Agenda item

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health, setting out the key findings of the needs assessment and changes in the delivery of sexual health services. Members are asked to either endorse or make a recommendation to the Cabinet Member on the proposed changes to the provision of sexual health services which are due to expire in March 2019.

Ms W Jeffreys, Public Health Specialist, and Mr M Gilbert, Senior Commissioner, were in attendance for this item. 

1.            Ms Jeffreys and Mr Gilbert introduced the report and updated the statistics set out in para 3.11 of the report; the percentage of late diagnosis of HIV in Kent had increased to 61.7% compared to 41.1% in England as a whole. They and Mr Scott-Clark then responded to comments and questions from Members, including the following:-

a)    the online ordering facility for testing kits allowed customers to access kits discreetly, without having to ask over a counter. It also reduced the demand for clinic visits, which were more expensive, as only those testing positive would then be invited to attend a clinic appointment.   Members were assured that kits obtained through the online service would come only from reputable, quality providers, approved and commissioned by the County Council. This saved customers having to search randomly elsewhere on the internet and perhaps finding products which were not quite so reliable;

b)    although the online ‘Get It’ programme was available only for people over 16, younger customers would be signposted to find support and products elsewhere.  A young person logging in would be required to enter their date of birth and would be guided through the system in such a way that they could not then change the entry later to make themselves seem older;

c)    young people would be told how to access the digital offer as it was part of the information provided by the school public health service.  The ‘Get It’ programme had been widely promoted and was accessible through youth hubs and numerous outlets frequented by young people;

d)    the County Council was seeking to have a longer contract for the new condom programme so the service would stay with the same provider for a longer period, thus minimising the frequency with which the access details would change.  Members were assured that a longer contract would include the same rigorous performance clauses to ensure that a good quality service was maintained. Kent’s digital offer had increased uptake above that of other neighbouring authorities and would continue to be developed.  A longer contract period would also give service staff more stability of employment;

e)    Kent’s sexual health services  were demand-led, and the County Council had a duty to provide treatment for all people testing positive. The Council had a reserve of cash to cover rises in demand;

f)     in response to a question about the County Council’s scope to own or ‘brand’ a campaign, Mr Gilbert explained that the ‘Get It’ campaign was owned by the provider, Metro.  Where the County Council bought an existing campaign, it would not usually be possible to own the brand and continue to use it with a different provider. Mr Gilbert undertook to liaise with prospective contractors to explore the possibility of negotiating an agreement for Council ownership or perpetual right to use a new brand for the service. He cautioned, however, that potential providers would most likely not allow the Council to take over their existing brand and use it with another provider. It would, however, be possible for the Council to develop and own a new brand and use it with any chosen provider. This idea was supported by some Members, with the suggestion that Kent could adopt an overall brand to cover its various sexual health services;

g)    asked about statistics for the prevalence of syphilis, how soon cases were being identified and how the UK compared to other countries in the way in which it approached the provision of sexual health services, Ms Jeffreys undertook to look into this and supply information to Members outside the meeting;

h)    sexual health service providers were being pro-active in liaising with universities and colleges, youth groups and early years support services to spread awareness of its sexual health services;  

i)     there was still some resistance to take up the offer of testing for STIs, due to the prevailing understanding of personal risk among many people; and

j)     a view was expressed that Kent should raise the profile of HIV testing and reassure people that requesting a test was a responsible move and not one which need jeopardise insurance, mortgage or loan applications. The extent of change since the HIV campaigns of the 1980s was emphasised.  Knowledge and understanding of HIV was just starting in the 1980s, but medical knowledge and public awareness had both increased greatly since then, along with the accessibility of testing and services.  

2.            It was RESOLVED that:-

a)    the key findings of the needs assessment and changes in delivery of sexual health services be noted;

b)    taking account of Members’ comments and concerns set out above, and in particular about branding and ownership, the decision proposed to be taken by the Cabinet Member, to make changes to the provision of sexual health services due to expire in 2019:

                      i.        the inclusion of integrated sexual health and related services into the existing Kent Community Health Foundation NHS Trust (KCHFT) partnership;

                    ii.        the formation of a new partnership agreement with Maidstone and Tunbridge Wells NHS Trust (MTW) and inclusion of integrated sexual health and online STI testing services;

                   iii.        continued contracting directly with GP surgeries for Long Acting Reversible Contraception (LARC) services, delivered within primary care; and

                   iv.        award of contract following a competitive process procurement for an online condom scheme and outreach services;

be endorsed; and

c)    the proposed plans for the continued delivery of Kent County Council-commissioned sexual health services, via Kent Community Health Foundation NHS Trust and primary care, be supported.