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Sexual health commissioning is “fragmented system”, inquiry reveals


14 July 2015

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There is confusion over accountability for sexual and reproductive health and HIV care in England, which is directly impacting patients and must be addressed urgently, an inquiry said.

There is confusion over accountability for sexual and reproductive health and HIV care in England, which is directly impacting patients and must be addressed urgently, an inquiry said.

Since commissioning was transferred to local government in 2013 through the Health and Social Care Act, there has been a lack of accountability, an inquiry by an All Party Parliamentary Group (APPG) into the standards of sexual health services revealed.

One of the key recommendations of the inquiry called for secretary of state for health, Jeremy Hunt, to publish a clear accountability structure for sexual and reproductive health and HIV services ‘as a matter of urgency’.

Baroness Gould of Potternewton, chair of the APPG, said: “A common theme throughout the inquiry was the lack of clarity identifying who is ultimately responsible at a national level for these services, and what powers they have to drive up standards and outcomes across the country.

“In transferring commissioning to a local level, it was anticipated that there would be integration and opportunities for joint working – all focused on the specific needs of local communities. In some places these aspirations are being realised and we heard evidence of good practice and successes but, in many areas, these structural changes have created a complex and fragmented system that is not in the best interests of the people who rely on these services,” she said.

Other recommendations include improving the training and development of the sexual and reproductive health and HIV workforce, which has a direct impact on patients, and giving CCGs clear guidance on what services they should commission to ensure open access for contraception and STI testing.

The APPG also recommended that public health ring-fence should be retained beyond 2016 to provide protection for sexual and reproductive health and HIV services, and local authorities must be held to account over their spending.  

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