Targets
77. The Strategy includes four targets. These are:
- To reduce by 25% the number of newly acquired
HIV infections and gonorrhoea infections by 2007.
- By the end of 2004, all GUM clinic attendees
should be offered an HIV test on their first screening for sexually
transmitted infections (and subsequently according to risk) with
a view to:
- increasing the uptake of the test by those offered
it to 40% by the end of 2004 and to 60% by the end of 2007;
- reducing by 50% by the end of 2007 the number
of previously undiagnosed HIV infected people attending GUM clinics
who remain unaware of their infection after their visit.
- By the end of 2003, all homosexual and bisexual
men attending GUM clinics should be offered hepatitis B immunisation
at their first visit;
- expected uptake of the first dose of the vaccine,
in those not previously immunised, to reach 80% by the end of
2004 and 90% by the end of 2006;
- expected uptake of the three doses of vaccine,
in those not previously immunised, within one of the recommended
regimens to reach 50% by the end of 2004 and 70% by the end of
2006.
- From 2005, commissioners should ensure that women
who meet the legal requirements have access to an abortion within
3 weeks of the first appointment with the GP or other referring
doctor.
As the Strategy does not have National Service
Framework status, these targets are not included in the Priorities
and Planning Framework around which PCTs base their annual agreements,
and progress against these targets will not be measured as part
of the NHS performance management system.[53]
78. A great many service providers welcomed the arrival
of the Strategy, and endorsed its general aims. They were
pleased to see that in 'joining up' HIV/AIDS with broader sexual
health issues, the Strategy presented a strong case for
prioritising sexual health on the grounds of public health. For
some participants in the Department's consultation, the breadth
of the Strategy was its strongest aspect. In written evidence
to us Dr Simon Barton, Clinical Director of HIV and Genito-urinary
Medicine at the Chelsea & Westminster Hospital, said it was
essential that:
sexual health and HIV, united together in a national
strategy, would be identified for primary care trusts and strategic
health authorities as areas of health care requiring prioritisation
on public health grounds, as well as ensuring that they developed
an integrated approach between HIV and sexual health services
on a network basis.[54]
79. However, much concern was expressed about whether
overstretched services would be able to implement the Strategy.
Consultant Physician Janette Clarke's response is representative
of the evidence we received:
The Sexual Health Strategy offers a vision of
comprehensive open access service for HIV, sexual infection and
contraception services. I sincerely hope that we can work towards
the vision but would plead that patients need services in the
interim.[55]
80. Dr Barton told us that he and his colleagues
responded to the Strategy with enthusiasm in July 2001:
Although the publication of the Strategy
had been delayed for several months, we were optimistic that the
consultation period which ended on 21 December 2001 would be followed
swiftly by clarifications of the Strategy and the implementation
action plan and identification of the resources to achieve this.
Unfortunately, since the end of the consultation period, we are
unaware of any formal response from the Department. This is particularly
disappointing and has contributed to losing the momentum, which
had been gained in the production and consultation period of the
Strategy.[56]
81. In June 2002 the Department announced that owing
to the overall support for the aims and interventions proposed
in the Strategy, the Strategy itself would not be
revised in light of the response to consultation. Instead, the
Department published an Implementation Action Plan for
the Strategy, which included a response to the key points
raised by the consultation.
82. Although we support the Government's drive
to improve sexual health services via the Strategy, without
wholesale advances in sexual health provision these targets will
be tokenistic.
83. The Strategy specifies that from 2005,
commissioners should ensure that women who meet the legal requirements
have access to an abortion within three weeks of the first appointment
with the GP or other referring doctor. In our view, three weeks
is too long for people to wait in these circumstances.
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