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Guidance in brief

Framework for improving sexual health outcomes


Sexual health is a key population health issue. The Department of Health has issued a new framework for England, which sets out the evidence base for sexual health services

Citation: Entwistle F (2013) Framework for improving sexual health outcomes. Nursing Times; 109: 22, 22.

Author: Fran Entwistle is assistant practice and web editor at Nursing Times.


Sexual health is often seen as a taboo subject and can be avoided by health professionals due to their own, or their patients’ embarrassment. But health professionals are exactly the people to whom the public should be turning for accurate advice and guidance. This is emphasised in A Framework for Sexual Health Improvement in England (Department of Health, 2013), which aims to:

  • Reduce inequalities and improve sexual health outcomes;
  • Build an honest and open culture where everyone is able to make informed and responsible choices about relationships and sex;
  • Recognise that sexual ill health can affect all parts of society.

Nurses from all sectors have a responsibility to ensure their patients have access to reliable information in order to fulfil the above aims. To do this, the DH has chosen to focus the current sexual health guidance on the following areas:

  • Tackling the stigma, discrimination and prejudice often associated with sexual health matters;
  • Reducing the rate of sexually transmitted infections using evidence-based preventive interventions and treatment initiatives;
  • Reducing unwanted pregnancies by ensuring that people: have access to the full range of contraception; can obtain their chosen method quickly and easily; and can take control to plan the number of, and spacing between, their children;
  • Supporting women with unwanted pregnancies to make informed decisions about their options as early as possible;
  • Tackling HIV through prevention and increased access to testing to enable early diagnosis and treatment;
  • Promoting integration, quality, value for money and innovation in the development of sexual health interventions and services.

Hard-to-reach groups

Despite the government’s aims with regard to the improvement of sexual health, as many nurses know, there are some groups that are particularly hard to reach when it comes to this sometimes sensitive subject. Culture and age often prevent engagement and it can be difficult for nurses to even begin the conversation with patients who adamantly do not want to discuss issues that they consider to be private. This can hinder nurses’ ability to promote safe sex and family planning.

However, whether they want to discuss it, nurses have a duty to make sure patients are offered the advice they need. This is particularly true for advice around the subject of contraception. In order to make an informed decision, as the DH suggests, patients must have the opportunity to weigh up information that is accurate, timely and of high quality, as well as being offered advice on what would best suit their lifestyle.

The DH describes preventive interventions as a way to help patients build personal resilience and self-esteem, in addition to promoting healthy choices. This means speaking to patients about contraception before they reach crisis - something health professionals often do not have the opportunity to do. Patients are far more likely to seek help on realising they are pregnant, for example, thereby making it necessary for all health professionals to be aware of the role of emergency contraception.

The DH states that health professionals must be able to support women with unwanted pregnancies and they must be confident in discussing options to help patients find their most appropriate way forward.


Readers' comments (2)

  • No one ahould be forced to speak about their sexuality or any sex related occurances, if they do not want to. I think it is so unfair to expect Nursing Home/Care home staff to question patients anout their sexuallity, at all! (every 3months?)This is being forced upon them and Homes with faith issues who have objected, have been critised and threatened to have charitable status removed. This is not right. Even in court when one is accused of crimes, they can refuse to comment! Why are vulnerable,usualy elderly people to be cross-examined about their sexual habits or preferences?

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  • Absolutely!

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