Welcome
28 November 2019 (Issue 56)
Welcome to the November issue of the Sexual Health, Reproductive Health & HIV Policy eBulletin. Over the course of 2019 calls for a new national sexual and reproductive health strategy to help address the current challenges facing the sector and prioritise sector-led improvement have been growing. The Government has now confirmed, as part of its recent response to the Select Committee report on sexual health, that it will be putting in place a process for starting work on a new strategy. The work will be led by the DHSC in partnership with PHE, NHS England and Improvement, local government and other key partners with the production of a new strategy by late 2020. The pressure for the next Government to deliver on this continues with the launch of a sexual health manifesto ahead of the general election. The manifesto is supported by over 36 sector organisations and charities and calls for government action in 8 key areas, including the development of a new strategy. Yesterday FSRH and RCOG also published a joint manifesto championing a life-course approach to women’s health and including calls for better co-commissioning of SRH services and the decrimalisation of abortion in England and Wales
Significant advances were made last month in sexual and reproductive health rights for women in Northern Ireland (NI) with new legislation decriminalising abortion coming into effect on 21 October 2019. A proposed new framework to provide lawful access to abortion services in NI should be in place by 31 March 2020. This momentous change comes after years of campaigning by parliamentarians, health professionals and advocacy groups.
In this month’s eBulletin we also bring you the launch of a new report from FSRH which sets out the case for embedding SRH services into new models of care and features best practice examples of local areas innovating in the design and delivery of SRH services. The report also unveils the results of an audit conducted by FSRH last year, showing that only a quarter of areas mentioned contraceptive services and other SRH services in their plans, potentially missing opportunities to improve access to sexual and reproductive healthcare.
Other items to look out for in this month’s round-up include: a call for evidence from the HIV Commission to inform a set of recommendations to end new HIV transmissions and HIV-attributed deaths in England by 2030; a new PHE report on how HIV impacts on women in the UK; latest data from NHS Digital on cervical screening coverage and contacts with SRH services in England and resources from both the DfE and LGA on engaging with schools to support inclusive teaching of RSE.
This month’s eFeature is by Leanne Bobb, Commissioning Manager, London Borough of Sutton.
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eFeature
Leanne Bobb is a Commissioning Manager at the London Borough of Sutton. She has been the commissioner for sexual and reproductive health since April 2016 and previously was coordinator of the UK's first sexual health and contraceptive provider network, SWAGNET. Leanne is also one of the London representatives on the English Sexual Health & HIV Commissioners Executive Committee. In this eFeature, Leanne looks at the challenges that sexual health and reproductive health commissioners are facing in the current climate. She believes that adopting a whole systems approach to service commissioning is key to delivering innovative, high quality services and says this will require excellent working relationships across the system – commissioner to provider, commissioner to commissioner, provider to provider and organisation to organisation.
>See Leanne Bobb eFeature
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Policy development and guidance
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Sexual Health Manifesto
Up to 36 HIV and sexual health sector organisations, professional bodies and charities have signed a Sexual Health Manifesto drawn up by Terrence Higgins Trust (THT) in the run up to the General Election. The Manifesto was launched on 12 November and calls for the new Government to act in 8 key areas, including delivering a national sexual health strategy, fully funding sexual health services and implementing routine commissioning of PrEP. Click the links below for more information on the Manifesto and to see how you can add your voice to the campaign.
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Joint FSRH/RCOG Manifesto
The Faculty of Sexual and Reproductive Healthcare (FSRH) and Royal College of Obstetricians and Gynaecologists (RCOG) have published a joint manifesto ahead of the general election. The manifesto outlines a vision for improving the health of girls and women in the UK, with five specific calls to action for the next government, including a national women’s health strategy, better co-comissioning of SRH services and decriminalisation of abortion in England and Wales.
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HIV Commission call for evidence
The HIV Commission is asking individuals and organisations to submit written evidence in order to inform a set of recommendations to end new HIV transmissions and HIV-attributed deaths in England by 2030. The Commission has identified five key themes on which to seek views and hopes to hear from a wide variety of organisations, including charities, public bodies, businesses, researchers and public health experts as well as those directly affected by HIV. Written evidence should be submitted by 31 January 2020. The HIV Commission aims to publish its recommendations by Spring 2020.
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Government response parliamentary report on sexual health
The Government has published its response to the Health & Social Care Committee report on sexual health. It responds to the Committees range of recommendations, most significantly agreeing to the development of a new sexual and reproductive health strategy for England. The Department of Health & Social Care (DHSC) will work with Public Health England (PHE), NHS England and Improvement, local government and other partners to deliver this.
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Advancing our Health consultation
The Department of Health & Social Care (DHSC) and Cabinet Office consultation on Advancing our Health: prevention in the 2020s closed on 14 October 2019. Sector organisations have submitted a responses identifying priority areas including more sustainable funding and greater accountability for co-commissioning for sexual health and SRH services.
