Agenda item

Purpose of the Report:

For the Health, Integration and Commissioning Select Committee to review performance against the Sexual Health and HIV Services contracts. Members will also be given the opportunity to review progress made by Central and North West London NHS Foundation Trust, NHS England and Surrey County Council  in implementing the recommendations made by the Committee at its meeting on 4 July 2018.

Declarations of Interests:

None

Witnesses:

Lisa Andrews, Senior Public Health Lead, Surrey County Council

Dr Simon Edwards, Clinical Director, Central and North West London NHS Foundation Trust

Ruth Hutchinson, Deputy Director of Public Health, Surrey County Council

Fiona Mackison, Service Specialist, NHS England Specialised Commissioning

Matthew Parris, Deputy CEO, Healthwatch Surrey

Stephen Tucker, Deputy Service Director, Sexual Health and HIV, Central and North West London NHS Foundation Trust

Key points raised during the discussion:

1.     The Committee acknowledged that significant improvements had been made in the provision of Sexual Health and HIV Services in the intervening period since the Service had last been scrutinised. Concern was, however, expressed about access into the service for those who feel less comfortable booking appointments or requesting testing kits online. Members were advised that online was one of a number of access points into the Service for residents and that Central and North West London NHS Foundation Trust (CNWL) had adapted services to ensure accessibility.

2.     Members sought clarity on progress that had been made to resolve some of the initial issues experienced by the service when the contract commenced with CNWL such as disabled access to clinics, increase in GP referrals and problems with the telephone system. The Committee heard that steps had been taken to address these issues in consultation with patients and stakeholders. This had included work with Disabled Go and Surrey Coalition of Disabled People who had made recommendations regarding how to improve the accessibility of clinics to those with disabilities.

3.     Discussions turned to the availability of services through the hub, spoke and outreach model implemented by CNWL. All of the spokes were fully operational and consultants had all been trained to treat both GUM and sexual health conditions which meant that there was greater flexibility within the Service.

4.     The Committee asked whether Sexual Health and HIV Services in Surrey were better than they had been before CNWL took over the contract in April 2017. Members were advised that the new service model offered a variety of access points into the service, in particular the use of online services to be able to cover the geography of Surrey. This meant that consultant time could be targeted more effectively towards those with the most acute conditions which was vital given the reduced financial envelope available to commission sexual health services. Witnesses also emphasised the challenges inherent in bringing three separate services together into a single Sexual Health and HIV Service for Surrey.

5.     Members heard that HWSy had held an event at Buryfields Clinic in Guildford to find out more about the experiences of patients and that, among a very small sample, the majority who spoke to HWSy indicated that they were very happy with the services they had received. Some patients had, however, expressed concern about reductions in the number of Sexual Health Advisors. Representatives from CNWL stated that patients in HIV treatment who have an undetectable viral load could not pass on the virus and the service had very good partner notification rates. CNWL had retained one SHA but it was felt that resources previously allocated to SHAs would be better targeted elsewhere.

Actions/ further information to be provided:

None

RESOLVED:

That the Health, Integration and Commissioning Select Committee notes the performance of the sexual health and HIV treatment and care service contracts.