Guidance

Commissioning local HIV sexual and reproductive health services

Tools and resources for commissioners of HIV, sexual and reproductive health services to help plan and commission regional and local services.

Published 22 November 2013
Last updated 26 March 2018 — see all updates

From:: Public Health England

Sexual and reproductive health is not just about preventing disease or infection. It also means promoting good sexual health in a wider context, including relationships, sexuality and sexual rights.

Commissioning responsibilities

Sexual health services are commissioned at a local level to meet the needs of the local population, including provision of information, advice and support on a range of issues, such as sexually transmitted infections (STIs), contraception, relationships and unplanned pregnancy.

Local authorities commission comprehensive open access sexual health services (including free STI testing and treatment, notification of sexual partners of infected persons and free provision of contraception). Some specialised services are directly commissioned by clinical commissioning groups (CCGs), and at the national level by NHS England.

Local authorities commission:

comprehensive sexual health services including most contraceptive services and all prescribing costs, but excluding GP additionally-provided contraception
sexually transmitted infections (STI) testing and treatment, chlamydia screening and HIV testing
specialist services, including young people’s sexual health, teenage pregnancy services, outreach, HIV prevention, sexual health promotion, services in schools, college and pharmacies

CCGs commission:

most abortion services
sterilisation
vasectomy
non-sexual-health elements of psychosexual health services
gynaecology including any use of contraception for non-contraceptive purposes

NHS England commissions:

contraception provided as an additional service under the GP contract
HIV treatment and care (including drug costs for PEPSE)
promotion of opportunistic testing and treatment for STIs and patient-requested testing by GPs
sexual health elements of prison health services
sexual assault referral centres
cervical screening
specialist fetal medicine services

Across England there is considerable regional variation in how sexual health services are provided and commissioned. They vary from distinctly separate general practice and community-based contraceptive provision with hospital-based abortion and genito-urinary medicine (GUM) services, to fully integrated sexual health services in the community. The variations occur because of differences in commissioning and contractual models used in local areas.

Resources

This section brings together existing resources that commissioners can use to support the commissioning process. It is primarily aimed at people working in local authorities who are either new to sexual health or new to commissioning, or to both. It should also be useful to those who have been working in the field for some time – as a reminder of a familiar issue, a prompt about something new or a useful reference point for key important documents.

The document should be used as a reference that can be dipped into at all stages of the commissioning cycle.

Further resources for commissioners

Various organisations provide additional information and guidance to inform the commissioning of sexual health services. These include statutory organisations, educational bodies and the voluntary sector:

National Institute for Clinical Excellence (NICE) provides evidence-based practice, pathways and guidelines for sexual health
British Association for Sexual Health and HIV (BASHH) champions good sexual health and provides training and workshops and information on governance and guidelines.
British HIV Association (BHIVA) is a national advisory body to professions and other organisations on all aspects of HIV care, providing clinical guidelines and standards as well as educational events
Faculty of Sexual and Reproductive Health produces guidance and advice on all aspects of contraception, including service standards and clinical governance for reproductive services
Family Planning Association has details of training courses for health professionals
Sexwise provides information and advice about contraception, pregnancy, STIs and sexual wellbeing for public and professionals including webinars
Brook has information for professionals about sexual health advice for young people
National Aids Trust has information, advice, a range of publications and useful leaflets, and also runs the English HIV and sexual health commissioners network
Terence Higgins Trust (THT) has resources and information on sexual health and HIV for several audiences, including for teachers, health

Published 22 November 2013
Last updated 26 March 2018 + show all updates

26 March 2018 Updated sources of information.
14 January 2015 Link to guidance 'Sexual and reproductive health in England: a guide to local and national data' added.
8 September 2014 Replaced consultation link to the published commissioning guidance.
1 April 2014 A link to 'PHE Guide to National and Local Sexual and Reproductive Health Data' is added to the 'Data to help commissioners identify local needs' section.
6 February 2014 Edited to update the guide with HIV and reproductive health resources
22 November 2013 First published.

Contents

Commissioning local HIV sexual and reproductive health services

Commissioning responsibilities

Resources

Policy context

Commissioning responsibilities

Needs assessments

Data and evidence

Designing services

Service specifications

Standards

NICE guidelines and resources

Keeping up-to-date

Further resources for commissioners

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