No assessment has been made. Local areas decide how to spend public health funding. Contraception is widely available from general practices, and sexual and reproductive health services and is free to all.

There is no requirement on local authorities to have cross-charging arrangements in place; this is a matter for local determination.

No estimate has been made of the number of local authorities that do not have cross-charging arrangements. Public Health England recently conducted a survey into the commissioning arrangements for sexual and reproductive health and HIV, including assessment of cross-charging arrangements.

There is no requirement on local authorities to have cross-charging arrangements in place; this is a matter for local determination.

No estimate has been made of the number of local authorities that do not have cross-charging arrangements. Public Health England recently conducted a survey into the commissioning arrangements for sexual and reproductive health and HIV, including assessment of cross-charging arrangements.

Data have been provided on the number of contacts with Sexual and Reproductive Health Services in England, from residents of Scotland, Wales and Northern Ireland for the last two years (2014-15 and 2015-16). Data are not available prior to this, as location of patient residence was not submitted by all providers.

NHS England does not hold data on the costs associated with these contacts. Attendances at genito-urinary medicine (GUM) services is collected separately through the GUMCAD data set. Data are not published in the format requested.

Contacts with Sexual and Reproductive Health Services in England, from residents of Scotland, Wales and Northern Ireland.¹

2014-2015 and 2015-2016

1. The quality of this data is dependent on the location of residence submitted by providers.

Source: Sexual and Reproductive Health Activity Dataset, NHS Digital.

The Department’s A Framework for Sexual Health Improvement in England (2013) sets out our ambitions to improve the sexual health of the whole population including ethnic minority communities. A copy of the Framework is attached.

In addition, Public Health England’s Health promotion for sexual and reproductive health and HIV: Strategic action plan, 2016 to 2019 highlights the sexual health inequalities within black African and black Caribbean communities that are disproportionately affected by HIV and sexually transmitted infections in different ways. The document highlights that activities that promote condom use and address stigma and discrimination should be supported in both communities, but the primary focus of health promotion activities should differ. The priority should be to increase HIV testing among black African communities, and to promote condom use and reduce sexual risk behaviours among black Caribbean communities. A copy of the Strategic action plan is attached.

As part of the Public Health England (PHE) commissioned national HIV Prevention programme, a national social marketing campaign took place through National HIV Testing Week to raise awareness of the importance of HIV testing and opportunities to test in different settings. The campaign has specifically tailored its message to ethnic minority women at a higher risk for HIV acquisition. In addition, all women from black African backgrounds can access the national HIV self-sampling service. PHE is funding all requests for HIV self-sampling kits made through the national service until 8 January 2017.

The national HIV prevention programme is focused on at-risk populations including black Africans and other black and minority ethnic groups with a high or increasing burden of infection. In addition, in the first nine months of operation (November 2015 to September 2016) of the national HIV self-sampling service 35,347 kits were delivered of which 18,270 were returned. Of the returned kits, 19% (3,447) were returned by individuals who self-ascribed as being from black and minority ethnic communities. Of the returned kits, 56 gave a reactive result (1.6%), which was above the service average of 1.1%.

The HIV Innovation Fund is supporting a number of projects which focus on ethnic minority communities including tackling stigma and promoting testing.

As part of the Public Health England (PHE) commissioned national HIV Prevention programme, a national social marketing campaign took place through National HIV Testing Week to raise awareness of the importance of HIV testing and opportunities to test in different settings. The campaign has specifically tailored its message to ethnic minority women at a higher risk for HIV acquisition. In addition, all women from black African backgrounds can access the national HIV self-sampling service. PHE is funding all requests for HIV self-sampling kits made through the national service until 8 January 2017.

The national HIV prevention programme is focused on at-risk populations including black Africans and other black and minority ethnic groups with a high or increasing burden of infection. In addition, in the first nine months of operation (November 2015 to September 2016) of the national HIV self-sampling service 35,347 kits were delivered of which 18,270 were returned. Of the returned kits, 19% (3,447) were returned by individuals who self-ascribed as being from black and minority ethnic communities. Of the returned kits, 56 gave a reactive result (1.6%), which was above the service average of 1.1%.

The HIV Innovation Fund is supporting a number of projects which focus on ethnic minority communities including tackling stigma and promoting testing.

My Lords, we welcome the new HIV testing guidelines from NICE, which are particularly timely on World AIDS Day. Early diagnosis of HIV through increased testing carries huge benefits. Progress is being made and in 2015 the rate of undiagnosed HIV fell to 13% from 25% in 2010. We will keep working with partners to use the guidelines to encourage people to get tested and fight the stigma associated with HIV.

Local authorities are responsible for the commissioning of services to test and diagnose HIV. NHS England commissions treatment and care for those accessing HIV services from the point of HIV diagnosis onwards. Commissioners will take account of the British HIV Association standards, but these are not mandatory. Public Health England (PHE) has a comprehensive surveillance system that captures new HIV diagnoses and subsequent HIV care throughout the United Kingdom. These data are not only used to monitor the numbers living with HIV, but the quality of care received. This information directly informs the commissioning of HIV services which ensures data are complete and includes every individual in HIV care.

In the UK, PHE data demonstrate 97% of patients were linked to care within three months of diagnosis in 2015 and overall, 96% of people seen for HIV care received treatment with anti-retroviral therapy, and 94% of those treated achieved viral suppression. People with a suppressed viral load are extremely unlikely to pass on their infection. These data show that the benefits of early HIV testing are fully realised as the vast majority of people are rapidly linked to care, and effectively treated, so that they are no longer at risk from passing on their infection.

