Listening to feedback: changes to York’s sexual health service

A number of changes have now been agreed to the way sexual health services are provided in York, which follows a consultation on proposed changes and listening to respondents’ feedback.

The consultation ran between July and September and saw over 100 people respond.

The sexual health service in York is delivered through YorSexualHealth, provided by the York and Scarborough Teaching Hospitals NHS Foundation Trust.

The council has worked closely with the York and Scarborough Teaching Hospitals NHS Foundation Trust to review the service and its partnership, as part of the re-procurement of the service for the next 10 years.

The consultation highlighted the need for a number of changes, following a 30 per cent reduction in the public health grant since 2015, which funds the service.

The provision of free, comprehensive, open access sexual health and contraceptive services is a mandated Public Health function of local authorities, as part of the Health and Social Care Act 2012.

A report was taken to an Executive meeting in June to outline what these changes could mean, before going out to consultation.

The contract with the York and Scarborough Teaching Hospitals NHS Foundation Trust was renewed in July, and following Executive approval was extended for an additional 12-month period.

In order to deliver the new contract, the York and Scarborough Teaching Hospitals NHS Foundation Trust and the council identified that some efficiencies would need to be made to the service. These will now be introduced soon, through a staged approach during the 12-month extension period, to ensure robust monitoring and evaluation.

The changes include these staged service reductions over a 12-month period:

1. A reduction in the number of clinic hours the service is open for: The council and York and Scarborough Teaching Hospitals NHS Foundation Trust listened to feedback on the Saturday closure proposals, which was unpopular with respondents. We have revised our thinking on this and are looking at closing the service at a different time to lessen the impact. Instead, the clinic will now close on a Wednesday morning.

2. A further cap on activity relating to Preventx for York residents. (online STI testing): The service will now offer an ‘enhanced triage’ or clinician recommended approach, to ensure that service users get the right test for them, which is better for both the service user and the cost efficiency of the service. This also brings the online testing provision in line with the testing that is offered when attending the service in person.

3. A cap on activity relating to LARC (Long-Acting Reversible Contraception) including contraceptive coils and contraceptive implants: York has a high number of LARC fitted per head of population, well above the national average. This means we are building from a strong position in access to contraception in the city, and need to ensure that this remains a specialist service available to those who need it. However, last year over 3,000 people attended for basic contraception needs, which GPs and Pharmacists can support with. Pharmacists can also issue repeat contraception and initial contraception. So our contraception activity will be focussed and prioritised according to need.

Peter Roderick, Director of Public Health, said: “We’d like to thank everyone for their feedback during the consultation. We’ve listened to everyone’s comments and have made some changes to the proposals as a result. These service changes are not being made lightly – we know there will be impacts, and its our role to mitigate these as much as we can.

“Sexual health services are vital, and we are proud of the quality of what has been available to people in York in recent years, and of the staff who deliver these vital services.

“Sexual and reproductive health is not just about preventing disease or infection. It also means promoting good sexual health in a wider context, including relationships, sexuality and choices around conception. It is a vital aspect of overall health and wellbeing and of public health.

“We are determined that we will meet York’s future needs to the same level, but there are always opportunities to make changes and do things more efficiently.

“That is reflected in our performance figures, which reflect very well on those involved in delivering the services.”

Jo Mannion, Consultant and Care Group Director for Family Health at York and Scarborough Teaching Hospitals NHS Foundation Trust, said: “We have successfully provided a range of high-quality, easily accessible sexual health services over the last few years, and we welcome the opportunity to build on this success in strong partnership with York.”

The council and the York and Scarborough Teaching Hospitals NHS Foundation Trust are continuing its analysis and work towards potential commencement of a new contract (under a section 75 partnership agreement) in 2025/6,

Sexual health services are a key part of public health and are funded via the ring-fenced Public Health Allocation.

The current contract with York and Scarborough NHS Trust and Nimbuscare Limited was extended earlier this year, following discussions with the providers through the Sexual Health Joint Management Board, chaired by the Director of Public Health.

A benefit of a new service contract with the current Integrated Sexual Health Services contract with York and Scarborough NHS Trust, is that they have a proven track record and have been a provider of sexual health services in York for over 10 years.

Following this consultation, a new legal agreement between two organisations will be agreed.

View the findings of the consultation here