Recommendation 3

HM Government · verbatim extract Accepted

Partially Accept The government partially accepts this recommendation; we agree that there is a critical need to ensure sexual health services (SHS) operate effectively and meet local need. The government recognises the pressures that local authorities are facing. Since 2010, the UK has experienced low productivity growth, rising debt levels and declining public service performance, which has contributed to the challenging fiscal and economic position that we have inherited. However, we understand the importance of ensuring we meet pressures on the local government Public Health funding. In 2025/26 we are increasing funding through the ringfenced Public Health Grant, and the 100% retained business rate arrangement for local authorities in Greater Manchester, to £3.858 billion. This is a cash increase of £198 million compared to 24/25, providing local government with an average 5.4% cash increase and 3.0% real terms increase. This represents a significant turning point for local health services, marking the biggest real-terms increase after nearly a decade of reduced spending (between 2016 and 2024). Subject to the spending review, we will aim to issue multi-year allocations from 2026/27 onwards to provide greater certainty to our local partners. Local authorities are in the best position to understand the needs of the communities they serve, and are therefore responsible for commissioning comprehensive, open access SHSs to meet local demand. These include online and face to face provision of advice and interventions. Overall, data indicates there was an increase in all attendances and consultations (face to face, telephone or online) at SHSs in England between 2022 and 2023 (up 5.0%, from 4.4m to 4.6m), with more face–to–face attendances (7.9% increase, from 2.1m in 2022 to 2.3m in 2023) and online consultations (7.5% increase, from 1.8m to 2.0m) accounting for the rise. However, these have still not recovered to pre pandemic levels and there is evidence of inequality of use of online services. The government is aware of the challenging broader sexual health landscape in which local services are operating and is committed to supporting them to deliver SHSs effectively. In March 2023, DHSC and UKHSA published the Integrated Sexual Health Service Specification to support local authorities in comprehensive commissioning of services and provide advice and guidance on managing STIs outbreaks. In response to the continued rise in STI diagnoses, UKHSA has led work to review our collective approach to controlling STIs with a focus on preventing adverse health outcomes and reducing health inequalities. As part of this work, UKHSA published the STI Prioritisation Framework on 10 October 2024. The framework, combined with ongoing support from UKHSA, will enable local systems to identify which combination of interventions to focus on for which populations, informed by the local situation. We will continue working together with system partners to support local authorities in the delivery of SHSs.