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Sexual health service cuts

Sexual health service cuts

2023

Nurses warn STI cases threaten to overwhelm clinics | Nursing Times | 7 Jun 2023
Sexual health services at risk of breaking point: LGA responds to UKHSA statistics on new STI diagnoses | Local Government Association | 6 Jun 2023
Gonorrhoea and syphilis sex infections reach record levels in England | BBC News | 6 Jun 2023

2018-2022

Breaking point: Securing the future of sexual health services | LGA | 14 Nov 2022
Sexually transmitted infections on the rise among over-65s in England | The Guardian | 15 Nov 2022
Overall trends in consultations, STI testing and diagnoses at SHSs among England residents | UK Health Security Agency | data to end of Dec 2021)

Along with many organisations, we joined a chorus of voices calling for the government to address funding and capacity of sexual health services in 2018. At the time, the British Association for Sexual Health and HIV set up a petition to reverse damaging cuts the sexual health services. It only reached 8,000+ signatures.

And yet, in 2022, we couldn't help but notice that gay men couldn't stop 'moaning' they couldn't get (or still get) a monkeypox vaccination or a sexual health check-up appointment. Granted, issues around funding and commissioning are long-standing and complicated - and there's been the COVID pandemic - but we should be mindful NEVER of taking our sexual health services for granted. This matters more than ever in these challenging austerity-driven times. Sometimes, we have to fight for what we need.

2018: Government funding cuts leave sexual health and HIV care at 'breaking point'

"Access to sexual health and HIV services has been dramatically reduced as a result of changes to the funding and organisation of sexual health services since 2013, according to the medical professionals providing care. Over half (54%) of respondents to a survey of members of the British Association of Sexual Health and HIV (BASHH) reported decreases in the overall level of service access to patients over the past year, with a further 16 per cent saying that access had significantly decreased. In a parallel survey of members of the British HIV Association (BHIVA), three quarters (76%) of respondents said that care delivered to patients in their HIV service had worsened."

Government funding cuts leave sexual health and HIV care at 'breaking point' | BHIVA | 29 Sep 2018

Kat Smithson, Director of Policy and Campaigns at NAT (National AIDS Trust) said: “The sexual health crisis is no longer a disaster waiting to happen, it is unfolding before our eyes. At a time when we have increasing rates in many STIs, we are destroying opportunities to diagnose and treat them. Clinicians are telling us that the very services that achieved success by reducing rates of HIV, are now under threat, putting this success at risk.

“In 2016 the Health Select Committee warned that public health budget cuts were a false economy, but was ignored. Now, as the same Committee conducts an inquiry on sexual health, we see the results: increasing sexual health inequalities, particularly affecting gay and bisexual men and BAME communities, and diminishing quality of services.

“As it stands, new funding for the NHS won’t benefit these health services that are actually delivered by local authorities through the public health grant. These continue to be cut right under our noses. Public health, which includes sexual health, drug and alcohol services, is in dire need of reinvestment.”

NAT respond to BHIVA and BASHH survey on sexual health | NAT | Sep 2018

London Sexual Health Transformation Programme

Written in 2017

Something which may have passed you by in 2017 is the roll-out of the London Sexual Health Transformation Programme "...a partnership of 29 London boroughs with the aim of drawing together a new collaborative commissioning model for sexual health services" say London Councils. "From April 2017, when the Programme is due to be implemented, patients will be able to access services through the internet rather than having to attend a clinic."

As the Programme is being rolled out, 6 sexual health services have closed, to date:

  • The Lloyd Clinic
  • Clare Simpson Sexual Health Clinic
  • Marlborough Clinic
  • The Courtyard Clinic
  • Artesian Health Centre Sexual Health Clinic
  • Vauxhall Riverside Sexual Health Clinic

MEN R US has asked about other clinics which we believe may be at risk, but we are (still) waiting for responses to our enquiries. However, we suspect more closures are on the way.

Online system not online until 2018

Worryingly, we understand that the web portal system where we (the patients) will access services is not online as planned. It appears we will have wait until 2018 at a time when there are already reports of sexual health services becoming further stretched, and turning away patients.

Poor communication

Communication regarding the closures seems to have been poor, the public often confused about what is open and closed. Ultimately, one gets the impression this Programme is more about the 'transformation' of sexual health services by stealth.

Dean Street Express massively over-subscribed

According to Gay Star News (27/10/17) "Around 1,500 people are trying to get just 300 appointments at the most popular sexual health clinic for gay and bi men in the UK, after other clinics closed." Dean Street Express replied "our service is currently massively over-subscribed due to the closure of several other clinics in London."

Cuts in England

The British Medical Journal (BMJ) sent freedom of information (FoI) requests about sexual health service provision and spending over the past three years to all 152 commissioning local authorities, 147 of which (97%) responded. Only 33 said that they had not reduced spending in any given year, whether by making efficiencies, through direct cuts to services, or because of natural variations in demand; 50 had done so in one year, 37 in two, and 27 in all three years.

Most of these annual reductions in spend were between 5% and 10%, but they ranged from 0.4% to 23%, the FoI responses show. And it’s likely that councils have now explored all viable options to contain costs.

The government public health grant, out of which sexual services are funded, has been steadily cut since 2015. It had an unscheduled 6% cut (£200m) in 2015-16. Scheduled annual cuts will amount to 9.6% by 2020-21.

Sexual health services on the brink | BMJ | Caroline White | 30 Nov 2017

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