Local authorities are responsible for the commissioning of services to test and diagnose HIV. NHS England commissions treatment and care for those accessing HIV services from the point of HIV diagnosis onwards. Commissioners will take account of the British HIV Association standards, but these are not mandatory. Public Health England (PHE) has a comprehensive surveillance system that captures new HIV diagnoses and subsequent HIV care throughout the United Kingdom. These data are not only used to monitor the numbers living with HIV, but the quality of care received. This information directly informs the commissioning of HIV services which ensures data are complete and includes every individual in HIV care.

In the UK, PHE data demonstrate 97% of patients were linked to care within three months of diagnosis in 2015 and overall, 96% of people seen for HIV care received treatment with anti-retroviral therapy, and 94% of those treated achieved viral suppression. People with a suppressed viral load are extremely unlikely to pass on their infection. These data show that the benefits of early HIV testing are fully realised as the vast majority of people are rapidly linked to care, and effectively treated, so that they are no longer at risk from passing on their infection.

Health Education England has developed a number of e-learning sessions on Sexual Health and HIV across programmes designed for foundation trainees, general practitioners, dentists and radiologists, as well as specialists. The programmes cover topics such as HIV testing, the importance of early diagnosis and oral manifestations of HIV and AIDS. The content for these programmes is available to all National Health Service employees irrespective of their speciality.

The Department has funded the Medical Foundation for AIDS and Sexual Health to produce resources to support non-specialist clinicians in primary and secondary care services to offer HIV testing to help reduce late diagnosis of HIV. This includes HIV Testing in Practice, an interactive web-based resource for primary care which went live in November 2014.

No such assessment has been made.

The continuing professional development of doctors and nurses is the responsibility of individual employers. Health Education England has a role in ensuring employers remain committed to continuing professional development and in developing the overall strategy for workforce skills and development in their areas.

Local authorities are mandated to commission open access sexual health services and are accountable for their statutory duty to improve the public’s health. Public Health England (PHE) has a specific role in assurance of the ring-fenced grant and that local authorities are meeting the grant conditions and the terms of the associated statutory regulations. PHE publishes data on outcomes from services for each local authority in England and can provide support and advice where necessary.

Departmental and PHE officials meet regularly with stakeholders where open access to sexual health services is discussed.

Public Health England (PHE) and the Department provide a variety of tools and support in the form of guidance, data and direct advice to local PHE Centre staff. For example PHE supports local decision making by including data on sexual health spend and outcomes in the Spend and Outcomes Tool (SPOT) provided to local authorities. SPOT gives organisations in England an overview of spend and outcomes across key areas of business. The profile supports understanding of the overall relationship between spend and outcomes, by identifying areas of significant variance which are likely to require more in-depth analysis.

Public Health England (PHE) is committed to supporting the health system to provide appropriate contraceptive services. PHE, supported by the Association of Directors of Public Health (ADPH), has undertaken a review of sexual health, reproductive health and HIV commissioning services. Currently, it is planned to publish the results of the survey in the autumn (September 2016). PHE is committed to continue to work with ADPH in order to improve sexual health outcomes using the findings from the survey, outcomes data and other relevant information.

Public Health England is working with the Department and other key stakeholders to develop a new public health workforce strategy that considers the needs of the whole public health workforce.

It is the responsibility of local authorities and clinical commissioning groups to commission appropriate services and for providers to ensure that their staff are appropriately trained to meet the needs of their local population.

The Government has also mandated Health Education England (HEE) to provide national leadership on education, training and workforce development in the National Health Service in England. In doing so, HEE has a role in ensuring employers remain committed to continuing professional development and in developing the overall strategy for workforce skills and development in their areas.

Public Health England (PHE) undertakes a number of actions to limit the spread of gonorrhoea and other sexually transmitted infections in populations most at risk of infection in England, which are outlined in PHE’s Strategic Action Plan for Health promotion for sexual and reproductive health and HIV. These activities are focused on (i) developing and providing high quality surveillance data to monitor rates of gonorrhoea and related antimicrobial resistance, (ii) producing national guidance and a service specification template to optimise infection detection, (iii) maintaining effective treatment by advising on national treatment guidelines, promoting good prescribing practice and updating national guidance on the management of gonorrhoea in primary care, (iv) leading the public health response to local and national outbreaks to control wider dissemination in the population (v) supporting high quality case and partner management by providing expert advice, (vi) improving prevention by raising awareness in professionals and affected communities through local and national campaigns, and (vii) co-leading research to improve the evidence base. A copy of the Strategic Action Plan is attached.

The Government’s Framework for Sexual Health Improvement in England sets out the need to increase access to all methods of contraception including long acting (LARC) methods and that better support is needed to access contraception after childbirth. Local authorities are mandated to provide access to the full range of contraception services and should work with clinical commissioning groups to ensure that contraception is discussed and all methods of contraception, including LARC, are accessible as part of the post-natal maternity pathway. Further guidance will be available in Public Health England’s Missed Opportunities in Pregnancy report. This addresses the missed opportunities for the provision of contraception along the maternity, abortion and early pregnancy loss pathways, and is now in the final stage of revisions and is expected to be published later in 2016.

The Government’s Framework for Sexual Health Improvement in England sets out the need to increase access to all methods of contraception including long acting (LARC) methods and that better support is needed to access contraception after childbirth. Local authorities are mandated to provide access to the full range of contraception services and should work with clinical commissioning groups to ensure that contraception is discussed and all methods of contraception, including LARC, are accessible as part of the post-natal maternity pathway. Further guidance will be available in Public Health England’s Missed Opportunities in Pregnancy report. This addresses the missed opportunities for the provision of contraception along the maternity, abortion and early pregnancy loss pathways, and is now in the final stage of revisions and is expected to be published later in 2016.