world class commissioning for hiv & sexual health services
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World class commissioning for HIV & sexual health services. Paul Ward Deputy Chief Executive March 2009. Contents. The scale of the challenge World class commissioning for sexual health & HIV Case study – Chlamydia screening Commissioning new sexual health & HIV service models. - PowerPoint PPT PresentationTRANSCRIPT
Paul Ward Deputy Chief Executive
March 2009
World class commissioning for HIV & sexual health services
Contents
The scale of the challenge World class commissioning for sexual health & HIV Case study – Chlamydia screening Commissioning new sexual health & HIV service
models
The scale of the challenge
Growth in STI diagnoses since 1995 Numbers of people with HIV growing by 10% p.a. 25%+ undiagnosed HIV Highest teenage pregnancy levels in W. Europe Under achievement of Chlamydia screening and
teenage pregnancy targets Variation in use of long acting reversible
contraception But:
Achievement of GUM access target Falling teenage pregnancies
World class commissioning for sexual health
Provision of leadership for sexual health service delivery and development
Orchestration role working with NHS providers, Local Government and Voluntary/community organisations
Specific steps to engage with people using services, recognising health inequality & stigma as barriers to participation
Engagement of clinical and non clinical sexual health/HIV specialists in development & delivery
Regularly updated needs assessment, public health surveillance and contract delivery data to maximise PCT knowledge
World class commissioning for sexual health
Review of investment patterns to maximise value for money, eg balance of hospital & non hospital activity
Stimulation of sexual health market to ensure there is both choice and specialism available
Capitalise on innovation opportunities afforded by diagnostic technology, Next Stage Review & policy levers
Effective use of procurement policy to maximise impact of investment, and to promote collaborative working
Active facilitation of partnership working & care pathway management between providers
WCC Case study Chlamydia screening - defining success
Routine opportunistic screening for all people 15-24 yrs, using community contraception and sexual health (CASH) services, abortion services and antenatal services
Routine GP opportunistic screening for 15-24 year olds
Increase access to screening in other health settings used by 15-24 year olds, e.g. community pharmacy
Assertive outreach screening in youth settings, e.g. schools, colleges, youth services, bars/clubs, YOIs
Effective partner notification function Postal testing programme Social marketing support & approach Achievement of 17%, 25% & 35% targets
WCC Case studyChlamydia screening – achieving success
Local Chlamydia Screening Plan in place PCT Executive & Board attention, with clear
delivery structure incl Local Chlamydia Screening Steering Grp
PCT engagement with full range of partners able to achieve the target, incl CASH, GUM, LA, VCOs
Delivery model focused on screening in core community sexual health & GP services supported by assertive outreach screening to maximise access
Motivational leadership by local Chlamydia Screening Office
WCC Case studyChlamydia screening – achieving success
Chlamydia screening as a performance requirement for all sexual & reproductive health contracts, incl abortion
Financial incentives in CASH, GP LES & Pharm contracts
Capacity building with GPs & Pharmacies Screening agreements in place with all principal
statutory and voluntary services used by young people
Assertive outreach contractor in place High quality lab reporting to count all screens & tests
WCC case study - Chlamydia screening – checklist for PCTs
What do we know about local Chlamydia need? What do we know about local service use by young
people? How do our services compare against NCSP best
practice? How does our performance compare with the 17%,
25% & 35% targets? How should we change services to optimise
screening in all settings used by 15-24yos? Is good use made of contractual & financial levers? Is there a local plan & timely/accurate dataflow to
PCT managers/ Boards
Commissioning new sexual health & HIV service modelsSexual health promotion
Coordinated public health programmes Targeted at those in greatest need Media & face to face, behavioural & clinical Young people coordination of HPV
vaccination, SRE, Chlamydia screening & school nursing
Increased role of vaccination & regular testing
Integrated with clinical services
Commissioning new sexual health & HIV service modelsCommunity sexual health services
Integration of contraception & STI services Level 1 & 2 services delivered from community based
clinics, polyclinics, pharmacies, GPs and VCOs Nurse & healthcare assistant delivery Self management emphasis Step up arrangements with Level 3 services for
people with complex needs Inclusion of all providers in managed service network Referral pathways into other services, eg, TOP, HIV
Commissioning new sexual health & HIV service modelsHIV long term condition mgt
Expanded promotion & availability of HIV testing Community delivered HIV ARV & primary care in
polyclinics, & larger GP premises HIV specialists for complex care & annual review New models of HIV primary care Proactive LTCM programmes, inc self
management, health trainers, web delivered services,
Integrated health & social care for greatest need
