Commissioning local HIV sexual and reproductive health services
Tools and resources for commissioners of HIV, sexual and reproductive health services to help plan and commission regional and local services.
Sexual and reproductive health is not just about preventing disease or infection. It also means promoting good sexual health in a wider context, including relationships, sexuality and sexual rights.
Commissioning responsibilities
Sexual health services (SHSs) are commissioned at a local level to meet the needs of the local population, including provision of information, advice and support on a range of issues, such as sexually transmitted infections (STIs), contraception, relationships and unplanned pregnancy.
Local authorities commission comprehensive open access SHSs (including free STI testing and treatment, notification of sexual partners of infected persons and free provision of contraception). Some specialised services are directly commissioned by integrated care boards (ICBs), and at the national level by NHS England.
Local authorities commission:
- comprehensive SHSs including most contraceptive services and all prescribing costs, but excluding GP additionally-provided contraception
- STI testing and treatment, chlamydia screening and HIV testing
- specialist services, including young people바카라 사이트檚 sexual health, teenage pregnancy services, outreach, HIV prevention, sexual health promotion, services in schools, college and pharmacies
- delivery of HIV pre-exposure prophylaxis (PrEP)
ICBs commission:
- most abortion services
- sterilisation
- vasectomy
- non-sexual-health elements of psychosexual health services
- gynaecology including any use of contraception for non-contraceptive purposes
- adult specialist services for people living with HIV (from April 2025)
NHS England commissions:
- contraception provided as an additional service under the GP contract
- promotion of opportunistic testing and treatment for STIs and patient-requested testing by GPs
- sexual health elements of prison health services
- sexual assault referral centres
- cervical screening
- specialist fetal medicine services
Across England there is considerable regional variation in how SHSs are provided and commissioned. They vary from distinctly separate general practice and community-based contraceptive provision with hospital-based abortion and genito-urinary medicine services, to fully integrated SHSs in the community. The variations occur because of differences in commissioning and contractual models used in local areas.
Resources
This section brings together existing resources that commissioners can use to support the commissioning process. It is primarily aimed at people working in local authorities who are either new to sexual health or new to commissioning, or to both. It should also be useful to those who have been working in the field for some time, as a reminder of a familiar issue, a prompt about something new or a useful reference point for key important documents.
The document should be used as a reference that can be dipped into at all stages of the commissioning cycle.
Policy context
, NHS England
, House of Commons Library 2024
, Kings Fund 2022
, NHS England 2019
A framework for sexual health improvement in England, Department of Health and Social Care (DHSC) 2013
Commissioning responsibilities
Sexual health, reproductive health and HIV: commissioning review, Public Health England (PHE) 2017
Making it work: a guide to whole system commissioning for sexual health, reproductive health and HIV, PHE 2015
Needs assessments
STI Prioritisation Framework, UK Health Security Agency (UKHSA) 2024
Variation in outcomes in sexual and reproductive health in England, PHE 2021
Prescribed places of detention: health needs assessment toolkit,听PHE听2014
, Department of Health 2007
Data and evidence
, Office for Health Improvements and Disparities (OHID)
Towards Zero: the HIV Action Plan for England: 2022 to 2025, DHSC 2021
Health economics evidence resource, PHE 2017
Local health and care planning: menu of preventative interventions, PHE 2016
Designing services
National Chlamydia Screening Programme (NCSP), UKHSA 2023
Teenage pregnancy prevention framework, PHE 2018
Teenage mothers and young fathers: support framework, PHE 2016
, Local 바카라 사이트 Association 2015
Sexual health: clinical governance, DHSC 2013
Service specifications
, NHS England
, NHS England
Integrated sexual health service specification 2023, OHID and UKHSA 2023
HIV pre-exposure prophylaxis (PrEP): monitoring and evaluation, UKHSA 2022
Sexual health services: key principles for cross-charging, DHSC 2018
Standards
, Faculty of Sexual and Reproductive Healthcare (FSRH)
Establishing youth-friendly health and care services, OHID 2023
, BASHH 2023
National chlamydia screening programme standards (8th edition), UKHSA 2022
, BASHH 2021
, Royal College of Obstetricians and Gynaecologists 2011
, FSRH and BASHH 2019
, British Association for Sexual Health and HIV (BASHH) 2019
, British HIV Association (BHIVA) 2018
,听BASHH听2016
National Institute for Health and Care Excellence (NICE) guidelines and resources
, NICE 2022
, NICE 2019
, NICE 2017
, NICE 2017
, NICE 2016
, BASHH 2016
, NICE 2016
, NICE 2014
Keeping up-to-date
, FSRH
Further resources for commissioners
Various organisations provide additional information and guidance to inform the commissioning of SHSs. These include statutory organisations, educational bodies and the voluntary sector:
- provides evidence-based practice, pathways and guidelines for sexual health
- champions good sexual health and provides training and workshops and information on governance and guidelines
- is a national advisory body to professions and other organisations on all aspects of HIV care, providing clinical guidelines and standards as well as educational events
- produces guidance and advice on all aspects of contraception, including service standards and clinical governance for reproductive services
- has details of training courses for health professionals
- has information for professionals about sexual health advice for young people
- has information, advice, a range of publications and useful leaflets, and also runs the English HIV and sexual health commissioners network
- has resources and information on sexual health and HIV for several audiences, including for teachers and healthcare staff
Updates to this page
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Links to new resources have been added and out of date links removed.
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Updated list of resources.
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Updated sources of information.
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Link to guidance 'Sexual and reproductive health in England: a guide to local and national data' added.
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Replaced consultation link to the published commissioning guidance.
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A link to 'PHE Guide to National and Local Sexual and Reproductive Health Data' is added to the 'Data to help commissioners identify local needs' section.
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Edited to update the guide with HIV and reproductive health resources
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First published.