To discuss how the Health and Wellbeing Board can broaden and lengthen the whole community approach to aid an increase in sexual health screening.

The Chairman advised the Board that due to the links between the two priorities, item 13 and 14, as listed on the agenda, would be considered together.

As part of its agreed approach, the Board gave consideration to two of its priorities within the Joint Health and Wellbeing Strategy, namely Priority 9 – Increase in Sexual Health Screening and Priority 3 – Reduce Teenage Pregnancy.  Representatives from the field of sexual health provided members with details of services and work that was currently underway to increase sexual health screening and reduce teenage pregnancy.

Members of the Board then discussed how the Health and Wellbeing Board could ‘broaden and lengthen’ the whole-community approach to the increase of sexual health screening and reduction of teenage pregnancy.  In particular, members were asked to pay particular attention to whether the actions within the joint Health and Wellbeing Strategy were the right ones, what needed to change locally to meet the outcomes required by the Board, and what could the Board do to promote integrated working to support this priority.

Members were advised that sexual health services were commissioned and designed to meet the needs of the population with the following sexual health services available in Torbay:

·         Torbay Sexual Medicines Services – is the provider of Torbay’s sexual health service with the aims and objectives of the service are to provide an open access (self referral), comprehensive, integrated contraception and sexual health service;

·         Outreach Team – works across schools and colleges in Torbay to provide sexual health outreach service for young people;

·         Sexually Transmitted Infections – The government reported nearly half a million new sexual infections nationally in 2012, whilst part of the rise can be explained by better sexual health reporting systems, it is suggested that too many people are putting themselves at risk, through unprotected sex;

·         C-Card Scheme – young people aged under 25 can register and access free condoms at approximately 70 outlets across Torbay;

·         Sexwize – web based information service providing clinic times and venues, as well as frequently asked questions and advice for emergency sexual health situations (www.s-wize.co.uk);

·         Sexual Health Training for Professionals – Eddystone Trust is commissioned to provide sexual health training for professionals including how to conduct sexual health interventions with young people;

·         Long Acting Reversible Contraception (LARC) – LARC methods of contraception are more cost effective than oral contraceptive methods.  90% of Torbay GP surgeries are trained to counsel, fit and remove LARC with a further £10,000 having been made available to train and accredit more primary health care professionals to fit LARC in the community.

·         Role of Pharmacies in Sexual Health Provision – pharmacies provide confidential sexual health services, on a drop-in basis, including the provision of emergency hormonal contraception, Chlamydia consultations, screening and signposting to other sexual health services;

·         Sexual Assault Referral Centres (SARC) – people who have been subject to a sexual assault in Torbay are referred to SARC for care.  SARC offers a holistic service to the individual and also acts as advocate for the individual and co-ordinator in the legal process going forward;

·         Abortion Services – the commissioning of abortion services lies with the CCG, with the Public Health Team working with the CCG to provide wider sexual health services, so that contraception services are provided at point of termination in order to prevent repeat procedures.  Just over half of all teenage conceptions in Torbay end with an abortion, whilst live births (from teenage conceptions) are highest in the more deprived communities.

·         Treatment of HIV – When an individual is diagnosed as having HIV, the treatment is anti-retroviral drugs, and treatment is more effective when the virus is diagnosed early.

Members discussed whether the young women who were pregnant were known to their GPs or Sexual Health Clinics and whether the young women were aware of contraception, whether risk factors (such as alcohol) resulted in contraception being less of a priority or whether attitudes towards the ‘morning after pill’ and abortion had become an acceptable form of birth control. 

Members questioned whether aspirations of young women contributed to the levels of teenage conceptions and challenged whether a mentoring programme with professional women in Torbay being the mentors could help raise aspiration levels.  Members were advised that Sue Matthews and Siobhan Grady were in the process of establishing a mentoring initiative.

Members did perceive there to be a benefit to having a community wide database of contraception and welcomed the Pioneer Bid that sought a system wide joined up IT system that incorporates an affective text message reminder system.