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11 October 2006

UK government profiles the state of the nation’s health

The UK government on 10 October published Health Challenge England: Next Steps for Choosing Health, and Health Profile of England, mapping out the public health records within the country.

The Department of Health (DH) identified obesity as the biggest challenge for public health. Caroline Flint MP, minister for public health, said the government was providing local authorities with a profile of public health challenges in their areas in an effort to help them identify where they might improve their record.

THealth Profile of England also highlights sexual health and teenage pregnancy rates. In the Health Challenge England factsheet on sexual health, the government states: ‘We will have delivered if there is improved access to a wider range of contraceptive methods, particularly long-acting methods and a reduction in the number of unintended pregnancies and rates of repeat abortions.’

The factsheet includes the following ‘Key Facts’:

  • Some Sexually Transmitted Infections (STIs) continue to increase particularly among the under 25s and other high risk groups.

  • Chlamydia is the most common STI and affects an estimated one in ten sexually active young women. If left untreated it can lead to pelvic inflammatory disease, ectopic pregnancy and infertility.

  • Rates of diagnoses of chlamydia in England have risen steadily since the mid-1990s. Rates are highest in young women aged 16-19.

  • Delays in access to diagnoses and treatment lead to more people being infected with STIs.

  • Although teenage pregnancy rates are at their lowest for 20 years, England still has one of the highest rates in Western Europe.

  • Nearly a quarter of all pregnancies in England and Wales end in abortion.

    In a section headlined ‘WHAT WE HAVE DONE SINCE CHOOSING HEALTH’, the government lists its achievements since the publication of its 2004 White Paper. These include:

  • Improving access to GUM services is one of the priorities for action in 2006-07 for the NHS.

  • Targets to introduce a maximum 48 hour wait for all GUM appointments by 2008 are included in NHS delivery plans and are being closely performance managed by SHAs and DH. Waiting times have improved from 38% of patients seen within 48 hours in May 2004, to 57% in August 2006.

  • We produced an extensive guide to rolling out the National Chlamydia Screening Programme (NCSP) across England which was distributed to every PCT. The aim of the guide was to facilitate the standardisation of the structures, processes, and outputs of the programme while still allowing local flexibility.

  • We have contracted Boots to undertake a two year pathfinder to test the acceptability of chlamydia screening in pharmacies. We have contracted TNS (expand) to undertake an independent evaluation of the pathfinder.

  • We have published jointly with DFES “Teenage Pregnancy Next Steps: Guidance for Local Authorities and Primary Care Trusts on Effective Delivery of Local Strategies”. The guidance asks local areas to review their strategies in the light of the findings from visits and new analysis and reflect them in their forward plans. It also sets out what support will be provided nationally to support local delivery.

  • DFES have published Teenage Pregnancy: Accelerating the Strategy to 2010 which has a stronger focus on tackling the underlying causes of teenage pregnancy. The document highlights that in future particular attention will be paid to the 21 areas with increasing rates of conceptions.

  • In conjunction with the DfES, the DH has continued to deliver the RU Thinking campaign aimed at younger teenagers; launched the Want Respect? Use a Condom campaign aimed at those older teenagers most likely to become teenage parents and have developed a new, soon to be launched, sexual health campaign targeting 18 – 24 year olds who engage in sexually risky behaviour and who are most at risk of contracting STIs.

  • We have supported the implementation of guidance from the National Institute for Clinical Excellence (NICE) on long acting methods of contraception.

    The section titled ‘WHERE WE ARE HEADING’ includes the following:

  • We will closely monitor progress towards the GUM access target with a focus on those who need to make most progress.

  • We will use opportunities from the new Commissioning agenda to improve the quality of commissioning in sexual and reproductive health and ensuring local needs assessments are undertaken.

  • Through the new campaign increase the acceptance of condoms as a ‘must have’ item; individuals being prepared to use condoms and carry them as part of their ‘going-out kit’ and an understanding of why using a condom is essential.

  • We will be monitoring the progress of all areas towards their teenage pregnancy reduction target with a particular focus on areas with high and increasing rates.

  • We will continue to develop a high quality multidisciplinaryworkforce in particular ensure that nurses are working in new and innovative ways in sexual and reproductive health. More sexual health nurses are now working in primary care settings, helping to improve access to services for patients. We are pursuing inclusion of sexual health in the pre-registration nursing curriculum nationally a core group of sexual health nursing experts have devised suggested core criteria for inclusion in the future pre-registration nursing curricula.

    The section titled ‘WE WILL HAVE DELIVERED IF’ includes the following goals: 

  • High quality sexual health services are easily accessible in all parts of the country and we have met the target that nobody has to wait more than 48 hours for a GUM clinic appointment from 2008.

  • We have a well trained, flexible and creative multidisciplinary workforce able to deliver optimum care in all health care settings, where services can be taken to the people, and a variety of models of delivery can be considered.

  • There is an increased focus on prevention and high quality health promotion material is widely available and the stigma surrounding sexual health and STIs is reduced.

  • Chlamydia prevalence reduces through the achievement of high screening volumes in the National Chlamydia Screening Programme.

  • We stop and reverse the increase in STIs.

  • We achieve, in the long term, the normalisation of condom use and a steady reduction in the rate of STIs among the target group.

  • There is improved access to a wider range of contraceptive methods, particularly long-acting methods and see a reduction in numbers of unintended pregnancies and rates of repeat abortions.

  • We stop and reverse the rates of increase in teenage pregnancies in the worst performing areas and reduce rates of under 18 conception in all areas.

    Health profile of England, Department of Health, 10 October 2006

    Download Health Challenge England factsheet on sexual health