Recommendation 16

HM Government Accepted in Part

Partially accept The government partially accepts this recommendation. Whilst we have inherited a fragmented health system, we are taking active measures and working collaboratively with system partners to ensure that those in need, particularly young people and high–risk groups, are able to access the necessary services. DHSC, UKHSA, NHSE together with local government, the voluntary and community sector, and patients with lived experience, are working together to develop a new HIV Action Plan, which we aim to publish in 2025. This will lay out the pathways to our 2030 goal of ending HIV transmissions and include an objective to stabilise and support SRH system enablers, including improving collaboration and integration in the wider sexual and reproductive health system. We will continue to work with the system as a whole to support the wider SRH system so it works more effectively and to continue tackling the issues identified by the report. Collaboration is at the core of our new HIV Action Plan, and we are therefore engaging a wide range of system partners in its development. Since September 2024, Professor Kevin Fenton, the Government’s Chief Advisor on HIV, has been hosting a series of engagement workshops with system partners, which will run until end of March 2025. This will help to ensure that our action plan addresses the system’s main challenges. The HIV Prevention England Programme (HPE), funded by DHSC and delivered by the Terrence Higgins Trust, will also lead engagement with the voluntary and community sector (VCS) in spring 2025 to ensure patients, their families, communities’, and charities’ views are adequately reflected in the plan. We are also working with NHSE, UKHSA, the VCS on aligning the plan to existing commitments on women’s health, work to develop a men’s health strategy, the government’s Health, Opportunities and Growth Missions and the forthcoming 10 Year Health Plan. Women’s health hubs provide integrated services in the community that are centered on meeting women’s needs across the life course. Hubs address fragmentation in commissioning and service delivery, and screening and treatment for STIs, and HIV screening are core services for women’s health hubs. As of December 2024, 39 out of 42 ICBs reported to NHS England that they had at least one women’s health hub. The government encourages ICBs to work with local authorities to collaboratively commission services as they continue to establish and expand women’s health hubs. DHSC is also planning to work closely with Department for Culture, Media and Sport colleagues on the upcoming new National Youth Strategy. Local authorities are responsible for commissioning open access SHSs. Dedicated SHSs play a key public health role in diagnosis, early treatment, and management of STIs. Individual local authorities are responsible for making funding and commissioning decisions, working with local partners including the NHS via integrated care systems, about the SHSs that best meet the needs of their local populations, including online and in–person provision. The government, however, continues to work closely together with local services by providing guidance and data through UKHSA and DHSC to support service delivery. 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 STI outbreaks. UKHSA is also undertaking work in conjunction with stakeholders to identify the best use of existing and emerging interventions to address the increase in STIs through its STI Prioritisation Framework, which was published in October 2024. It has also published a Syphilis Action Plan to address the increase in syphilis diagnosis in England, focusing on key interventions such as targeted testing, partner notification and awareness raising. Other work includes informing STI prevention programmes such as the National Chlamydia Screening Programme delivered by local authorities. The adolescent HPV immunisation Programme (run by NHSE and UKHSA) which offers vaccination to school aged children has had a huge impact on reducing genital warts in young adults as well as reducing cases of cervical cancer. UKHSA has supported the Joint Committee on Vaccination and Immunisation (JCVI) in the development of their statements on vaccination for gonorrhoea and mpox. UKHSA and British Association for Sexual Health and HIV (BASHH) published a joint Position Statement on doxycycline post–exposure prophylaxis (doxyPEP, an intervention that could reduce the risk of syphilis) and are working with BASHH on developing the UK’s first national guideline for the use of doxyPEP for the prevention of syphilis. UKHSA convenes multi–agency (including DHSC, NHSE and MHRA) vaccination programme boards to implement new vaccination programmes to prevent STIs, and, as part of the 2022 mpox outbreak response.