The Health and Social Care Committee has written a
letter to the Department of Health and Social Care
(DHSC) with recommendations for strengthening England's sexual
health and reproductive services.
It comes after the Committee held a deep-dive evidence
session with experts on policy and frontline service delivery
in the field of sexual health services, who told of fragmented
services, scarce resources and misinformation.
Chief among its recommendations, the Committee calls for DHSC to
develop a national, overarching strategy for sexual and
reproductive health services, supported by sustainable funding.
This should clear up what can be a confusing picture of what
services are offered by different parts of the health service or
local authorities. Such fragmentation can cause long delays to
patients getting the services they need, experts said. A strategy
of this kind has not been published since 2013. The cross-party
Committee also strongly recommends that a new strategy should
provide a unified framework for service planning, integrating
existing approaches to HIV, women's health, and LGBT+ health
under a single, coherent vision.
The Committee heard evidence of how waiting rooms at A&E
could be used to offer screenings for diseases such as HIV and
syphilis. As well as during A&E visits, the letter also
recommends exploring options for integrating sexual health
screening into wider healthcare interactions, such as GP
registration and school nurse interactions. This could improve
access, reduce stigma, and reach underserved populations.
The MPs' letter says DHSC should urgently increase the number of
funded training posts for sexual healthcare specialists as part
of its NHS 10-Year Workforce Plan. The training pathway for
sexual and reproductive healthcare specialists is six years
post-foundation, with intense competition. Witnesses told the
Committee that 1,400 applicants for just 14 posts this year, and
that a 2023 workforce survey suggested one-third of the sexual
health workforce was expected to retire by 2028.
After hearing about a scarcity of postal testing kits, and a lack
of click-and-collect options for individuals who require
discretion, the Committee recommends national coordination of
online platforms that test kits can be ordered from. This model
has been successfully adopted in Wales, where there is a
centralised postal kit testing service. Experts also said this
could avoid duplication of effort among multiple services that
offer online-ordered postal tests.
To help tackle stigma, DHSC should develop a public information
campaign and social media strategy on sexual health. This should
be developed with organisations working with young people and
marginalised groups who are less likely to access services, to
build trust and ensure that messaging is inclusive and culturally
sensitive.
Lastly, the Committee recommends that DHSC take targeted action
to improve national data collection on emerging sexual health
challenges, such as chemsex-related harm, to inform service
design, support and funding decisions. This should include
coordinated efforts across sexual health, mental health, and
substance misuse services, with clear leadership and
accountability at national and local levels.
Health and Social Care Committee Chair MP said:
“Despite having a dedicated and passionate workforce, we
heard that sexual health services can feel like an overlooked and
undervalued part of the health service for those on the front
line. And the fact that no policy review has been carried out for
over a decade is an inexcusable oversight. This Government must
now take a panoramic view of the confusing landscape of sexual
health and reproductive services. It should come up with a
comprehensive strategy to take the anxiety out of accessing care,
and make sure services are patient-centred and sustainably
resourced.”
