs, specialised commissioning) vs PH England, Local
Authorities – Let’s drive governance agenda in 2012-2013
London Sexual Health Commissioning
• Board Report to London SCG
Priorities for London Sexual Health
Programme and Commissioning Board in
2012-2013
Implement Sexual Health Tariffs
Strategic commissioning of the Havens
Focus on reducing late diagnosis of HIV – HIV testing standard
in Primary Care
Opportunities for procurement efficiencies
2012 Olympic and Paralympic Games - Legacy
Shaping transition
Conclusion
• 2012: focus on London for Sexual
Health
• Many achievements and firsts
because of YOU, US ALL
• Shape change – address challenges
and opportunities
LET’S SIEZE THE DAY
LET’S BE BOLD!
THANK YOU