Agenda item

To receive a report from the Cabinet Member for Strategic Commissioning

and Public Health and the Director of Public Health, setting out an update on the performance, outcomes and value for money of the sexual health services commissioned by the County Council. The committee is asked to note the performance of the County Council-commissioned sexual health services and the processes in place to manage the contract effectively.

1.            Ms Sharp and Mr Gilbert introduced the report and emphasised that performance management of the contract was robust and that adjustments would be made to payments to the provider for any shortfall in performance. The service had delivered and was delivering very good value for money and had introduced innovative use of technology, including online testing kits.  Ms Sharp and Mr Gilbert responded to comments and questions from Members, including the following:-

a)    asked if young people were intimidated about attending a sexual health clinic, and if better engagement might be made if testing were to be done at a venue already familiar to young people, for example, a youth centre or gym, Mr Gilbert confirmed that young people’s clinics were well attended and there was no data evidence of them staying away.  Holding clinics which were just for young people meant that they would not be intimidated by attending a general clinic with older people.  A pilot project to test the idea of taking clinics to other venues would run for 3 – 6 months and the feedback from this analysed. In response to concerns expressed, Mr Gilbert undertook to look into a specific example of local practice and liaise with the local provider if necessary;   

b)    the number of outreach sessions available reflected the staff capacity. Most outreach work took the form of drop-ins and opportunistic contacts rather than bookable sessions. Attendance varied but it was very rare to have a session at which there was no attendance;

c)    usage levels of all services were monitored, with a guide level of 80% reflecting a sustainable level of provision. Trends would be identified and responded to, for example, sessions at one venue had been set up on Saturday mornings in response to local demand;

d)     concern was expressed that service supply might not be able to meet demand. Mr Gilbert explained that, as the commissioner and provider were separate bodies, demand could be identified honestly, and commissioners were practised at doing this. Dr Duggal added that, as best practice, the public health team would also consult youth groups such as Youth Advisory Groups to gain first-hand feedback from service users; 

e)    the ‘condom distribution’ programme had proved to be cost-effective and presented good value for money.  Ms Sharp explained that the  budget for this project had covered both the equipment and promotion work and clarified that the current project, which had replaced the previous ‘condom card’ programme, cost less.  She added that it was unusual for the County Council to have statutory responsibility for this sort of provision, however, it sought to reduce costs where it could, for example, by optimising the use of online testing, to achieve best value for money.  The current provision model had proved most successful and had expanded capacity in Maidstone and Canterbury.  The ability to pioneer this sort of provision was a benefit of the flexible contracting arrangements which the County Council had negotiated with providers;

f)     Mr Gilbert clarified that the contract values set out in Appendix A to the report, including for the condom programme, were the maximum possible value of each contract, assuming maximum activity; the actual amount paid for each would be lower than the price listed;

g)    the target that sexual health support services aimed to meet was that every client requiring support urgently should be able to access it within 48 hours.  The County Council strove not to be complacent and would always look for unmet demand and changing patterns of demand;

h)    data gathered would contribute to the preparation of the Joint Strategic Needs Assessment (JSNA). Concern was expressed that some of the data in the JSNA was from 2013 and would need to be updated.  Dr Duggal explained that public health data took a while to collate and evaluate but was of excellent clarity and value once it became available for use;

i)     concern was expressed that Gravesend might need a campaign targeted particularly to that area, and Dr Duggal undertook to look into this and advise the questioner outside the meeting; and

j)     clarification was sought of the total number of clients accessing psychosexual counselling sessions, and questions asked about the qualification of the counsellors delivering these sessions and what the sessions would cover.  Mr Gilbert assured Members that counsellors delivering sessions were fully trained specialists in that field, and so their number was necessarily finite.  The provider was paid per session for the provision of psychosexual counselling, and each client would attend 6 – 8 sessions, so the approximate number of clients could be calculated by dividing the total. Client satisfaction rates for this part of the service were high. 

2.         It was RESOLVED that the performance of the County Council-commissioned sexual health services, and the processes in place to manage the contract effectively, be noted and welcomed.