Presentation on sexual health services in Birmingham and Solihull given by Scott Hancock and Jo Plumb at the CLAHRC WM Programme Steering Committee meeting on 15th April 2015.

2. 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

3. New service
Integrated 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

4. Sexual HealthServices
across Birminghamand
Solihull10 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

5. The Vision

6. 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

8. 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

9. • 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

10. Self-sampling
• Self-sampling kits available via:
– Internet
– Collection from partners
• Return by post
• Some proactive rather than reactive initiation

11. SexualViolence,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)

12. 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

13. 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

14. 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

15. Governance

16. 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

17. How do we know what
to pay for?

18. 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?

19. 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

20. Umbrella and
CLAHRC

21. Themes
• Theme 3 Prevention and Detection of diseases
• Theme 5 Implementation and Organisational Studies
• Theme 6 Research Methods

22. 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