Survey reveals sexual health and HIV are neglected by local NHS plans

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A new survey demonstrates how services to tackle the rapidly rising sexually transmitted infection and HIV epidemics have been neglected because of a lack of priority for those issues in the NHS. Despite guidance from the National Sexual Health & HIV strategy, abortion and contraception services don’t warrant a single mention and sexually transmitted infections and HIV feature in few Local Delivery Plans (LDPs) outside London. Equally worryingly, no Strategic Health Authority plans show how they intend to improve local sexual health services or increase investment to cope with rapidly rising need.

24 out of 28 Strategic Health Authorities provided their LDPs to sexual health organisations Brook, fpa, Medical Foundation for AIDs & Sexual Health, National Aids Trust and Terrence Higgins Trust for analysis. Key findings show that:

Just 29% of plans mentioned HIV – five in London and two in southern England. There was no service improvement commitment or identified investment targets.
Only 40% mentioned sexual health in its broadest sense – five in London – again with no service improvement commitment or investment targets identified.
Just two authorities made specific mention of STIs in full – South East and South West London SHAs – despite rocketing STI figures across the UK.
The majority (62%) of LDPs make commitments to teenage pregnancy work, but there is little apparent correlation between StHA commitments and teenage pregnancy levels in these areas.
No LDPs mentioned abortion and contraception services despite it being an area of considerable unmet need.
Paul Ward, Deputy Chief Executive of Terrence Higgins Trust said: “Local Delivery Plans do not appear to be adequately reflecting local needs. PCT Chief Executives tell us that existing targets and national health priorities are taking all their energy and resources. We understand their considerable delivery agenda, and we strongly support the need to help modernise the way the NHS spends its limited resources to best effect for local people.
“Equally vital is the need to reduce health inequalities, and that means properly investing in local sexual health and HIV services, and making the sexual health needs of the population a national priority.”

Anne Weyman, Chief Executive, fpa said, “These survey findings are cause for great concern. It is vital that local development plans take sexual health services into account if we are to reduce the numbers of STIs and ensure that contraception and abortion services receive adequate and sustained investment.
“It is totally unacceptable that PCTs are neglecting this vital area of health provision within their local development plans. They need to be supported at regional and national level to respond to the vast amount of unmet need.”

Worrying themes highlighted by the survey show that Local Delivery Plans:

Do not reflect the growth of the STI epidemics
Do not reflect the growth of the HIV epidemic
Do not reflect difficulties in access to abortion and contraception services
Do reflect national NHS priorities
Are unclear about specific improvements in relation to HIV and sexual health
In the light of the survey findings, the organisations call on the Government to:

Increase the attention paid by the NHS to tackling the growing HIV and STI epidemics
Maintain the focus upon tackling unintended teenage pregnancies
View sexual health in its broadest sense and improve abortion and contraception services
Incorporate sexual health and HIV within the national NHS Planning and Priorities Framework
Encourage PCTs to increase investment in the area of HIV and sexual health.

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