Blackpool Council has worked with neighbouring areas to share good practice when it comes to sexual health services. It has helped the council improve and develop the way it provides support. This case study forms part of our sexual health resource.
Blackpool is one of the most deprived areas of the country with historically high rates of teenage conception and abortion rates.
Overall the trend for STI diagnoses is down, although rates still remain at concerning levels. The re-infection rate is also high, significantly so for young people.
In developing sexual health services, Blackpool has recognised the benefits of working with other councils in the region and sharing good practice.
Regionally Lancashire and Cumbria have a sexual health commissioners network – and this has provided the foundations for collaborative working.
There was a joint procurement exercise for STI testing and contraception services in 2014. This involved a shared market engagement process, although each council was able to make its own decision on which provider to award contracts to.
Public Health Specialist Judith Mills said, “this exercise was important to do as many of the councils shared the same providers and residents cross borders to access services. There was a potential for providers to be destabilised by a series of individual procurement process taking place.”
Since then there has been a number of sector-led improvement workshops with neighbouring councils and Public Health England to look at what has worked across the different providers.
Ms Mills said: “The approach has allowed us to really share good practice and learn from each other. Performance – whether it is on chlamydia screening or long-acting reversible contraception (LARC) can vary enormously.
“We have built up a good idea of what works and have started introducing new measures to improve the service we provide to people.”
Over the past 18 months, a series of new initiatives has been launched. These include a domiciliary care pathway to ensure vulnerable women have access to LARC. It is aimed at those engaged with services such as mental health, substance misuse and learning disabilities and involves their key worker and a sexual health practitioner carrying out home visits to arrange LARC.
This scheme has worked in partnership with Blackpool’s Pause Project, which is part of a national movement to provide support to women who are at risk of having their children taken into care.
Other collaborations have also been developed. These include sexual health workers and harm reduction staff working together to support sex workers and the co-location of sexual health and substance misuse workers so people can be offered help with drug and alcohol addiction alongside STI testing and contraception services.
Introducing new initiatives nearly always requires some kind of evolution and adaptation
Ms Mills said: “Take the co-location of substance misuse and sexual health for example. When we first launched it, we did not have much success. Clients were not coming forward for testing.
“What we realised was that they need to be stable in their drug and alcohol treatment before they were ready for other help. So we now offer the sexual health services later on.
“It is proving much more effective – with lots more people getting tested.”
How is the approach being sustained?
New initiatives are being looked at all the time. HIV testing started to be offered to all patients aged 16 to 70 who were in the acute medical unit at the Blackpool Victoria Hospital last year. The success of that led Blackpool to start testing for Hepatitis C recently.
Blackpool also wants to make progress with offering self-testing at home. In 2018 access to full screen online postal kits was launched with the uptake of this offer growing and the average return rate of 50 per cent.
The service is also busy preparing for statutory relationship and sex education from 2020. A coordinator has been appointed to liaise with schools and partner agencies, such as school nursing, mental health and tobacco control.
“There is a lot we want to build on. Through our work with others in the region we are always finding out about new ways to deliver services,” Ms Mills added.
Judith Mills Public Health Specialist