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 Sexual Health, Reproductive Health & HIV Policy eBulletin
Supporting those working for high quality sexual health, reproductive health and HIV services 

 Welcome 


11 May 2021  (Issue 65)

Welcome to the May edition of the Sexual Health, Reproductive Health & HIV Policy eBulletin.  Following a raft of recent policy announcements from the Department of Health & Social Care (DHSC), the new (and transforming) English public health system is beginning to take shape.  The UK Health Security Agency was formally established in April to lead on health protection and a new Office for Health Promotion is expected to be up and running by Autumn, to drive forward health improvement across key public health issues including sexual and reproductive health.  On top of this the Government is in the process of developing new national strategies on Women’s Health and on Sexual and Reproductive Health as well as putting together an HIV Action Plan to end new HIV transmissions by 2030.

In this month’s eFeature, Dr Sue Mann puts the spotlight on women’s reproductive health.  She looks at the new policy opportunities and system reforms on the horizon and considers how we can better meet the reproductive health needs of women in the emerging landscape.

In this month’s round-up look out for:  new Ofsted-led government review into sexual abuse in schools; new Parliamentary inquiry into violence against women and girls; Parliamentary approval of new Regulations to address the continued lack of commissioned abortion services in Northern Ireland; recently announced APPG inquiry into the HIV needs of Black, Asian and minority ethnic communities across the UK; updated NICE guideline on postnatal care including postnatal contraception;  new SRH Behavioural Intervention Toolkit commissioned by PHE and a briefing on the next phase of the It Starts With Me campaign focusing on maintaining good sexual health and wellbeing as England continues to emerge out of lockdown.

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The Government’s call for evidence to better understand women’s experiences of the health and care system and inform the new Women’s Health Strategy has been extended until 13 June 2021

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eFeature


Meeting women’s reproductive health needs better in the emerging landscape 

Dr Sue Mann is a Consultant in Women's Health at Homerton University Hospital and Medical Expert in Reproductive Health at Public Health England.  In this month's eFeature, Sue gives a comprehensive overview of the emerging landscape around reproductive health. She looks at the impact the pandemic has had to date and considers key opportunities on the horizon to improve access to good equitable reproductive healthcare, including the development of Government-led strategies on Women's Health and Sexual and Reproductive Health and new integrated and collaborative system reforms.
>Dr Sue Mann eFeature
 

Policy development and guidance

Transforming the public health system: reforming the public health system for the challenges of our times


This policy document sets out reforms to the public health system in England, providing more detailed information on the UK Health Security Agency and announcing the establishment of a new Office for Health Promotion. The new Office for Health Promotion will sit within the DHSC, combining Public Health England’s health improvement function with existing DHSC health policy capabilities, in order to promote and deliver better health to communities nationwide. It will address and tackle important public health issues, including obesity, mental health and sexual and reproductive health, amongst other areas.
See Transforming Public Health policy document
See DHSC news release on UK Health Security Agency
See DHSC news release on Office for Health Promotion
Read ADPH response
Read FPH response
Read FSRH response
Read NAT response
Read Kings Fund blog

Public Health Grant 2021/22


The public health ringfenced grant to local government for 2021/22 of £3.324 billion was confirmed on 16 March 2021.  This represents a 1.4% increase since 2020/21.  The grant includes £23.4 million to cover the costs of routine pre-exposure prophylaxis (PrEP) commissioning.  The PrEP funding has been allocated using a bespoke formula.
See PHG announcement (inc LA allocations)
See LGA response

HIV Action Plan 


Terrence Higgins Trust (THT), National AIDS Trust (NAT) and Elton John AIDS Foundation have called on the Government to ensure its proposed HIV Action Plan - currently being drafted - is bold and ambitious, drawing on the rich information and detailed analysis in the HIV Commissions How England will end new cases of HIV report. The organisations have identified key elements that need to be in the HIV Action Plan to ensure it is effective and 'worthy of its name' and have launched an email campaign to gain support from MPs.  The Chair of the All Party Parliamentary Group on HIV and AIDS has written to Matt Hancock in support of this and to request an update on progress with the Plan.
See what elements need to be in HIV Action Plan
See letter from APPG on HIV and AIDS
Get more information on email campaign

Contaminated Blood Inquiry 


The Government has confirmed that it is introducing a number of changes to address UK-wide disparities in financial support for individuals infected and affected by contaminated blood products.  It has also signalled its intention to appoint an independent reviewer to look at options for a framework for compensation for those infected and affected by contaminated blood products. This process is separate from the Inquiry and will not duplicate the work of the Inquiry or cut across its findings. 
Get further information
See THT press statement