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Changes to the law in NI on Abortion
Legislation decriminalising abortion in Northern Ireland came into effect on 21 October 2019. This means that no criminal charges can be brought against women who have an abortion or health care professionals who provide abortion care. The UK Government has set up a 6-week consultation (4 Nov -16 Dec) seeking views on a proposed new framework to provide lawful access to abortion services in NI by 31 March 2020. It has also issued interim guidance to health professionals covering the period from now until the end of March 2020. Until then every woman in NI who requests an abortion will be able to access funds to travel to England for abortion care.
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Buffer Zones around abortion clinics
A coalition of charities and medical bodies which includes Marie Stopes, British Pregnancy Advisory Service, FSRH, Royal College of Midwives (RCM) and RCOG has written a letter to the new Home Secretary, Priti Patel, urging her to look again at the issue of clinic protests in light of new FOI evidence that the previous consultation was based on “incomplete evidence” that underplayed the impact of anti-abortion activists on pregnant women.
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IPPR analysis on public health funding
A new analysis and briefing from the Institute for Public Policy Research (IPPR) has found that the most deprived areas in England have faced a disproportionate burden of public health cuts, despite having the greatest public health need. While public health services across the country have all had budget cuts, absolute cuts faced by the poorest areas have been six times larger than the least deprived. IPPR urges the next Government to deliver fair funding for public health and redistribution where service need is greatest and where cuts have been felt the hardest.
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Health and social care and LGBT communities
The Women and Equalities Select Committee has published its report on health and social care and LGBT communities. The report says that deep inequalities exist in health outcomes for LGBT people and that services must work to ensure they are inclusive and take into account the needs of these communities.
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Service standards & guidelines
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New NICE guidance on abortion care
The National Institute for Health and Care Excellence (NICE) has issued new guidance on abortion care. The guidance, developed with RCOG, includes recommendations on improving access, reducing waiting times and improving choice of procedure.
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Heavy Menstrual Bleeding quality standard update
NICE has opened a consultation on a draft quality standard for heavy menstrual bleeding. The standard will update the existing standard on heavy menstrual bleeding published in 2013. The consultation on the updated standard closes on 16 December 2019. The final quality standard is expected to be published in June 2020.
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NICE consultation on quality standard on community pharmacies
NICE has also started the process of developing a quality standard on promoting health and wellbeing in community pharmacies. The full consultation is scheduled to take place in January 2020, with a final publication date of June 2020.
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Joint statement on tattooing and cosmetic treatments for people with HIV
The British HIV Association (BHIVA), British Association for Sexual Health and HIV (BASHH), NAT, THT and HIV Scotland have recently produced a joint statement explaining that HIV and HIV treatment do not present a barrier to tattooing, piercing and cosmetic or routine beauty treatments. The statement is in response to reports from the HIV positive community of being refused tattoos or asked about their HIV status by beauty treatment providers in pre-treatment questionnaires.
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Guidance on management of potential exposure to blood-borne viruses in emergency workers
This guidance contains recommendations for frontline emergency service workers on how to prevent and control exposure to common blood-borne viruses (BBVs) such as hepatitis C and HIV following injury or assault. It includes the steps that should be taken in the event of exposure as well as information on the stigma and myths often associated with concerns about transmission of infection.
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BHIVA guidelines for the management of HIV in pregnancy and postpartum 2018 (2019 second interim update)
These guidelines provide guidance on best clinical practice in the treatment and management of women living with HIV in the UK during pregnancy and postpartum. The purpose of a further 2019 interim review is to update significant developments that would either lead to a change in recommendation or a change in the strength of recommendation.
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Data, evidence & research
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Cervical Screening Programme, England – 2018/19
The latest annual report on cervical screening coverage has been published by NHS Digital. 71% of eligible women aged 25-64 were screened in 2018/19, only a 0.5% increase on the previous year and still well below the target of 80% coverage. The outcome of a national review of adult screening programmes commissioned by the DHSC and led by Sir Mike Richards was published in October. It acknowledges that SRH services have a role to play in increasing uptake of cervical screening and FSRH has called for an integrated approach to commissioning cervical screening between primary care and sexual and reproductive health.
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Quarterly conceptions to women aged under 18 (Q3, 2018)
Quarterly statistics on conceptions to women under 18 in England and Wales (Q3, 2018) were released by the Office for National Statistics (ONS) on 26 November 2019. For England, there has been a 3.6% reduction in rates compared to the same quarter in 2017. Five regions have seen a reduction in rates and four an increase in rates compared to Q3 in 2017.
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Key Data on Young People 2019
The Association for Young People’s Health (AYPH) has published the 12th edition of the Key Data on Young People series. The new edition reflects current issues and concerns about young people’s health and includes a chapter on sexual health and identity.
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Women and HIV in the UK
This PHE report, with contributions from THT and Sophia Forum, provides detailed information on how the HIV epidemic impacts women in the UK. Key findings include that women receive fewer HIV tests and that women with HIV are still very likely to be diagnosed late and experience poverty, stigma and unmet health and social needs. The report points out that health and social care services need to respond to the diverse and complex health issues of women with HIV to prevent inequalities in their care and ensure they enjoy long, healthy lives.
