Website of the Department of Health

Rates of diagnoses of uncomplicated genital chlamydial infection by sex, GUM clinics, England 1995-2003

Source: KC60 statutory returns and ISD(D)5 data.

76. Chapter 2 set out our plans for a major new campaign on sexual health. But information alone will not be enough. We are committing new capital and revenue funding to tackle the high rate of STIs in England. This will support modernisation of the whole range of NHS sexual health services, to communicate better with people about the risk, offer more accessible services to provide faster and better prevention and treatment, and deliver these services in a different way. This will need action to break down the boundaries between primary and specialist services, and new staff roles and skills. It is why National Standards, Local Action: Health and Social Care Standards and Planning Framework (2005-06/2007-08) includes improving sexual health within the national targets for the NHS and why sexual health will be included in the forthcoming round of Local Delivery Plans.

77. In future, sexual health services will be delivered through a flexible multidisciplinary workforce, in a range of settings, including:

78. Services like testing and screening for STIs will increasingly be delivered in the community particularly targeting young people, vulnerable people and those who are hard to reach or at significant risk, such as black and minority ethnic groups. There are already excellent examples of good practice, but these are in small pockets and need to be expanded. The following models could form the building blocks for this expansion:

79. We will have at the cornerstone of the drive for better sexual health a systematic campaign to reduce the incidence of chlamydia. Chlamydia can cause profound distress later in life through infertility or pelvic inflammatory disease. High-volume testing for chlamydia is essential if we are to see an impact on rates of infection and the knock-on effect of ill health.

80. We will accelerate implementation of a national screening programme for chlamydia, to cover the whole of England by March 2007. The 1.2 million women who attend contraception services each year - the vast majority under 25 years old - will be the main focus for offering chlamydia screening as well as wider health advice. We believe that the independent sector could contribute to providing efficient and convenient screening services. As part of the national programme we will take steps to introduce and evaluate the effectiveness of chlamydia screening in retail pharmacies starting in London.

81. Prevention services also need to be developed and modernised. Contraception services have a key role to play in protecting against both unplanned pregnancies and STIs. To support this, the NHS will also strengthen the infrastructure for sexual health and contraception services in primary care. Currently contraceptive services are patchy and in some areas virtually nonexistent. We will therefore carry out an audit of contraceptive service provision in early 2005 and invest centrally to meet gaps in local services in particular to ensure that the full range of contraceptive services is available, good practice is spread and services modernised.

82. Modernising the whole sexual health service will also involve transforming access to specialist treatment services. There is little point in screening people for STIs if they cannot also access specialist treatment quickly and easily. Current GUM services are struggling with the demands placed on them and primary care services need strengthening. We are carrying out a national review of treatment services to provide advice and support on ser vice modernisation for both commissioners and service providers and will follow this up with investment in both services and infrastructure.

83. Delay in the detection and treatment of STIs promotes onward transmission, the development of expensive complications and the spread of HIV.

84. We intend that the NHS should offer the same fast access to high quality GUM services that patients expect of other NHS treatment. The goal is that by 2008 everyone referred to a GUM clinic should be able to have an appointment within 48 hours - a target that is currently only met for 38% of attendances.

Case study

www.healthm8.net has been created by the Northamptonshire Healthy Schools Development Team, which works on behalf of Daventry and South Northants PCT, Northamptonshire Heartlands PCT, Northampton PCT and Northamptonshire County Council Schools Service. The website was designed in response to research which established that young people want an information source that is up to date, speaks their language, and is relevant and interactive. Young people and local partners have been involved in its development. 

The site can be accessed anywhere that young people have the opportunity to use the internet, whether at school, at home, or in a cyber cafe, and they remain anonymous. It deals with subjects topic by topic. The sex and relationships section deals with building a relationship without feeling pressured to have sex; contraception; STIs; HIV and AIDS; confidentiality and where to go for help. The drugs section provides information about all categories of drugs, including prescribed and legal drugs and the law. It also deals with the consequences of taking drugs including their impact on health, travel, future opportunities and sport. Alcohol and smoking sections are also live. Healthm8 has an online agony aunt to answer any sensitive questions that young people may have. 

Young people say that, 'It's just what we wanted, it actually talks about sex!' and 'It made us laugh, but got us talking'. Teachers talk about the fact that, 'It takes the pressure off of them having to introduce an embarrassing subject.' Health professionals have welcomed the introduction of online confidential support for young people.

• www.healthm8.net (opens new window)