On Monday 11 February 2019 the Health and Social Care Committee visited Plymouth in connection with their inquiry into sexual health. The following Members and staff attended:
Dr Sarah Wollaston (Chair); Rt Hon Ben Bradshaw; Diana Johnson; Johnny Mercer; Dr Paul Williams.
Laura Daniels, Senior Committee Specialist; Dr Joe Freer, Clinical Fellow; Victoria Pope, Inquiry Manager.
The visit programme was arranged by Laura Juett, Public Health Specialist at Plymouth City Council. The Committee are extremely grateful for the time and effort put into hosting the visit by Laura and by the wide range of others who contributed, and for the generous welcomed that was extended to them by Cllr Ian Tuffin, portfolio holder for health and social care at Plymouth City Council; by the Council’s public health specialists; by managers and clinicians at University Hospitals Plymouth NHS Trust; and by the staff of the Zone.
The Committee places a high value on meeting those directly involved in the planning and provision of services in their own local areas to hear first hand about the challenges being faced and the innovations being adopted in delivering health and social care. The Committee is also committed to meeting service providers from as wide a range of areas as possible, and following recent visits to services in Lancashire, Yorkshire and Essex, was keen to hold a visit in the South West of England.
Recorded rates of sexually transmitted infections in Plymouth are high when compared to similar areas. In 2017, the rate of all new STI diagnoses was the 28th highest out of 326 local authorities in England. Overall, 2,860 new STIs were diagnosed in residents of Plymouth, a rate of 1,090.1 per 100,000 residents (compared to 743 per 100,000 in England).
In response to the challenges of increasing demand for health and social care services, complexity of need and severe financial pressures Plymouth formed an integrated commissioning function in April 2015. This whole system approach is characterised by joint strategic leadership, an integrated fund (including the Public Health Grant), shared financial framework and risk share arrangements and a series of joint commissioning strategies.
It is within this context that the council re-commissioned sexual health services in 2017. Following detailed discussions with legal and procurement experts the council used a negotiated procedure to work with existing providers of sexual health services to design a new integrated model of provision and ensure continuous improvement and cost efficiencies. More detail about the Plymouth experience can be found in their written submission.
The Committee began their visit at the SHiP sexual health centre based at Derriford Hospital, part of University Hospitals Plymouth NHS Trust. The visit was hosted by Dr Derval Harte (Consultant in Sexual Health and HIV Medicine) and Keith Chapman (Care Group General Manager, Women and Children’s), and provided Members with an opportunity to see a working clinic; to discuss demand/capacity, innovation and integration, and to see a demonstration of the online service.
Other attendees included Anne James, Chief Executive, University Hospitals Plymouth (UHP) NHS Trust; Megan Griffiths, Consultant Sexual and Reproductive Health; Dr David Pao, Consultant in Sexual Health and HIV; Emma Collins, Sexual Health Nurse Consultant; Debbie George, Admin Lead; and Kath Williams, Matron.
The Committee then visited the Zone, a charity which provides free and confidential information and support to young people in the centre of Plymouth. Its drop in service offers young people emotional support and information around housing, sexual health and mental health and the options available to them.
The visit, where the Committee met Mike Jarman, Chief Executive, Jodie Frost, Emotional Health and Wellbeing in Schools Lead; and Lucy Green, Sexual Health Project Lead - gave Members the opportunity to see a young people’s service being delivered in a different setting, and to discuss the importance of whole systems approach, prevention, community based approaches and to hear first hand about the challenges and issues facing young people in Plymouth.
Finally, the Committee attended a roundtable discussion with a wide range of people involved in commissioning and providing sexual health services in Plymouth.
Cllr Ian Tuffin, Portfolio Holder for Health and Social Care, Plymouth City Council; Dr Ruth Harrell, Director of Public Health, Plymouth City Council; Laura Juett, Public Health Specialist, Plymouth City Council; Dave Schwartz, Public Health Specialist, Plymouth City Council; Dr. Shelagh McCormick, Chair, Western Locality, NEW Devon Clinical Commissioning Group; Dr. Derval Harte, Consultant in Sexual Health and HIV Medicine SHiP–UHP NHS Trust; Keith Chapman, Care Group General Manager, Women and Children’s, UHP NHS Trust; Dr. Megan Griffiths, Consultant Sexual and Reproductive HealthSHiP–UHP NHS Trust; Zoe Warwick (title); Mike Jarman, Chief Executive, SHiP - The Zone; Jodie Frost, Progeny Lead–Emotional Health and Wellbeing in Schools, SHiP–The Zone; Lucy Green, Project Lead—Sexual Health, SHiP–The Zone; Emma Collins Sexual Health Nurse Consultant; Shelley Shaw, Development Support Officer, NSPCC, Together for Childhood; Matilda Fraser, Vice President Welfare and Diversity, University of Plymouth Student Union; and Nick Cook, Strategic Children’s Services Manager/Care Journey Services Barnardos.
The session gave the Committee the opportunity to hear views on a wide range of issues including the public health grant and financial challenges; commissioning of sexual health services; innovations and whole systems approaches; accountability; prioritising prevention; workforce; primary care; and Relationships and Sex Education and the impact of pornography.
Published: 2 June 2019