Sexual Health

If you are looking for sexual health information from a patient's perspective please visit the NHS Direct Wales links alongside.

Below you can find out more about what the NHS is doing to help improve the sexual health and wellbeing of the population in Wales. 


Background

Since the launch of the Strategic Framework for Promoting Sexual Health in Wales in 2001 there have been positive changes to sexual health and sexual health services.
 
There has been a consistent downward trend in the diagnosis of new infections of gonorrhoea since 2004 and of chlamydia since 2005.
 
Services previously provided by family planning and GUM clinics (Genitourinary Medicine) have been integrated to help improve the experience for patients with the majority now being seen within 48 hours of referral.
 
An evaluation of the All Wales Sexual Health Network has shown success in achieving its aim in providing a forum to promote best practice and support for the delivery of sexual health information, advice and services.
 
There has been less impact in other areas though. The rates of teenage conceptions remain relatively static and numbers of new diagnoses of HIV have been rising (though latest figures for 2008 show a reduction in new diagnoses from the previous year).
 

Policy Context

The Sexual Health Strategy 2010-2015 renews a commitment to improve the sexual health and wellbeing of the population, to narrow sexual health inequalities and to develop a society that supports open discussion about relationships, sex, and sexuality. It forms part of "Our Healthy Future" the Welsh Assembly Government’s strategic approach to improve the quality and length of life and to ensure that everyone has a fair chance to lead a healthy life.

The Welsh Assembly Government’s Strategic framework for promoting sexual health in Wales sought to address the high rates of teenage pregnancy and increasing rates of sexually transmitted infections (STI’s) in Wales.

The aims of the strategy were:

  • To improve the sexual health of the population of Wales;
  • To narrow inequalities in sexual health;
  • To enhance the general health and emotional well-being of the population by enabling and supporting fulfilling sexual relationships.

You can download the document below:

As part of the development of  the Public Health Strategic Framework for Wales - ‘Our Healthy Future’, the Task and Finish Group considering health related behaviour and risk
identified sexual health as a continuing challenge.

The Group recognised that more effort is required to improve and narrow inequalities in the sexual health of the population.


What are we doing?

 

Initiatives

The All Wales Sexual Health Network was set up to share information and promote good practice in sexual health interventions. It is aimed at practitioners/sexual health professionals and is managed by Public Health Wales.
The All Wales HIV Network is also run by Public Health Wales and offers an online service directory. The Network website is aimed at people living with HIV as well as practitioners in the field. You can find more information below:

Service Planning

Planning of services needs to take account of the specific needs of local populations, including: young people; young carers and those in or leaving care; older people ; black and minority ethnic groups; gay and bisexual men; people misusing drugs and alcohol; people living with HIV and other people affected by HIV; people with physical disability; people with learning difficulties; people with mental health problems; people living with chronic conditions; sex workers; people in prisons and youth offending establishments; people with any specific cultural or language needs; and people living in rural areas where long journeys and patchy provision often restrict access.
 
Sexual health and wellbeing is a responsibility of local Health, Social Care and Wellbeing (HSCWB) Partnerships working with Children and Young People’s Partnerships (CYPP). Each local authority and each Local Health Board is under a statutory duty to jointly formulate and implement a health, social care and well-being strategy for the public in the local authority’s area. Each local authority is under a statutory duty to publish a children and young people's plan (CYPP) setting out the authority’s strategy for discharging its functions in relation to children and young persons.The Partnerships must demonstrate that the sexual health and wellbeing needs of their local population are met in their delivery plans. You can find more information below:

Delivering Sexual Health Services

 
The NHS in Wales provides a comprehensive range of sexual health services in integrated sexual health clinics (formally Genitourinary Medicine (GUM) and family planning clinics), GP practices and pharmacies.
 
Part of the drive to improve sexual health services in Wales has been the development of Quality Requirements for Sexual Health. These include requirements for sexual health networks; sexual health promotion; sexually transmitted infections; contraceptive care; abortion service provision; HIV and AIDS and psychosexual services.

Integrated Sexual Health Services

Sexual health services in Wales have changed considerably since the review of services published in December 2004. At that time Family Planning and GUM services worked in parallel, patients accessing services for management of Sexually Transmitted Infections (STIs) were seen by doctors, and waiting times of up to 15 weeks for appointments were reported. Now family planning services and GUM services are integrated and in all services, nurses, as a minimum, provide care for asymptomatic patients (this constitutes at least 60% of all attendees). This approach maximises the opportunity for preventative health checks, allows for prompt diagnosis and treatment of infections, and provides a more effective, efficient and acceptable service for both patients and staff. You can find more information via the links below:

 


 

Primary Care

A number of GP practices are delivering a Sexual Health Enhanced Service which provides an increased range of services in the GP surgery. The GP Quality and Outcomes Framework is promoting the increased provision of information for patients and contraceptive registers which can be used to review and improve services.

Abortion Services

There are wide variations in access to abortion services and in the method of termination. The availability of medical abortion, which can be used early on in pregnancy and avoids the need for anaesthesia and surgery also varies.
You can find more information below:

 

Treatment and social care for people with HIV/AIDS

The needs of people with HIV infection are different now to when services were first established over 20 years ago. HIV is now a complex, chronic medical condition and
the challenges for patients now are much more about maintaining a good quality of life, helping them to adjust to their diagnosis, building empowerment, and increasing
self-esteem and skills for living with a chronic illness. Many with HIV infection will require little support while a few may require a considerable amount. Third sector organisations such as the Terence Higgins Trust play an important role in the provision of care for people with HIV/AIDS.

 


 

 

Psychosexual and sexual dysfunction services

A wide range of practitioners provide psychological and sexual dysfunction services in the private, third and NHS sectors. General practice and specialist sexual health
services help to make patients feel that they can discuss problems about their sex lives. Services to be able to assess patients and refer them on to specialist services when  appropriate.

 


Resources

The All Wales Sexual Health Network, in conjunction with the Family Planning Association, has released advice sheets for parents.
 
This is to help those who want to talk to their children about sex and relationships, or those faced with difficult questions from their children about the subject. 

You can download the advice sheets, and find out more information, on the All Wales Sexual Health Network page below:
 
Map of Medicine Healthguides show you the ideal, evidence-based patient journey for common and important conditions. It is a high-level overview aimed at patients. The Map also provides a framework for creating localised pathways using modified or new content specific to a local healthcare community. The NHS Wales view delivers current evidence based clinical knowledge for professionals and requires Athens log-in. 

The National Institute for Health and Clinical Excellence (NICE) is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health.

NHS Evidence provides free access to clinical and non-clinical information - local, regional, national and international. Information includes evidence, guidance and Government policy. It is primarily aimed at professionals and practitioners working in health and social care.


 

Strengthening health intelligence and research are important aspects in improving sexual health and wellbeing of the population. They define the characteristics of the population being served, both young and old; provide an evidence base for proposed action and are key to evaluating the success of the programme.

The Health Behaviour in School Children (HBSC) Survey makes comparisons in sexual behaviour of school aged children between 34 participating European and North American countries.

One role of Public Health Wales is to contribute to protecting the population of Wales from infection. This includes prevention and control strategies for STIs and BBVs through surveillance of symptomatic infection, independent advice, epidemiological investigation and research. The Health Protection division produces surveillance data for Sexually Transmitted Infections (STIs) and Blood Borne Viruses (BBVs), Sexual Health Reports and has helped to develop a Blood Borne Viral Hepatitis Action Plan for Wales.