Sexual and Reproductive Health
Our priorities
We have identified four key priorities:
Why is this a priority?
Improving sexual health and wellbeing requires a holistic approach that takes into account the physical, mental, social and economic factors that all influence sexual behaviour. We know the importance of ensuring people have the information, knowledge, skills and accessible services that allow them to make healthy choices about their sexual lives.
- Following the introduction of compulsory delivery of Relationships and Sex Education (RSE) in September 2020, statutory, high-quality relationship education in primary schools and relationships and sex education in secondary schools equips young people with the skills to improve their sexual and reproductive health and overall wellbeing. We will provide support to schools to ensure continued implementation of the new national guidance for RSE. We will also support schools around the delivery of education linked to overlapping riskier behaviours which also impact on sexual health, such as drugs and alcohol use.
- Engage with the wider partners in relation to young people’s sexual health education (such as youth clubs and sports clubs), to spread messages and information, whilst also utlising social media channels in a positive way.
- Ensure that sexual health specific information is widely accessible across the life course, in particular in relation to contraception and sexually transmitted infections, including the promotion and accessibility of emergency hormonal contraception (EHC), and pre-exposure prophylaxis (PReP), used in the prevention of contracting HIV.
- Ensure the accessibility of information in relation to wider issues such as perimenopause, menopause and post-reproductive health, psychosexual health, emotional wellbeing, communication skills and managing relationships.
- Ensure sexual health information is embedded into existing training for professionals, adopting Making Every Contact Count (MECC) principles to enable the workforce to opportunistically promote sexual health and wellbeing in all conversations.
Why is this a priority?
In Cheshire West and Chester we want to see more people being diagnosed early, particularly important in HIV, and STI infections such as chlamydia. We know that the earlier someone with HIV starts medication, the more beneficial the medications are in helping them to live well1. We also know that chlamydia infections can be asymptomatic in the early stages, and, if left untreated in young women increases their risk of ill health and infertility.2
- As diagnosis is the first step, it is important to ensure there is information and advice to help people access services and support easily in a timely manner. This includes making the best use of digital technologies, building on the more agile and flexible approach to service delivery and design seen during the COVID-19 pandemic such as postal testing.
- We need to recognise that contact with clinicians is not to be restricted to General Practitioners (GPs) and sexual health clinics. There are a range of other professionals, for example Pharmacists, who can also provide some sexual health services.
- Working with our local primary care providers, secondary care providers and the third sector is essential to ensure that our residents have local access to support, advice, support and treatment at times and places that are convenient for them.
- Ensure health professionals have the necessary training to enable them to provide a range of sexual health services and be a source of information. We also want to increase education and training to enable more opportunistic screening and diagnosis.
References
- Care, Department of Health and Social. Towards Zero - an action plan towards ending HIV transimission, Aids and HIV related deaths in England, 2022-25. s.l. : Department of Health and Social Care, 2021.
- NHS: Chlamydia complications
Why is this a priority?
Enabling people to consider their sexual health and wellbeing in the context of their whole life, by ensuring services are joined up and address the wider determinants, is a key priority. For example, lifestyle choices such as using drugs and/or alcohol can affect people's inhibitions and judgement, leading to risky sexual behaviour for example, unprotected sex.
- Strengthen and embed sexual health knowledge and support into inter-linked services, those experiencing poor mental health or dealing with alcohol or drug misuse, including providing stakeholder sexual health awareness training.
- Improve sexual wellbeing for our most underserved communities and those where sexual health inequalities are greatest through strengthening conversations and reducing stigma in respect of sexual health and HIV.
- Ensure that sexual health services are well linked with other health partners such as GPs and pharmacies, to provide a joined up approached to delivering good sexual health services.
- Ensure that the accessibility of services is considered, taking into account our more vulnerable communities, or those who feel less heard. For example through the positioning of services and their hubs, or through engagement with service users to understand how to make their experience of accessing services feel more equitable.
Why is this a priority?
Many people remain sexually active beyond their reproductive years. We know that in Cheshire West and Chester in 2021, 75,900 people were aged 65+ (21 percent), above the England average1. We recognise that adults who start relationships in later life need access to inclusive services and targeted information, support and advice. We will work to:
- Ensure that information relating to STIs is communicated, recognising that STIs do not only effect young people
- Raise awareness to support adults in this age group seeking help for problems related to sexual activity and function, which may have important impacts on quality of life. The known sexual health problems in this age group may well be underestimated because of a possible reluctance to seek help, due to embarrassment or stigma.
- Understand the demographic profile of our service users and use health promotion techniques to target sexual health messages aimed at specifically at older men and women
References
Measuring the Impact - what will success look like?
- People have safe sexual health lives without the risk of adverse experiences, unplanned conception or sexually transmitted infection
- There is good quality support and information available to people from the pre-diagnosis stage and throughout the diagnosis journey and people know where to access this.
- Service access is supported using a range of technology and digital opportunities (online, social media, mobile apps, postal testing).
- Cheshire West and Chester residents are supported appropriately across the life course to establish and maintain good sexual health practices and understand the effects of behaviours on their sexual health.
- Older people are able to find and access sexual health advice, support and services to help them meet their needs and enjoy healthy sexual lives.
Potential Indicators
- Rate of new sexually transmitted infection diagnoses (all ages)
- Under 18s conception rate
- Under 25s repeat abortions rate
- Uptake of condom distribution scheme (C-card).
- Number of people accessing Sexual Health services year on year.
- Number of people accessing Sexual Health services year on year.
- Number of young people accessing sexual health services
- Chlamydia detection rate aged 15 to 24
- New HIV diagnosis rate
- HIV late diagnosis rate
- Total prescribed Long Acting Reversible Contraception (LARC), excluding injections.
- Number of young people choosing LARC as their main method of contraception
