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Sexual Health Services in Wales

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Brian Gibbons, Minister for Health and Social Services

Strategic Framework for Sexual Health
The Strategic Framework for promoting sexual health in Wales was launched in 2000. It aims to improve the sexual health of the population by ensuring that people have access to sexual health information, advice and services.

Key objectives within the Strategy were:

  • To ensure that all people have access to sexual health services.
  • To reduce the incidence  of sexually transmitted infections (STIs)
  • To create an environment supportive to improving sexual health
  • To ensure that all young people receive effective education about sex and relationships education (SRE)
  • To reduce rates of unintended teenage pregnancy;

HIV and Sexual Health Service Modernisation Programme
In line with the objectives of the Strategic Framework for Sexual Health, a review of HIV and Sexual Health Services in Wales was carried out. The Welsh Assembly Government published the outcome of the review in December 2004 and announced its intention to introduce a Modernisation Programme for HIV and Sexual Health Service.  

The overarching aim of the Modernisation Programme is the integration of the existing genitourinary medicine and family planning services into a single health service based in the community as far as possible. This single service will maximise the opportunity for preventative health checks, prompt diagnosis of infections and provide a more effective, efficient and acceptable service for both patients and staff.

The main objectives for achieving this aim are:

  • To develop national evidence based quality requirements to underpin the planning, organisation and delivery of these services and ensure equity of access to high quality integrated care.
  • To expand the role of nurses within the service.
  • To develop local HIV and Sexual Health networks to ensure a multidisciplinary and collaborative approach to patient care.

National leadership
Funding for both genitourinary services and family planning has been protected within the Local Health Board annual financial allocations from April 2005. An additional £500k has been provided by the Assembly Government from April 2005 to assist the NHS in making the necessary changes to services. To spearhead improvements, Dr Marion Lyons, Consultant in Communicable Disease Control in the National Public Health Service has been seconded to the Assembly Government as Director of the Modernisation Programme.  A multidisciplinary Advisory Group for Sexual Health has been established to support and advise Dr Lyons.

One of the 2005-06 SaFF target required that by March 2006, all patients should have access to core sexual health services within two working days to test for infection and to emergency contraception within 24 hours.  This target was intended as a driver to bring about the changes in the way services were organised as quickly as possible.  NHS Trusts and Local Health Boards were required to develop action plans for the modernisation of their services.

Progress to Date
The additional £500k being provided by the Assembly Government has been allocated to a number of key service developments right across Wales. A service specification has been issued to Local Health Boars to help inform the commissioning process. Most Trusts now have detailed action plans in place to deliver the new integrated community based service. The Modernisation Programme Director and the Department of Health and Social Services’ Regional offices are working with the remaining Trusts to identify the changes needed and how they will be achieved.

Draft quality requirements designed to ensure high quality sexual health services have been developed and will be issued for public consultation shortly. The all Wales Contraception & Sexual Health Senior Nurses Forum are mapping nursing workforce development needs with the intention of developing education and training programmes, for nurses working in sexual health services The Advisory Group for Sexual Health will shortly be considering a competence framework to underpin the development of a more nurse-led service.  It will also be considering the results of detailed work on how high quality accessible testing for chlamydia in the under 25 age group can best be introduced across Wales.   The Group will also be developing an audit tool which Commissioners and providers can use to measure the quality of their sexual health services and ensure they are meeting the requirements of the Assembly Governments policy aims.

Overall the Assembly Government is satisfied that good progress is being made in most NHS Trusts in improving timely access to modern sexual health services during 2005-06. During 2006-07, this progress needs to be built on further and action taken to tackle those services which are not moving forward as they should.  Through effective performance management, the Department of Health and Social Services’ Regional Offices will monitor this progress and ensure that the NHS continues to make the improvements needed.