Review into sexual abuse in schools 


The Government has asked Ofsted to undertake an immediate review of safeguarding policies in state and independent schools and has also set up a new helpline to support potential victims of sexual harassment and abuse in education settings. Both are in response to the numerous accounts of the sexual abuse and harassment young people have suffered at school and in the community that were posted on the Everyone’s Invited website.
See DfE news release
See terms of reference for Ofsted review
See LGA response
See Brook statement on tackling abuse

Women’s safety and domestic abuse during COVID-19: a reminder of advice for NHS staff


National clinical leaders at NHS England have written a letter to NHS staff advising them of the key signs of domestic abuse and the services that are available for women, including Sexual Assault Referral Centres (SARCs). The letter details the signs of domestic abuse that staff should look out for, gives details of how the public can access support and provides details of helplines and online resources. 
See letter from NHS England

NHS Confederation consultation on leadership in Integrated Care Systems


The NHS Confederation has recently completed a consultation to gather feedback on proposed principles for clinical and care professional leadership in Integrated Care Systems (ICSs). In its response FSRH calls for the embedding of clinical leadership for women’s health at every level of the healthcare system and highlights the importance of collaborative working, and transparent workforce planning.
Download FSRH response

Sex Education Forum: move to independent status 


On the 1 April the Sex Education Forum (SEF) - formally hosted by the National Children's Bureau - became an independent charity.  SEF, now with its own organisation and governance, will seek to bring even greater focus to the task of ensuring statutory RSE delivers quality relationships and sex education to all children and young people. To mark this new chapter, SEF is offering a free taster membership from now until June. 
More information about new status & membership offer

Three Steps to RSHE Success


SEF have joined forces with the PSHE Association, ASCL, NAHT, NEU, Public Health England (PHE) and the Association for Young People’s Health to launch Three Steps to RSHE Success guidance for schools to give practical advice on three key steps to successfully implementing the statutory changes: consulting with parents, what to teach and how to teach it and sustaining success.  The guidance is accompanied by the launch of a new ‘RSHE Ready’ podcast series on everything from engaging parents to supporting teachers’ own wellbeing.
See three steps guidance
Access podcasts

Parliament

Abortion (Northern Ireland) Regulations 2021 


On 28 April Parliament approved new regulations - Abortion (Northern Ireland) Regulations 2021 - to address the continuing gaps in commissioning abortion services in Northern Ireland. The new regulations give the Secretary of State for Northern Ireland, Brandon Lewis, a power to direct the commissioning of abortion services to ensure the law - enacted over a year ago - is acted on and delivered. The Co-Chairs of the All-Party Parliamentary Group on Sexual and Reproductive Health (APPG SRH) and other key signatories have written to Robin Swann, Minister of Health for Northern Ireland expressing support for the action taken at Westminster and urging him to commission abortion services as a matter of urgency.
See Hansard
See initial NI Office press release
Read letter from APPGSRH and others

NIACT Report on Sexual and Reproductive Health in Northern Ireland


The Northern Ireland Abortion and Contraception Taskgroup (NIACT) has published a new report, outlining a vision for how education and healthcare providers can support sexual and reproductive health. The report provides 38 recommendations to inform the funding and commissioning of comprehensive sexual and reproductive education and integrated healthcare for Northern Ireland which is compliant with the regulations which came into effect in 2020.  FSRH, the Royal College of Obstetricians and Gynaecologist (RCOG) and Royal College of Midwives (RCM) have welcomed the report and urged the Northern Ireland Executive to act on its recommendations without delay.
See news item and download report from FSRH website

The Domestic Abuse Act


The Domestic Abuse Act has now completed its parliamentary stages and has received Royal Assent. The Act will provide further protections to the millions of people who experience domestic abuse and strengthen measures to tackle perpetrators.
See Government news release

Inquiries into violence against women and girls and prosecutions of rape 


The Home Affairs Select Committee has recently launched an inquiry into violence against women and girls. As part of the Committee’s overarching work into violence against women and girls, it will also run an inquiry into investigations and prosecutions of rape.  
See news release and terms of reference for both inquiries

APPG inquiry on needs of BAME communities in relation to HIV 


The APPG on HIV & AIDS has opened a new inquiry to look at whether the needs of Black, Asian and minority ethnic communities (BAME) across the UK are being adequately addressed in relation to HIV.  The inquiry will look specifically at testing, prevention and quality of life for people living with HIV.  The APPG has called for written evidence on what is happening and what needs to happen to address HIV within Black, Asian and minority ethnic communities across the UK.  The deadline for evidence is 23 July 2021.
See Call for Evidence

