Agenda item

Rebecca Willans, Consultant in Public Health presented the Sexual and Reproductive Health Needs Assessment findings.

The Board noted the national context around sexual and reproductive health.

Benchmarking for Bracknell Forest indicated that chlamydia testing for young women aged 15 to 24 was below the benchmark, screening of young people was below the national average, and the HIV diagnosis rate was below the national benchmark of having 25% of new HIV diagnoses diagnosed late.

The current Sexual and Reproductive Health service was delivered by Berkshire Healthcare Foundation Trust and this contract had been renewed to June 2026. A Health Needs Assessment had been conducted to inform the service specification of the new contract.

Rebecca presented the Health Needs Assessment and highlighted the following findings:

·        Regarding contraception, the main finding was that ethnicity was the main population characteristic which most affected women’s access to services, and uptake amongst Asian women was much lower overall. It was critical to ensure that women who wanted to access contraception felt able to do so.

·        Regarding reproductive health outcomes, it was disproportionately more likely that Black and Black/British women would have a termination. It would be important to understand the pre-conception care offer to women from Ethnic Minority populations.

·        Regarding long-acting reversible contraception (LARC), the majority of GPs in Bracknell Forest offered the service but the total percentage of those accessing the service was lower than in areas with a similar deprivation index.

·        The Health Needs Assessment had explored the Specialist Reproductive Health clinic sites, and had found a significant increase in online sexual health care since the COVID pandemic which offered STI testing, and an increase in those accessing the clinic in Slough. It was suspected that this might be because those who needed to be seen in person were in need of Tier 3 services which were only offered in Slough. It was noted that the current online offer only provided online STI test kits, but may in future provide contraception.

·        Regarding STI test rates, Bracknell Forest had seen a gradual increase in STI testing rates but had not got back to pre-COVID rates. The percentage of people testing positive was broadly in line with those accessing STI testing.

·        Regarding HIV, it had been found that of people living with HIV in Bracknell Forest, 62% were male, 90% were White or Black African. Of those who were white and living with HIV, 89% were men, and of those who were black African and living with HIV, 77% were female. There were queries whether access to PrEP (pre-exposure prophylaxis) was equal across demographic groups as 90% of prescriptions across Berkshire were for gay or bisexual men.

Rebecca explained that the priority areas for development going forward would be:

·        the digital sexual and reproductive health offer

·        sexual and reproductive health promotion for young people, people who were neurodiverse, ethnic minorities, refugees and asylum seekers

·        developing an engagement strategy

·        developing a local sexual and reproductive health network

·        greater focus on women’s health and pre-conception care

·        HIV prevention.

Arising from questions, the following points were noted:

·        The Skimped Hill Sexual Health clinic was open for two days a week on limited hours. The service specification for the new Sexual and Reproductive Health service had asked specialist providers to explore suitable opening days and times to ensure service users could get access when and where they wanted it. A digital offer would also be explored.

·        Sexual Health clinic staff were well trained in signs of exploitation and safeguarding issues.

·        The was a broad pattern of lower uptake of Sexual and Reproductive Health services amongst Asian women, however this data and the reasons behind this trend needed further exploration.

·        The data needed further interrogation to understand the decline in numbers accessing services at Skimped Hill and in Reading, but it could be that these service users were accessing online services instead.

·       To investigate the inequalities around accessing Sexual and Reproductive Health services, Public Health colleagues had worked with young people, the British Pregnancy Advisory Service and the Frimley Park Maternity Voices Partnership to explore national themes. Reproductive autonomy had not come through as a theme from the consulted groups, and there had been more reference to beliefs around contraception. Further work and engagement with specific groups around issues including contraception was planned.