Birmingham sexual health services under review

By on 14/10/2013 in Cllr Bedser, News

Improved support for people vulnerable to sexual violence and exploitation, a further reduction in teenage pregnancies and fewer Sexually Transmitted Infections (STIs) are among the key aims of a major review of sexual health services in Birmingham.

Public Health Birmingham has promised a greater emphasis on prevention as the £19 million-a-year service is re-modelled to meet 21st Century requirements.

And, in an effort to serve previously hard to reach vulnerable groups, GP surgeries and the voluntary sector will be given a significant role in the future service.

A public consultation has been launched and Cabinet Member for Health and Wellbeing, Cllr Steve Bedser is confident the new-look service will better meet the needs of people across the city.

He said: “As in many areas of public health, there’s no doubt we need a greater emphasis on prevention. In addition to testing, treatment and contraception. We need to focus on advice, support and preventative measures.

“We want to ensure that all residents have the opportunity to live a healthy sexual and reproductive lives, free of discrimination, regret, coercion and violence.”

Director of Public Health, Dr Adrian Phillips, added: “Taking care of your sexual health means more than being free from sexually transmitted infections, or not having to face unplanned pregnancy as a result of ineffective contraception or no contraception at all. It means taking care of your health, your partner's health, and your decisions about relationships.

“Sexual health is one of the five key national priority areas for Public Health and in Birmingham we want a service that can meet the needs of people wherever they are in the city.”

To take part in the consultation go to: https://www.birminghambeheard.org.uk/adults-communities/sexual-health-consultation

Background

The sexual health system in Birmingham must be able to support better performance against nationally set targets, namely:

  • Reducing under 18 conceptions
  • Increasing chlamydia diagnoses in the 15 - 24 age group
  • Reducing the late diagnosis of HIV

Whilst the numbers of teenage pregnancies have significantly reduced they still remain very high in some areas of the city.

In addition to these national requirements, we have identified the following priority outcomes for Birmingham:

  • Improving support for people vulnerable to, and victims of, sexual coercion, sexual violence and exploitation
  • Providing better access to services for high risk communities
  • Ensuring prompt access for earlier diagnosis and treatment
  • Increasing the use of effective good quality contraception
  • Reducing the number of people repeatedly treated for STIs
  • Reducing the number of abortions and repeat abortions
  • Reducing the transmission of HIV, STIs and blood borne viruses (BBV)

We are now asking the people of Birmingham, service users and potential service users, and current service providers to let us know whether these are the right outcomes. https://www.birminghambeheard.org.uk/adults-communities/sexual-health-consultation

Current and future need

Birmingham is growing and has the youngest population of any city in Europe.

This means that nearly 500,000 people (aged 15-44) may need to access sexual health services. Many of these are from vulnerable groups, or higher risk populations such as men who have sex with men.

The city celebrates a population from a wide range of national, ethnic, cultural and religious backgrounds. The changing age, ethnic, social and cultural structure of the population has important implications for the City's sexual and reproductive health needs.

For these reasons we need to make sure services are located in the right places and set up in the right way for now and the next few years.

Sexually Transmitted Infections & HIV

There are important patterns of these infections that need to be considered in deciding our approach to commissioning services. Latest data shows in particular:

  • Birmingham has the second largest concentration of people living with HIV (outside London). Of these, 50% had a late diagnosis, leading to avoidable ill health and potential transmission
  • Over the last five years, the number of STIs diagnosed has risen by nearly 30%.
  • Last year, 8,820 new STIs were diagnosed
  • Young people, black minority ethnic communities and men who have sex with men (MSM) are disproportionately affected
  • HIV is no longer considered a terminal diagnosis and is now a chronic disease.

Contraception

The majority of people use their family doctor for contraception services, but many use reproductive sexual health (RSH) clinics, especially young people and vulnerable groups. With a young, growing and diverse population, this represents a significant number in Birmingham. Teenage pregnancy numbers have dropped, but there is wide variation across the city with the majority of conceptions occurring in the immediate north and southern edges of the city. Birmingham has a higher than average level of repeat abortions. All of which suggests there should be better outcomes from RSH services.

Sexual coercion, exploitation, and violence

The nature and scale of these issues have started to be understood in recent years. There is a variety of services such as those for Looked After Children, the Sexually Inappropriate Behaviour Team, projects for sex workers; but they are not joined up or with clear partnerships with sexual health services. This is an area where we know that more needs to be done and we feel that working in partnership with voluntary organisations is the best way to do this because they have good links with our most vulnerable communities.

Vulnerable and at risk groups

We know that certain groups in society are more likely to experience poor sexual health, lesslikely to access services and that services do not meet their needs well, which needs to be addressed. The following vulnerable groups will be a higher priority for services:

  • Children in need and care leavers
  • Substance misusers
  • Lesbian, gay, bisexual, and transgender (LGBT) people
  • Men who have sex with men (MSM)
  • Offenders
  • People with mental health problems
  • People with learning disabilities
  • Homeless people
  • Sex workers
  • Gypsies and travellers
  • Trafficked people
  • New arrivals from abroad

An initial review of services in Birmingham carried out earlier this year indicates that there are:

  • Variations in geographical service coverage and access for Birmingham citizens
  • Variations in desired outcomes for high risk groups

And there needs to be:

  • Stronger links between services
  • More use of Family Doctors (GPs) and Pharmacies
  • Better links between voluntary organisations and the NHS

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