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The Healthcare Commission is today releasing the findings of a review of data on sexual health that also highlights initiatives currently in place to improve sexual health in England and outlines the Commission's approach to assessing sexual health service delivery.

Sexual health is an important part of physical and mental health. Good sexual health services are vital in inspiring public health and tackling health inequalities.

The review has found that tracking progress and recognising where improvements are needed in sexual health are difficult because of gaps in the data currently available.

As a result, services are limited in their ability to target groups at high risk, use data to plan and allocate resources where they are needed, or monitor effectively people's access to services and levels of sexual health.

The findings of the review show data is derived from different geographic levels such as local authorities, primary care trusts and GUM (genitourinary medicine) clinics, meaning there is not a clear indication of where improvements are needed.

It is also collected at different intervals of time such as monthly or quarterly and from different sources, for example the Health Protection Agency, the Office of National Statistics or the Department of Health. This makes comparison of data difficult.

Furthermore, data is often missing vital information for tracking progress, such as age, gender, ethnicity of patients, or the information itself is out of date. This makes it difficult to target prevention and treatment services at those who need them most.

The review also found there are many initiatives in place to improve sexual health, including the Department of Health's National Chlamydia Screening Programme and the Department of Health and Medical Foundation for HIV and Sexual Health (MedFASH) review of GUM services.

The Department also runs a sexual health National Support Team, which helps services in areas with the greatest challenges. The priorities for this team are to help services meet the national target of 48-hour access to GUM services and the national target for reducing the conception rate for under-18s.

Key recommendations highlighted in the report include:

Improving data, information and planning

There is an urgent need for a comprehensive data set to allow more effective targeting of services for those who need them most, and to track progress.

The Department of Health and its partners are already developing the Common Data Set for Sexual Health and HIV to support and monitor implementation of the national strategy regarding sexual health.

However, if these developments do not improve the quality of sexual health data in the next year, the Department should produce guidance to providers of sexual health services to support routine collection of information on age, gender and ethnicity as a minimum requirement. Data on where patients live (through a partial postcode) would enable regulators, performance managers and others to track achievement more effectively.

Government Offices and strategic health authorities, which monitor the performance of local government and healthcare organisations on the commissioning of services, need to make use of the data available on sexual health in their performance management of PCTs and local strategic partnerships.
 
Providers of sexual health services should collect data in line with nationally agreed guidelines, including the Common Data Set for Sexual Health and HIV, ensuring that age, sex, locally tailored ethnic monitoring and postcodes are used.

Ensuring progress, standards and effectiveness are maintained

The Department of Health is urged to measure progress on its National Strategy for Sexual Health and HIV and to review the MedFASH standards for sexual health and HIV service delivery.

Sexual health service providers should engage with patients and the public to ensure that services meet the needs of local communities.

The Healthcare Commission's Head of Public Health, Jude Williams said: "We know that sexual ill health is a significant problem in England.

"In order to identify problem areas a specific, detailed and consistent data set on sexual health is urgently needed.

"It is vital that everyone involved in sexual health services, from the Government through to those providing front-line services, makes improving data collection, and using that data to deliver effective services, a top priority.

"The Commission will play its part in driving this improvement by monitoring and reporting on progress in this area."

As part of this review the Commission has collated previously published data on sexual health, to identify themes and trends. This data was collated from a variety of sources including the Health Protection Agency, the Department of Health and the South West Public Health Observatory. It is clear from data on sexual health, such as the following, that sexual health needs to remain a top health priority:

Teenage pregnancy

Between 1998 (the baseline year for the Government's Teenage Pregnancy Strategy) and 2005 (the latest year for which data is available) the under-18 conception rate in England fell by 11.8%. This is the lowest rate for over 20 years.

However the under-18 conception rate in the most deprived 10% of wards is still four times higher than the rate in the least deprived wards.

Evidence from the Teenage Pregnancy Unit in the Department for Children, Schools and Families shows the impact teenage conceptions can have. Teenage mothers are 22% more likely to be living in poverty at age 30 than those who give birth at the age of 24 or over.

Abortions

The rate of abortions has increased by nearly 50% between 1984 and 2005, with more than 180,000 abortions carried out in 2005.

Chlamydia

The known incidence of chlamydia, which increases the risk of pelvic inflammatory disease and ectopic pregnancy, increased by more than 300% (from 35,840 to 109,958) between 1996 and 2005.

HIV

The known incidence of HIV increased from 2,500 cases in 1995 to almost 7,500 in 2005. Areas with the highest number of diagnoses have also been found to be in the most deprived populations.

The Healthcare Commission will be monitoring progress in sexual health services through its annual health check and ongoing assessment and surveillance of services.

Read the full sexual health report (pdf 502kb)

Read the summary of the sexual health report (pdf 231kb)

More information about improving sexual health services

Notes to editors

Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services. 

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.

The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.

For further information contact Janine Maher on 0207 448 9313, or on 0777 999 0845 after hours.

Related Files

• Sexual health full report pdf | 502kb
• Sexual health summary report pdf | 231kb