Legacy• 175,000 clinic attendances a year across the

two authorities• £17.8m spent annually• Unknown effectiveness of some services• No centrally coordinated strategy• Large areas of high deprivation• Large areas of high STI, teenage pregnancy,

sexual violence and coercion

New serviceIntegrated Sexual Health Treatment and

Prevention Services for Birmingham and Solihull

• Prime contractor model• UHB as lead partner and accountable body• £83m fixed funding for 5 years• Threat to funding due to Public Health / Local Authority

‘pressures’• Commissioned for outcomes not for inputs/outputs• Complete risk transfer to provider

Sexual Health

Services across Birmingham and

Solihull 10 outcomes, including 3 national public health outcomes:• Increase rates of chlamydia diagnosis (15-24 year olds)• Reduce rates of late HIV diagnosis • Reduce rates of conceptions in under-18s• Better access to services for high risk communities • Improved support for people vulnerable to, and victims of,

sexual coercion, violence and exploitation• Increased use of effective good quality contraception• Reduced number of initial and repeat abortions• Prompt access for earlier diagnosis and treatment• Reduced number of people repeatedly treated for STIs• Reduced transmission of HIV, STIs and blood borne viruses

The Vision

The Vision• Secondary to primary (GP and Pharmacy) and

community care• Health promotion, education and support• Pro-actively reaching out to vulnerable groups• Upskilling and accreditation of the Umbrella

system • Improved patient access to information and

services and self-care

When and where will

services be available? 7 days a week:

•Boots City centre (expanded to provide a dedicated young persons’ service)

6 days a week:•Whittall Street•North, South, East and West Birmingham•Chelmsley Wood•Solihull Town centre

• GP Surgeries

• Pharmacies

• Youth Centres

• BLGBT Centre

• SIFA Homeless Centre

• St Basil’s

• St Martin’s

• Targeted Schools

• Health & Wellbeing clinics e.g. YMCA and Midland Mencap

• SAFE project service

Self-sampling• Self-sampling kits available via:

– Internet– Collection from partners

• Return by post

• Some proactive rather than reactive initiation

Sexual Violence,

Coercion and

&Exploitation • Delivery strategy– Building capacity (IDVAs & ISVAs)

• System wide training & education – ‘Universal triage’– ‘Spotting the signs’

• Managing transition – Data Migration – Safeguarding database – Policies and Procedures – Safeguarding system integration (e.g. Safeguarding

Boards)

Third Sector/Public Sector

Commissioning • Commissioning Strategy• Market engagement

– 50 partners– Birmingham based– Upskilling– Unique contributions (ISVA, IDVA)

• Integration of transformed service model • Contract confirmation

Primary Care• Commissioning Strategy• LMC & LPC engagement and support• Expand the current offer• Opportunity for all GPs and Community

Pharmacists– Confirming specification & scope– GPs confirmed – Community Pharmacists – Training and upskilling - rolling programme

• Family Doctors (GPs) ‘brokered’ by Badger

Communication&

and &Health Promotion

• Promoting access– Brand developed & agreed

– Social Media Strategy

– GP/Pharmacy signposting

• Building awareness– Umbrella awareness campaigns

– Annual cycle of campaigns

linked to outcomes

– Mini campaign bursts promoting activities around events

• Changing behaviour – Reducing risks

– “Respect” agenda

Partnership Workshop 24/2/15Partnership Workshop 24/2/15

Governance

How do we know what to pay for?

Some of it is easy:•Contraceptive services•STI treatment services

Some of it is very hard:•Behaviour change programmes•Culturally sensitive campaigns to change demand

How do we know what to pay for?

How do we know if it works?

• What can we measure?

• What does it mean?

• How do we establish causality?

• What effect do the time lags from input to outcome have?

What does success look

like?• Improving the 10 outcomes

• Reduced unmet need (aware or unaware)

• Increased social well-being as well as health well-being

• Sustainable and effective business model

Umbrella and CLAHRC

Themes • Theme 3 Prevention and Detection of diseases

• Theme 5 Implementation and Organisational Studies

• Theme 6 Research Methods

Research opportunities

Lots of opportunities for research, including:• Digital health• Self-care• New approach to services• Targeting of interventions• Outcomes measurement / evaluation• Health Economic Evaluation