Healthwatch briefing on sexual health

Healthwatch Brighton and Hove produced this briefing in 2019 to examine the pressures facing local sexual health services and to explore how funding and commissioning arrangements affect provision. The report highlighted that Brighton and Hove has some of the highest rates of sexually transmitted infections (STIs) and HIV outside London, alongside very high levels of demand for sexual health services. At the same time, local sexual health services were operating within a context of reduced public health funding and increasing concern about whether resources were sufficient to meet current and future need. 

The report found that sexual health demand was increasing nationally and locally. Brighton and Hove had particularly high rates of chlamydia, gonorrhoea and syphilis compared with regional and national averages, while certain groups, including younger people, Black communities and men who have sex with men, were disproportionately affected. The city had also committed to international Fast-Track City targets aimed at ending HIV transmission and reducing HIV-related stigma, placing additional importance on maintaining effective testing, prevention and treatment services. 

Healthwatch identified concerns about public health funding and the way sexual health services were commissioned. The report noted that local authority public health budgets had been reduced over a number of years and that cuts had particularly affected sexual health promotion and prevention services. It also highlighted concerns that responsibility for different aspects of sexual health care was split between local authorities, NHS England and Clinical Commissioning Groups, creating a fragmented system that could make services harder to coordinate and navigate. 

Despite these challenges, the report highlighted a range of strengths within local provision. Services such as the integrated Sexual Health and Contraception Service (SHAC), Terrence Higgins Trust programmes, Brighton Station walk-in services and HIV testing initiatives were providing innovative approaches to increase testing and improve access. Healthwatch concluded that maintaining effective sexual health services would require ongoing investment, improved commissioning arrangements, stronger collaboration between organisations and continued efforts to reach communities most at risk of poor sexual health outcomes.