New LGA report warns local sexual health services are at ‘breaking point’

Local sexual health services are at breaking point as attendance has skyrocketed whilst funding has reduced, a new Local Government Association report published today has warned.

Analysis by the LGA, which represents more than 350 councils in England and Wales, has found that there was a total over 4 million consultations at sexual health services in 2021, a 16 per cent increase compared to 2020 and an increase of 36 per cent since 2013.

At the same time, funding for these services have been slashed, with over £1 billion having been cut from councils’ public health grant, resulting in a 17 per cent reduction in spending on STI testing, contraception and treatment over the last seven years.

Councils are calling on the Chancellor to reverse these spending cuts and provide long term funding increases to manage the rise in demand at the upcoming Autumn Statement.

The LGA said councils currently face a perfect storm as demand for services continuing to rise just as the price of providing them is also escalating dramatically. This risks hampering efforts to reduce levels of sexually transmitted infection, access to contraception and teenage pregnancies.

The new LGA report also found that:

• There were around 2 million diagnostic tests for chlamydia, gonorrhoea, syphilis, and HIV, an increase of 19 per cent compared to 2020, and an increase of 29 per cent since 2013.
• The number of women who use their sexual health service for long-acting reversable contraceptives (LARC’s) including implants, coils and injectable contraceptives, has doubled, with 56 per cent of women who attend clinics for contraception receiving this in 2021, compared to just 29 per cent ten years earlier.
• The number of common STI’s caught among the over 65’s has increased by 20 per cent, with the largest proportional increase in gonorrhoea and chlamydia seen in people aged over 65.

Local authorities have been engaged in one of the biggest modernisation exercises in the history of public health, such as a rapid channel shift to online consultations, data collection via app, home testing and home sampling. However, the ability for local authorities to innovate and increase efficiency is nearing its end.

The report highlights the role that council commissioned sexual health services continue to play an important role in tackling the Monkeypox outbreak, helping to identify the first cases of the infection as well supporting the rollout of a successful vaccination campaign. 

Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board said:

“It’s really encouraging to see so many people take their sexual and reproductive health seriously and attend their local sexual health clinic for advice and support.

“However, as this report shows, councils are facing a perfect storm of increased demand for services whilst at the same time continued cuts to their funding. This is unsustainable and risks a reversal in the encouraging fall in some STIs and potential increases in unwanted pregnancies.

“To ensure councils can continue to meet the sexual and reproductive health needs of their communities, they need to see long term increases in the public health grant at the upcoming Autumn Statement.

“Cuts to spending on sexual health, as with other areas of public health expenditure, are a false economy. Looking forward to the Autumn Statement the Government must ensure sexual and reproductive health funding is increased to levels which do not jeopardise people’s sexual and reproductive health. Inadequate prevention and early intervention increase overall costs to the health service.

“There can be no sustainable long-term solution to NHS pressures unless we have an equally sustainable solution for public health.”

James Woolgar, Chair of the English HIV and Sexual Health Commissioners Group said:

“Sexual and reproductive ill-health and unplanned conception has a detrimental effect on relationships, emotional and physical wellbeing as well as financial impact for the individual and the healthcare system. As with many health related conditions, the burden of sexual ill health is seen disproportionately by people experiencing poverty, people from ethnic minority groups, young people and people from the LGBTQ+ community.

“Services were already becoming stretched and required more resource pre-pandemic, we have been innovative and opened up access online, but as know this often leads to us finding even more unmet need. This is a good thing, but it requires proper funding.

“Good sexual and reproductive health is dependent on good quality services with the capacity to enable good access and to empower our residents to look after their own sexual health and wellbeing. Unfortunately with overstretched and underfunded services this is often not the case and the increasing demand means that health inequality is widening”.