A radical rethink of sexual health services is urgently needed to tackle rapidly increasing rates of sexually transmitted infections (STIs) including HIV/AIDS.

That is the warning issued in a timely report published today (December 1) by the NHS Confederation and the Terrence Higgins Trust to coincide with World AIDS Day.

Sexual health services says that the way in which these NHS services are currently run must be comprehensively overhauled because existing services cannot cope with Britain’s growing sexual health crisis.

Latest figures published by the Health Protection Agency last Thursday (November 24) show that the rapid increase in STI rates shows no signs of slowing down:

More than 58,000 are now living with HIV in the UK
A 9% increase in the number of chlamydia cases diagnosed means that 104,155 new cases were reported in 2004
A 37% increase in the number of syphilis cases diagnosed means that 2,254 new cases were reported in 2004.
Jo Webber, Deputy Policy Director at the NHS Confederation which represents more than 90% of NHS organisations, says: “Sexual health has traditionally been a ‘Cinderella service’ but the forthcoming publication of a government White Paper on out of hospital care is a golden opportunity for us to rethink these services.

“The government’s target that by 2008 all patients must be able to access NHS sexual health services within 48 hours presents a significant challenge and it requires a partnership approach between the NHS, local authorities and voluntary organisations.

“Dedicated NHS staff are doing their best to deal with the consequences of a rapid deterioration in our nation’s sexual health but we believe a fresh approach is needed to provide more services in the community.”

The report has five key recommendations to improve sexual health services:

Establish integrated community-based sexual health promotion services led jointly by primary care trusts and local authorities – to include schools, GP surgeries, face-to-face and outreach work in local communities
Integrate contraception and STI services – community-based services need to be strengthened so that both contraception advice and testing and treatment for STIs are available in health centres, walk-in centres, pharmacies and less traditional settings such as leisure centres, community centres and on the High Street
Expand the role of community and voluntary groups in providing sexual health services – organisations such as the Terrence Higgins Trust and many others must be better utilised to expand capacity and relieve pressure on NHS trusts
Strengthen the management of HIV/AIDS as a long-term condition – patients now live with HIV for longer and so knowledge of the condition among GPs and other primary care staff such as nurses must be increased to help manage their care, for example by establishing full or part-time GPs with a specialist HIV interest
Establish new models of sexual health and HIV primary care services – for example, enabling patients to register with a GP with a specialist interest in sexual health.
Paul Ward, Deputy Chief Executive of the Terrence Higgins Trust, says: “This report highlights the need for the extra £250 million allocated to PCTs for improving sexual services to be spent wisely over the next two years.

“It is crucial that this money gets to the frontline where it is desperately needed, and also used to expand the range of patient-led community services. If it’s diverted elsewhere, we will continue to have the worst sexual health in Western Europe for the foreseeable future.”

The joint NHS Confederation and Terrence Higgins Trust report Sexual health services is published today to not only coincide with World AIDS Day but also to influence debate about the potential for more health services to be delivered in the community, prior to the imminent publication of a government White Paper on out of hospital care.

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