Sex Exploitation Bill 


NAT, THT and The Love Tank have written an open letter to Diana Johnson MP and others involved with the Private Members Sexual Exploitation Bill, highlighting concerns that the 'nordic model' proposed in the Bill has the potential to increase the risk of harm to sex workers. An accompanying briefing paper has also been produced highlighting how the criminalisation of sex work obstructs evidence-informed HIV responses and increases vulnerability to HIV and other sexually transmitted infections.
See joint letter
Read briefing paper

PrEP access


The Vice-Chair of the All Party Parliamentary Group on HIV and AIDS, Elliot Colburn MP, along with the Chief Executives of NAT, THT and National Pharmacy Association, has written to NHS England calling for a widening of access to the HIV prevention drug PrEP beyond sexual health clinics, to other health care settings including community pharmacy.
See letter

New RSE Curriculum in Wales


The Welsh Parliament has passed legislation which provides the legal framework to introduce a new skills-based curriculum in all schools in Wales from September 2022, including mandatory Relationships and Sexuality Education. The Welsh government will issue guidance to schools on how to provide RSE that is age-appropriate and relevant to pupils’ developmental stage, but it will give schools the flexibility to design their own programme of teaching that reflects diversity and difference in relationships, sex, gender and sexuality.
Get more information

Service standards & guidelines 

The response to COVID-19 is evolving and guidance from key professional organisations may change as new information becomes available.  Below are links to regularly updated COVID-19 guidance and resources. 

NICE Postnatal care guideline 


The National Institute for Health and Care Excellence (NICE) has updated its guideline on postnatal care for women and their babies in the first eight weeks after the birth. The guideline recommends that healthcare providers discuss contraception with women during postnatal appointments and includes the FSRH guideline on contraception after pregnancy as a resource. FSRH urge commissioners and service providers to work collaboratively to ensure that women can access the full range of contraception during postnatal appointments.
See guideline
Read FSRH statement

New curriculum for Community Sexual and Reproductive Health (CSRH)


FSRH’s new CSRH specialty curriculum has been approved by the General Medical Council and published on their website.  The specialty curriculum in SRH - designed to train a consultant workforce with the necessary leadership skills clinical skills for community based sexual and reproductive health services - will come into effect on 1 August 2021.
See FSRH news
Get more information about new curriculum

FSRH guidance on Astra Zeneca COVID-19 vaccine, combined hormonal contraception and blood clots


FSRH has released a statement on the Astra Zeneca COVID-19 vaccination and combined hormonal contraception and has issued related guidance for healthcare professionals to provide safe and effective contraceptive care for users of the combined pill, transdermal patch and vaginal ring.
Read FSRH statement
Download guidance

BASHH position statement multiplex testing platforms and STI treatment 


The British Association for Sexual Health and HIV (BASHH) has issued a position statement on the inappropriate use of multiplex testing platforms, and suboptimal antibiotic treatment regimens for bacterial sexually transmitted infections by some online providers.  BASHH recommends that all services offering STI testing and treatment to the public should be inspected and assessed on their performance in relation to BASHH guidance and standards, that all STI service providers should be able to demonstrate accreditation by a relevant regulatory body and that the public should be alerted to the importance of using only reputable online sites for testing.
See position statement

BASHH guidelines for the management of STIs and related conditions in children and young people (2021)


The new BASHH guidelines for the management of STIs and related conditions in children and young people (2021) have now been published and are available on the BASHH website.
See guidelines

Consultation on BHIVA guidelines for the management of HIV-2, 2021


The British HIV Association (BHIVA) is currently consulting on draft guidance on best clinical practice in the treatment and management of adults with HIV-2. The consultation is open until Friday 28 May 2021.
Access draft guidelines

UK guideline for the use of HIV Post-Exposure Prophylaxis 2021


The joint BHIVA/BASHH guideline for post-exposure prophylaxis (PEP) to HIV following sexual exposures, occupational exposures and other non-occupational exposures in the community has now been published and is available on both websites.  The new guideline serves as an update to the 2015 BASHH guideline on PEP following sexual exposures and the 2008 Expert Advisory Group on AIDS guidelines on HIV PEP.
See new guideline

