Oxfordshire Sexual Reproductive Health Needs Assessment

Background
The Oxfordshire ISHS have been commissioned as an integrated model under one joint service specification with two providers Oxford University Hospitals (OUH) and Terrence Higgins Trust (THT), working in partnership to deliver integrated sexual health service across the county. There is a single contract with OUH; OUH subcontracted to THT to deliver outreach education services.

What was the problem?
Improving sexual health is a national and local public health priority. Sexual ill health is influenced by a complex network of factors ranging from sexual behaviour and quality of SRE (sex and relationship education), through to biological risk and genetic predisposition as well as health inequalities, which extend beyond health. Sexual ill health is not equally distributed within the population. Strong links exist between deprivation and sexually transmitted infections (STIs), teenage conceptions and abortions, with the highest burden borne by women, men who have sex with men (MSM), teenagers, young adults and black and minority ethnic groups. Similarly, HIV infection in the UK disproportionately affects MSM and Black Africans in the UK. Some groups at higher risk of poor sexual health face stigma and discrimination, which can influence their ability to access services. Sexual health affects people’s physical and psychological wellbeing and can have an enduring impact on overall quality of life. It is a key part of an individual’s identity and includes human rights to privacy,a family life and living free from discrimination. The core elements of good sexual health are equitable relationships and sexual fulfilment with access to information and services to avoid the risk of unintended pregnancy, illness or disease.

How did PHAST help?
The Oxfordshire Sexual Health Needs Assessment report has been prepared by the Public Health Action Support Team (PHAST) to inform Oxfordshire council about the sexual health profile for the area and performance on key sexual health indicators and trend analysis; it also highlights activity data for the current Oxfordshire Sexual Health Services.

The methodology has included comparison of the key sexual health indicators with the Combined Intelligence for Population Health Action (CIPHA) 16 statistical neighbours to Oxfordshire, as well as the performance of England. In addition, thecorporate needs assessment included online surveys distributed to service users, staff, GPs pharmacists, as well as 11 key stakeholder interviews. The recommendations set out in this report are derived from analyses carried out on data supplied by a variety of local and national data sources and on the information elicited from the corporate needs assessment.

What was the impact?
This needs assessment has reviewed the latest available data for Oxfordshire for each of these priority areas and PHOF indicators, and also includes feedback from stakeholders on their assessment of current needs. The report has identified and included key guidance that can be used to inform and support commissioners to design future integrated sexual health services. Requirements regarding the exact types of service delivery are not imposed; service delivery should reflect local requirements; however, guidance recommends fully integrated consultant led sexual health services that include primary and secondary prevention and contraceptive care. Open access services, rapid access to diagnosis and treatment and promotion of outreach primary prevention to educational establishments and high-risk groups are all recommended. Oxfordshire County Council (OCC) is responsible for commissioning ‘comprehensive sexual health services’, which are currently provided by Oxford University Hospitals NHS Foundation Trust (OUHFT) via the Integrated Sexual Health Service (ISHS). The ISHS coordinates closely with other providers of sexual health services, including General Practices, School and College Health Nurses and Community Pharmacies.