Belated moves to tackle crisis in sexual health

Long-awaited plans to tackle the growing crisis in sexual health will involve the creation of three service levels networked within the NHS.

The first-ever national strategy on sexual health and HIV was finally published last Friday - four years after the government promised to deal with the issue.

Among the proposals is an extra£47m over the next three years to support the initiatives to end the 'unacceptable' variations in services across the country.

Improved access and information will be the main weapons used to combat the spread of sexually transmitted infections, with primary care, acute and community trusts working together along 'managed service networks'.

The three levels of service provision will involve GP surgeries, specialist sexual health teams in primary care and the development of clinical teams working across more than one PCG/T (see box).

They will be linked together into networks based on those currently operating in cancer services.

The strategy accepts that this system will 'take time to establish', but says it expects locally integrated services to be developed over the next few years.

The government will also be running three pilot one-stop sexual health clinics as well as projects for primary care youth service in liaison with the teenage pregnancy unit.

Professor Michael Adler - chair of the sexual health and HIV strategy integrated steering group which put the report together - said: 'No-one really knows what the right model will be. While developing the strategy, we consulted with a lot of young people and they wanted a one-stop shop for a variety of conditions.We are going to evaluate the benefits of different types of models for the sexual health service.'

Targets will also be set to reduce the number of HIV and gonorrhoea infections, and a national chlamydia screen programme will be phased in next year.

The proposal to end special funding allocations for HIV and AIDS treatment and care has attracted criticism. The government wants the money to be given within health authorities' mainstream allocations instead.

Neil Gerrard, chair of the allparty parliamentary group on AIDS, warned: 'There is a danger that most work with the groups genuinely at risk of HIV will fade away.Health authorities will put it to more 'acceptable' uses.'

Consultation on the strategy ends on 21 December.

Level best - provision of sexual health services Level one General practice setting:

Sexual history and risk assessment; sexually transmitted infection testing for women; HIV testing and counselling; pregnancy testing and referral; contraceptive information and services; assessment and referral of men with STI symptoms; cervical cytology screening and referral; hepatitis B immunisation Level two Primary care teams with a special interest in sexual health:

Intrauterine device insertion; testing and treating sexually transmitted infections; vasectomy; contraceptive implant insertion; partner notification; invasive sexually transmitted infection testing for men Level three Specialist clinical teams - focus on chronic conditions:

Outreach for STI prevention; outreach contraceptive services; specialised infection management; highly specialised contraception; specialised HIV treatment and care