Guidance for the detection of gonorrhoea in England


This PHE guidance aims to inform the commissioning and delivery of gonorrhoea testing in England and provides recommendations for best practice. It updates the previous 2014 guidance.
See updated guidance

CHIVA COVID-19 young people online survey


This report details the Children’s HIV Association (CHIVA) evaluation of the impact of the first UK COVID-19 lockdown, between March and July 2020, on young people living with HIV and the support services CHIVA developed during the pandemic.
See the full report

Evidence, data & research 

PrEP Impact Trial enrolment data 


The first data from HIV pre-exposure prophylaxis (PrEP) Impact Trial in England were presented at a joint British HIV Association and British Association for Sexual Health and HIV conference last month. The baseline enrolment data shows that the biggest discrepancy in both coverage and uptake was between age groups, with younger people aged 16-25 being under-represented relative to their risk of HIV, compared with older people.
Get more detail from NAM aidsmap article

HPV vaccination uptake in gay, bisexual and other MSM - National programme 2019 annual report


This PHE report provides an update on the progress of the national HPV MSM vaccination programme in its second year of delivery. Vaccination activity was reported by 93% of specialist sexual health services (SSHS) and 69% of HIV clinics by the end of December 2019: data from these reporting sites are included in the report.
See report

Sex, PrEP and HIV in trans and non-binary people


NAM aidsmap has recently published this new research briefing.  It covers PrEP awareness, PrEP efficacy in trans people, interactions between PrEP and hormone therapy, and trans-friendly PrEP services.
See research briefing

Understanding young people’s use and non-use of condoms and contraception (CONUNDRUM Report)


This report presents findings from CONUNDRUM – a study commissioned in 2019 by three Scottish NHS health boards, in partnership with Scottish Government, to provide insight into the social context shaping use and non-use of condoms and contraception among young people in Scotland.  The report includes 31 recommendations for future sexual health policy and service provision which have been co-developed with young people and stakeholders to inform further action.
See Exec Summary
See Full Report

Reports & other resources

Sexual and Reproductive Health Behavioural Intervention Toolkit


This toolkit recommends behaviour change intervention strategies that can be used by those commissioning, developing, and delivering interventions to support women to choose/access a preferred contraception method, plan and prepare for a pregnancy or manage reproductive symptoms. The toolkit was commissioned by PHE and completed by a team at Warwick University.
See Toolkit

HIV and the Police 


This report from NAT explores how local community organisations and police forces in Merseyside and Avon and Somerset worked together to improve understanding of HIV and address HIV stigma in the force. The report is designed to facilitate knowledge sharing and collaboration between forces and to encourage new localised action on this issue between the police and community to reduce HIV-related stigma in other areas.
See full report
Read related press release

COVID-19 and LGBT Sexual Health: Lessons learned, digital futures?


This report published by the LGBT Foundation explores the experiences of LGBT service users accessing online services during the COVID-19 pandemic. It examines the impact that the COVID-19 pandemic has had on LGBT sexual health and sets out a series of recommendations for sexual health services.
Download report

Call for innovations addressing LGBT+ health inequalities


The LGBT Foundation has also joined forces with the Academic Health Science Network (AHSN) to launch a nationwide call for innovations that tackle the health inequalities faced by LGBT people.
Find out more about this initiative

#GetSexSmart series


Brook, in partnership with BASHH, have produced a new series of videos to ensure young people get accurate information on a range of issues including STIs, emergency contraception and MSM health.  The videos can be accessed via Instagram or You Tube. 
See videos

RSE for disabled and neurodiverse young people


This Brook blog looks at the importance of high quality RSE for disabled and neurodiverse young people.  It also gives top tips for developing truly inclusive RSE practices.
Read Brook blog

Campaigns & other news 

It Starts With Me Summer Campaign: Ready for a hot summer?


The next phase of the It Starts With Me campaign will focus on raising awareness of good sexual health and wellbeing as England continues to emerge out of lockdown. The campaign will launch on Monday 17 May 2021 and will continue until the end of June with minimal social media promotion starting Thursday 6 May 2021.
See campaign briefing
Access campaign social media pack

The Sexual Health & HIV Policy eBulletin was originally developed and published by MEDFASH. 

It continues to be compiled and edited by Helen Christophers on behalf of FSRH and coalition partners. If you have any comments on the eBulletin or eFeature or suggestions for topics you would like to see covered in future eFeatures please get in touch (ebulletineditor@fsrh.org).

You can access previous eBulletins and eFeatures via the links below:
> eBulletin archive (MEDFASH)
> eFeature archive (MEDFASH/FSRH)

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