Shocking report reveals HIV and sexual health services are ‘at breaking point’

Illustrated rainbow pride flag on a white background.

A new report has revealed that HIV and sexual health services are stretched to breaking point, amid warnings of a growing crisis in the sector.

Public Health England today published a report into the current picture of sexual health and HIV services across England.

The report flagged concerns from service commissioners  about a potentially-devastating combination of a decrease in capacity and an increase in demand, which has stretched sexual health services to their limit.

The report cited funding issues as one of the main reasons for a decline in services, as struggling local authorities are forced to cut sexual heath funding.

2013 healthcare reforms have also led to a “fragmentation of the system” for providing sexual health care, as various services are funded and maintained in drastically different ways.

The report says: “Whilst all commissioners had concerns about future funding, concerns were most pronounced in local authorities.

Shocking report reveals HIV and sexual health services are ‘at breaking point’

“The previous cut in the Public Health Grant was a recurring concern. Analysis of the figures would indicate that there has been a reduction in spend of the Public Health Grant of 2.1% between 2013-14 and 2015.

“This is in line with the 2.3% overall grant reduction.

“Within these headline figures there has been a realignment of spend with a decrease of 8% on STI
treatment and testing but increases in spend on contraception and promotion and prevention”.

It adds: “Respondents to the survey expressed concerns about the impact of future cuts and whether current provision was sustainable.


“Local authorities described moves to reduce access to specialist services and redirect those requiring less specialist care to GPs and pharmacies.”

It warned: “There was concern that resources would not be maintained for sexual, reproductive health and HIV services.

“The discussions on future funding mechanisms for public health are far wider than sexual health. However, the importance of it as part of the Public Health Grant needs to inform the ongoing national discussions on funding.”

Public Health England called for immediate action to improve the commissioning of sexual health services.

Ian Green, Chief Executive of Terrence Higgins Trust, said: “We welcome this report, which sets out honest reflections on the current state of HIV and sexual health services in England.

“Sadly this confirms the fears that we, and many others, have highlighted – these vital services are at breaking point.

“Demand is rising, while budgets are shrinking; HIV and sexual health services are reeling from a combination of national government funding cuts to local authorities, a lack of prioritisation by some local councils, and lasting damage from the Health and Social Care Act, which led to fragmented and uncoordinated commissioning.

“This cannot go on. We welcome the actions set out in this report, however, this action plan does not commit to new funding, and does not address the shortfall left by the damaging cuts made to public health budgets.

“Without additional investment in HIV and sexual health services, it is unclear how a sexual health crisis can be avoided.

“In these challenging times, commissioners need to work closely alongside affected communities and third sector organisations to find innovative ways to deliver services that meet the need – and clear unmet need – of local people at risk of HIV and poor sexual health.”