JSNA topic report: sexual and reproductive health

The Buckinghamshire Sexual Health services have been commissioned as an integrated model under one joint service specification with 2 providers (Buckinghamshire Healthcare NHS Trust (BHT) and Terrence Higgins Trust (THT). They work in partnership to deliver integrated sexual health service across the county within a shared common branding, Buckinghamshire Sexual Health & Wellbeing Service (bSHaW).

Buckinghamshire council commissions open access sexual and reproductive health services, which provide the following:

• sexual health services including STI testing and treatment, partner notification, contraception, chlamydia screening; except for Level 1 services provided under the General Medical Services (GMS) contract at general practice level
• HIV outreach and prevention including support to those living with HIV, education/training and improving access to rapid testing
• specialist services including young people’s sexual health, teenage pregnancy services and health promotion/outreach
• sexual health promotion services in the community, schools and colleges
• sexual health services provided by community pharmacies excluding any services provided under the NHS Pharmacy Contract
• all schools and colleges are offered free RSE (Relationships and Sex Education) training through the WISH (Wellbeing in Sexual Health) programme, accessed via the sexual health website

Together these services aim to:

• meet the sexual health needs of an individual in one visit wherever possible, rather than a service user being required to visit multiple service locations for different aspects of sexual health care; utilising the skills of clinicians and non-clinicians in a cost effective and clinically appropriate manner
• integrate sexually transmitted infection (STI) management and contraception provision in to one visit with clear referral and use of integrated pathways, including a robust pathway into the HIV treatment and care and sexual assault services commissioned by NHS England
• involve innovative and digital approaches across IT, information systems and communication
• include the specialist expertise, clinical governance and standardised training/professional development and skills of clinicians across the whole sexual health system
• provide opportunities for co-ordinated working on cross cutting issues such as risk taking, substance misuse issues, child sexual exploitation/vulnerable young people and a coordinated approach with general practice and community pharmacy provision across the county

A service user online survey was conducted as part of the Health Needs Assessment.

Unfortunately, only 50 people completed this survey and therefore it is not fully representative of people who use Buckinghamshire sexual health services.

The results showed:

• 76% of respondents found confidential and privacy most important
• 62% found courtesy and respect shown to you by the doctor or nurse as important
• 58% found friendly staff who listen to you as important
• 58% thought services could be improved through improved opening hours in the evening and weekends
• 38% thought integrated services could be improved
• 24% wanted improved waiting times

All respondents lived in Buckinghamshire:

• 20% of respondents were aged 16 to 19
• 40% aged 20 to 29
• 36% aged 30 to 49
• 4% were aged 50 to 64
• 88 % were female
• 10% were male
• 78% were straight or heterosexual
• 6% were gay or lesbian
• 4% were bisexual
• 10% preferred not to say
• 10% had a disability

Following the completion of the Health Needs Assessment a refresh of the Buckinghamshire Sexual and Reproductive Health Strategy is planned for early 2023.

This refresh will be completed in conjunction with a range of partners and stakeholders to ensure the strategy reflect a whole system approach to sexual and reproductive health.