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. Sexual health is an important part of public health and is funded via the ring-fenced Public Health Grant Allocation provided by central government.
The Public Health grant has not increased with inflation and, in real terms, is 30% smaller since 2015. If it had kept pace with inflation, an extra £2 million would have been available to fund public health services in York, and this has created a significant pressure on the budgets. We must match services to the budget available, and to do so requires us to makes changes. The Sexual health service is the second biggest spend within the public health grant.
Sexual health is an important component of public health. Most adults are sexually active and good sexual and reproductive health matters to individuals and communities. Sexual health, reproductive health and HIV needs vary according to factors such as age, gender, sexuality, ethnicity, mental wellbeing, sensory difficulties, education and literacy, and cultural factors. However, there are certain core needs common to everyone including high quality information and education to enable people to make informed decisions, a reduction in stigma and discrimination, and access to high quality services, treatment, and interventions.
The consequences of poor sexual and reproductive health are preventable and include:
- unplanned pregnancies
- infections including HIV
- cervical and other genital cancers
- pelvic inflammatory disease and infertility
- psychological consequences
- stigma
- poorer educational, social, and economic opportunities
Poor sexual health outcomes fall disproportionately on certain groups.
The sexual health service in York is delivered through YorSexualHealth, provided by the York and Scarborough Teaching Hospitals NHS Foundation Trust ("the Trust").
The Trust have been the commissioned provider since commissioning of sexual health services became the responsibility of the local authority in 2013.
The York sexual and reproductive health services provision consultation was held jointly by City of York Council, who are the commissioners of the service, and the Trust who are the providers of the service to further understand the impact of service reductions and how these may be mitigated, and other options considered.
The consultation took place between 16 July and 2 September 2024.
This report has been prepared by the Public Health Specialist, in October 2024.