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Sexual health services at 'tipping point' due to rise in demand and funding cuts

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A rise in demand for sexual health services at a time of cuts to funding has made it “extremely challenging” to maintain provision, the Local Government Association has warned.

The LGA, which represents more than 370 councils in England and Wales, said services had now reached “tipping point”, after demand increased by 25% in five years and the government reduced the public health grant by £531m.

“Sexual health services are now reaching a tipping point”

Izzi Seccombe

It highlighted that there were 2,456,779 new attendances at sexual health clinics in 2016, compared with 1,941,801 in 2012.

Although the number of new diagnoses of sexually transmitted infections (STIs) fell by 4% last year, the LGA warned that patients could face longer waiting times and a reduced quality service unless the government reversed funding cuts.

Compared to 2015, the total number of new STIs diagnosed in 2016 decreased from 436,928 to 417,584. Specifically, the LGA noted a 12% decrease in gonorrhoea diagnoses, from 41,262 to 36,244, and an 8% decrease in genital warts, from 68,444 to 62,721.

Izzi Seccombe, chair of the LGA’s community wellbeing board, said it was “encouraging” that more people were taking sexual health seriously but warned there was concern over the capacity for councils’ to cope.

Izzi Seccombe

Warning over rise in demand for sexual health services

Izzi Seccombe

She said: “The reduction in public health funding could also compound problems further and impact on councils’ ability to meet demand and respond to unforeseen outbreaks.

“It is obviously good news that diagnoses of sexually transmitted infections are down, but sexual health services are now reaching a tipping point where it will be extremely challenging to maintain this progress,” she added.

The government reduced the public health grant by £331m between 2016-17 and 2020-21 following a £200m in-year reduction in 2015-16.

According to the LGA, councils spend about £600m a year on sexual health services and the overall public health budget for 2017-18 is £3.4bn.

In response, the Royal College of Nursing warned that, without adequate funding, the clock would be turned back on recent progress in tackling STIs.

“We’ll just be turning back the clock, as pressures build and patients wait longer”

Helen Donovan

Helen Donovan, the RCN’s professional lead for public health,  said: “Delayed appointments risk further transmission, potentially turning individual cases into a much wider public health issue. These worrying figures show how the government is undermining decades of progress in sexual health.

“None of the improvement we’ve seen would have been possible without local sexual health services. Nurses working in the community are experts in understanding their local area’s needs, but without the right funding this is all at risk,” she said.

“We’ll just be turning back the clock, as pressures build and patients wait longer to get the treatment they need,” she said. “We join the LGA’s call to reverse these cuts to public health funding and prevent further crises in the future.”

The British Association for Sexual Health and HIV (BASHH) told Nursing Times that it echoed the concerns raised by the LGA that sexual health services were at a “tipping point” due to significant and sustained cuts to public health budgets.

Leaders from BASHH said the organisation had heard reports from across the country where services had been closed or access to services or tests was restricted.

“This risks missed or delayed diagnosis and treatment of STIs, leading to increased complications such as infertility and chronic pelvic pain,” they warned. “Unprecedented demand for services, record levels of new STI diagnoses and the emergence of treatment-resistant infection means we are facing the prospect of a ‘perfect storm’ in sexual health, with serious long-term consequences not only for individuals but also for the whole community.”

“We are speaking out for the voiceless that need our services, either now or in the future, and particularly those who are the most vulnerable, including young people and those at risk of child sexual exploitation, as these ultimately stand to lose the most. We urge the government to act immediately and safeguard funding for sexual health care. Failure to do so will be the falsest of false economies, the consequences of which will be felt for years to come,” they added.

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