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SRH Services (Contraception) in England 2018/19
NHS Digital has published the latest data on sexual and reproductive health services in England. There were 1.4 million contacts with SRH services for contraception in 2018/19, down 3% on the previous year and 25% compared to 2014/15.
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Local Authority Health Profiles 2019
Local Authority Health Profiles 2019 were published on 22 October. These profiles provide a summary of the health of the population in each local authority area. They pull together data on a range of indicators for local populations, including teenage conception rates and new STI diagnoses rates (excluding chlamydia).
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Sexual and Reproductive Health Profile
PHE's sexual and reproductive health profile indicators have also been updated to include latest data on abortions, contraceptive use, teenage conceptions, STIs and HIV.
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Sexual Orientation and Inclusive Gender Identity Monitoring survey
For the past two months NHS England has been conducting a survey to ascertain the extent to which services are currently collecting Sexual Orientation Monitoring data for patients. The Sexual Orientation Monitoring Information Standard provides the categories for recording sexual orientation but does not mandate collection. The survey closed yesterday (27 November).
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Reports & other resources
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FSRH new models of care report
A new report - Opportunities to embed sexual and reproductive healthcare services into new models of care. A practical guide for commissioners and service providers – has been launched by FSRH. The report sets out the case for embedding SRH services into new models of care and features best practice examples of areas innovating in the design and delivery of SRH services. The report also unveils the results of an audit FSRH conducted last year, showing that only a quarter of areas mentioned contraceptive services and other SRH services in their plans, potentially missing opportunities to improve access to sexual and reproductive healthcare.
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Guides for parents on Relationships and Sex Education
Earlier this year the Department for Education (DfE) produced guides for parents of primary and secondary age pupils on the teaching of relationships and sex education. The guides have been translated and are now available in Arabic, Somali and Urdu.
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Parental engagement in Relationships Education
This document from the DfE and other partners provides information to primary schools on what is expected of them in terms of parental engagement on the forthcoming introduction of Relationships Education in September 2020. It also provides advice, tips and case studies on effective parental engagement.
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Managing issues with LGBT teaching: advice for local authorities
The DfE has also recently produced advice for local authorities on how to manage parental concerns about the teaching of LGBT content in primary schools. This is in response to protests at a small number of primary schools earlier this year.
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Engaging with schools and communities to support inclusive teaching of RSE
This briefing provides top tips, helpful resources and case studies from seven councils, showcasing a small selection of pro-active approaches being taken across the country to support inclusive RSE.
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World AIDS Day 2019
World AIDS Day will take place on 1 December 2019. It’s an opportunity for people in the UK and worldwide to unite in the fight against HIV and to show support for people living with HIV. A range of posters and social media images are available to download from NAT’s WAD website with the #ROCKTHERIBBON theme. You can also find information about events taking place around the country.
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#SmashAbortionStigma campaign
Leading global sexual and reproductive healthcare charity Marie Stopes International has launched a campaign to smash abortion stigma and champion the right of women to access abortion care. #SmashAbortionStigma addresses the need for open conversation by calling on people to break the silence around abortion and to bring abortion to the forefront of everyday conversations. The charity is encouraging people to get involved by sharing their stories on social media using the hashtag or by recording a short video explaining why they are pro-choice.
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FSRH office move
The FSRH are now based in South London with the RCOG. The move took place on 11 November and the new address is 10-18 Union Street, SE1 1SZ.
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Ensuring access to the full curriculum
The Welsh Government has opened a consultation seeking views on the impact of the proposal to change parents' ability to withdraw their children from Religious Education (RE) and Relationships and Sexuality Education (RSE) in the new curriculum to be introduced in 2022. The consultation runs until 28 November.
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Guidance for inspectors of care services in Scotland
The Care Inspectorate and National AIDS Trust (NAT) have worked together to produce the first ever guidance for inspectors of care services to assess whether the needs of people living with HIV in Scotland are being met in care services.
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New UK aid to prioritise women's sexual and reproductive health rights
The Department for International Development (DFID) has announced new funding which will give millions of women and girls access to family planning over the next five years and support global efforts to promote sexual and reproductive rights for those living in the poorest countries.
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October edition of EUROBulletin
The latest edition of the Sexual Health & HIV Policy EUROBulletin is now available. It includes a round-up of policy news from the region as well as an interview with Alice Lucas, Advocacy and Policy Manager at Refugee Rights Europe about the sexual and reproductive healthcare issues facing displaced people in Europe.
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The Sexual Health & HIV Policy eBulletin was originally developed and published by MEDFASH.
It continues to be compiled and edited by Helen Christophers on behalf of FSRH and coalition partners. If you have any comments on the eBulletin or eFeature or suggestions for topics you would like to see covered in future eFeatures please get in touch (ebulletineditor@fsrh.org).
You can access previous eBulletins and eFeatures via the links below:
> eBulletin archive (MEDFASH) > eFeature archive (MEDFASH/FSRH)
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