Agenda item

To provide a comprehensive report on sexual health service provision in Blackpool informed by the ‘Enhancing the value of sexual health, reproductive health and contraception services through council scrutiny’ guide.

Ms Judith Mills and Ms Janet Duckworth, Consultants in Public Health, presented a report on sexual health services in Blackpool. The Committee was informed that the report had been written to include all the information recommended by the “Enhancing the value of sexual health, reproductive health and contraception services through council policy” guide.

Ms Mills reported that in Blackpool responsibility for sexual health services was split across a number of commissioners, both public and private. As a result of this partnership working between commissioner, to ensure that the best quality service possible was required. A joint strategic needs assessment was therefore in place to drive the development of sexual health services. This assessment was reviewed every four years to ensure it addressed the relevant priorities for Blackpool.

The report showed that levels of chlamydia had been reducing and becoming closer to the national average. In addition, the transmission of Human Immunodeficiency Virus (HIV) had fallen and it was hoped that it could be prevented in Blackpool by 2030. Instances of teenage pregnancy had also reduced and Blackpool was narrowing the gap with the England average.

Despite this, instances of abortions and syphilis had risen. Although figures were in line with national trends, partners were looking at how to address both issues, in particular through the promotion of contraception.

Following the restrictions experienced by the Covid-19 pandemic Ms Mills informed the Committee that services had returned to normal but that work was needed to understand how sexual behaviours had changed during lockdown.

Ongoing work to improve service delivery included the greater use of digital platforms to order tests for Sexually Transmitted Infections (STI) and the ordering of contraception. It was hoped that this would make it easier for some individuals to engage with services. Although this had been undertaken in response to a high level of digital demand for sexual health services, Ms Mills informed Members that it had been recognised that the use of such platforms should be balanced against the demand for traditional access to services. Talks were therefore ongoing with Public Health and Blackpool Teaching Hospitals NHS Foundation Trust to determine service provision.

Work was also being undertaken with schools to put in place effective sex education practices and programmes to teach healthy behaviours in relationships. This would include the introduction of the ‘Green Dot bystander intervention programme’.  The programme involved the use of workshops and training to create cultural changes that aimed to reduce harassment and inter-personal violence amongst young people, encouraging them to respond when they noticed unhealthy behaviours and to engage in behaviour that benefited the community. Members queried if the Relationships and Sex Education Curriculum, highlighted in the report, would be rolled out to all schools, including faith based ones. Ms Duckworth confirmed this was the case and that it was hoped that all schools would eventually adopt the Green Dot programme, but that a place based approach would be undertaken to ensure it matched the needs of each school.

Ms Mills also reported that a model for Women’s Reproductive Health Provision was being considered, with the development of a business case being under discussion between Public Health, NHS England and Blackpool Clinical Commissioning Group (CCG).

The Committee queried the quality of sex education provided to young people after they had left secondary education. Members expressed concern that those at college and other learning institutions would not have access to the same sexual health information as those in school. In response, Ms Mills recognised that more work could be undertaken across Blackpool, noting that there had been a focus on Blackpool and the Fylde Coast College (BFCC).

Concerns were raised regarding the increase in abortion levels and rates of gonorrhoea and syphilis in Blackpool and the damage that could be caused to young people by both later in life. Ms Mills replied that regarding abortions, providers sought to ensure that the use of contraception was embedded within their work with patients. While it was noted that this could be very difficult in some cases, providers had indicated a commitment to this approach. In respect of the increase in certain STIs, Ms Mills informed Members that education regarding such infections was now mandatory in schools which would look to increase young people’s awareness of the dangers of STIs. This would be coupled with greater consistency in messaging from partners and sexual health campaigns targeted at the groups most at risk.

The Committee also discussed the counselling available to abortion patients and if alternatives to the procedure were raised with them. It was explained that every patient wishing to access abortion services undertook in-depth counselling to ensure that an abortion was the right course of action for them. This would include all the available alternative options being outlined to them. Ms Mills added that support also needed to be provided following a patient’s accessing of services to ensure their long-term health and wellbeing.

The ending of opportunistic screening for chlamydia in boys and young men was noted by the Committee, with Members asking if the impact had been assessed. Ms Mills reported that screening was still available for women in support of health and wellbeing, but that positive rates amongst men had historically been very low. Therefore nationally it had been decided to end general screening, while noting that contact tracing for positive tests would continue and young men would be identified and screened through this process. The screening for HIV on admission at the Accident and Emergency department at Blackpool Victoria Hospital was also raised, with the Committee being informed that this operated on an opt-out basis. Ms Duckworth noted that while uptake was between 25% and 35%, and therefore could be improved, it was still considered as being a successful scheme. Councillor Farrell, Cabinet Member for Adult Social Care and Health added that she had submitted a letter to the Treasury, on behalf of the Council and its partners, requesting that more money be made available to support this and other STI reduction schemes.

The roll out of Human Papillomavirus (HPV) vaccines in schools was considered by the Committee, with Ms Mills reporting that the vaccine was now routinely administered. The use of HPV vaccines had been shown to have a significant impact on some STI transmission rates and to reduce the likelihood of cervical cancer in later life. Uptake of the vaccine was reported as high.