Purpose

To award each of the four Primary Care Networks (PCNs) across Tameside £0.025m in 2023/24 (total spend for 2023/24 will be £0.100m). This will be funded by realigning in-year underspends in existing activity-based sexual health budgets within Population Health. This will enable the delivery of preventative sexual and reproductive healthcare (SRH) interventions aimed at improving SRH outcomes and reducing SRH inequalities, with a particular focus on contraception.

Decision

That it be DETERMINED that each of the four Primary Care Networks (PCNs) across Tameside is awarded £0.025m in 2023/24 (total spend for 2023/24 will be £0.100m) as a one-off payment.  This will be funded by realigning in-year underspends in existing activity-based sexual health budgets within Population Health.  This will enable the delivery of preventative sexual and reproductive healthcare (SRH) interventions aimed at improving SRH outcomes and reducing SRH inequalities, with a particular focus on contraception.

Reasons for the decision

·         To enable improvement in access to preventative SRH in primary care and reduce SRH inequalities, which will contribute to fewer terminations, reduced under-18 conceptions and fewer unplanned pregnancies, which can reduce costs for council services such as Children’s Social Care. This will also support the primary care workforce to tackle inequalities in SRH outcomes around wider issues including HIV and sexually transmitted infection prevention.

·         To enable improvement in SRH training amongst primary care front line clinicians. This will ensure more sustainable delivery going forward by maintaining SRH competencies across the primary care workforce and strengthening the leadership role of primary care in community sexual health service delivery.

·         This investment will support the ongoing local delivery of the ten-year Women’s Health Strategy for England, which contains priorities around menstrual health and fertility. 

·         Investment in these preventative interventions at a PCN level will enable a more sustainable delivery model, which can tackle local inequalities and support the implementation of other local work such as the model for Primary Care Women’s Health Hubs.

·         Investment in SRH, and contraception particularly, has a strong evidence base and a good return on investment across the wider health, social care and public system. Preventing just 10 unwanted pregnancies can save up to £0.245m of wider costs.

·         Rates of under 18s conceptions and terminations in Tameside remain among the highest in England. While rates have improved in recent years, this has stalled and more work is needed to further reduce these adverse outcomes.

·         This proposal directly supports the delivery of one of the objectives under Tameside’s Health & Wellbeing Strategy to provide excellent contraceptive advice and choice for as many births as possible to be planned.

·         This proposal supports the redirecting of investment in SRH services in Tameside away from reactive, treatment focussed activity, towards more targeted, preventative provision as outlined in the change model for SRH outcomes in Tameside, which was signed off by Executive Cabinet as part of the SRH commissioning intentions in 2021. This underspend is evidence that the model and different approach is having an impact.

·         The evaluation and outcomes of the work this report proposes over the next 12 months will inform further work including how to divert more resources towards preventative interventions; and learning around this innovative work will be shared with colleagues across Greater Manchester, including the Sexual Health commissioners network; the wider Primary Care Networks in GM; and the ICB as this pilot approach could be supported via other sources and/or replicated in other areas going forward.