North Yorkshire Integrated Specialist Sexual Health Services - Partnership Agreement

The Local Authority is mandated to ensure that comprehensive, open access, confidential sexual health services are available to all people in North Yorkshire - whether they live here or not.

The requirement includes screening services for STIs (Sexually Transmitted Infections) and STDs (Sexually Transmitted Diseases), GUM (Genito-Urinary Medicine) and Contraception and Sexual Health (CaSH) services.

North Yorkshire County Council wishes to put in place a formal partnership (referred to as a “Section 75 Partnership Agreement”) with York Teaching Hospital NHS Foundation Trust to work collaboratively to deliver the fully Integrated Sexual Health Service responsibility on behalf of the council. This partnership agreement will delegate sexual health services to York Teaching Hospital NHS Foundation Trust. The NHS and Local Authorities Partnership Arrangements Regulations 2000 stipulate that “the partners may not enter into any partnership agreements [under Section 75 (S75) of the NHS Act 2006] unless they have consulted jointly such persons as appear to them to be affected by such arrangements”.

Scope

North Yorkshire County Council and York Teaching Hospital NHS Foundation Trust are jointly consulting for the purpose of the proposed collaborative arrangement.  This is a 30-day consultation beginning on 7 October 2019 and ending on 6 November 2019. For any questions about this consultation please email nypublichealth@northyorks.gov.uk

The Section 75 Agreement will be a partnership agreement with current Provider York Teaching Hospital NHS Foundation Trust under Section 75 of national Health Services Act 2006, to work collaboratively to continue to deliver a fully integrated sexual health service. The agreement will also involve the setting up of a joint management board between North Yorkshire County Council and York Teaching Hospital NHS Foundation Trust to oversee the agreement, improve integrated pathways and ways of working and develop a joint accountability framework. The Partnership Agreement itself will not directly affect the service model.

How to respond

Our short survey is available to complete.

Compliance with government and local practice on consultationThe Section 75 Agreement is planned to be in place, subject to the outcome of the consultation, from 1 April 2020.

The consultation has been set at 30 days which is considered sufficient time to enable interested parties to respond to this particular consultation. The proposal is to put in place formal partnership working for the Service in North Yorkshire through a Section 75 Agreement. The Section 75 Agreement is planned to be in place, subject to the outcome of the consultation, from 1 April 2020.

Summary

The Integrated Sexual Health Service (also referred to as a ‘one-stop-shop’) includes all health screening and treatment, contraceptive services, outreach services for young people and vulnerable groups, counselling, HIV support and sexual health promotion and information. North Yorkshire County Council wishes to enter into a formal collaborative agreement to allow York Teaching Hospital NHS Foundation Trust to continue to deliver the Integrated Sexual Health Service on the Authority’s behalf. In keeping with good practice and NHS Act requirements, the Council and the Trust, as potential partners, are required to consult with stakeholders who may be affected by such an agreement being in place. The Partnership Agreement itself will not directly affect the service model.

Background

We understand people want and deserve the best possible public services, which protect and improve their health and wellbeing. In the NHS Act of 2006, Section 75 identifies 2 flexibilities which can enable partnership agreements to develop to give National Health Service organisations and local authorities the flexibility to be able to respond effectively to improve services, either by joining up existing or developing new, co-ordinated services. The intention of a Section 75 Partnership Agreement is to improve services for users through either ‘pooled budgets’ (where two organisations bring together resources) and/or ‘delegated functions’ (where one organisation exercises an agreed function on behalf of another).

The intention of the partnership arrangement is to offer flexibility to support better coordination and innovative approaches in services across a range of NHS and Local Authority functions. Ultimately we want to improve the health and wellbeing outcomes for people who use services and we believe that the most effective approach for delivering these outcomes is through a partnership arrangement to ‘delegate’ functions from the Council to York Teaching Hospital NHS Foundation Trust. You can read the full North Yorkshire County Council Cabinet report detailing the background behind the proposed agreement. 

Current provision and benefits of a partnership approach

The Integrated Sexual Health Service currently provides open and booked access to sexual health testing, treatment and contraception to all ages in North Yorkshire.

This includes sexual health promotion and information (which provides evidence based sexual health information to service users), clinical assessment (medical and sexual health history including a risk assessment is undertaken for all service users accessing the service), contraceptive services (including pregnancy testing and counselling, male and female condoms and lubricant, emergency oral contraception, emergency intrauterine device (IUD) insertion, prescribing of hormonal contraception including oral, transdermal and transvaginal methods, injectable contraception, copper and medicated IUD/IUS insertion and removal, diaphragm fitting, contraceptive implant, natural family planning information, and the management of complex contraceptive problems), condom distribution scheme (promoting and providing free condoms, the use of condoms to high-risk groups and promoting the double-dutch method), STI services (including immunisations against Hepatitis A and B, and HPV (Human Papilloma Virus), accurate diagnostic tests, clinical management and partner notification for transmittable diseases), targeted sexual health services for young people up to 25 and vulnerable groups, psychosexual health counselling service, community outreach service for the most at risk populations, HIV positive support service, training service (training for the wider sexual health system to ensure they have an understanding and awareness of current and local sexual health issues and service knowledge, as well as advanced training to primary care professionals), and sexual health campaign support and awareness raising.

York Teaching Hospitals NHS Foundation Trust is currently contracted by North Yorkshire County Council to provide the Integrated Sexual Health Service (as outlined above) in North Yorkshire until 31 March 2020. York Teaching Hospitals NHS Foundation Trust is very experienced and has established a high quality, well regarded integrated sexual health service across North Yorkshire which is continually reviewed to explore ways of improving service delivery. The service is performing to expectations and often above, delivering the KPIs within the contract.

The responsibility for Integrated Sexual Health Services transferred from Primary Care Trusts to North Yorkshire County Council in April 2013. With this responsibility, we want to take the opportunity to continue to provide effective, high quality, value for money services to residents of North Yorkshire under a Section 75 Agreement. The proposed Partnership Agreement between the Council and York Teaching Hospitals NHS Foundation Trust will allow the NHS trust to provide the Sexual Health services on the Council’s behalf. We believe this will enable both organisations to develop the best approach to continue to deliver high quality cost effective care to our residents and visitors. The agreement itself will not directly affect current service provision or planned service developments.

Duration of consultation

This will be a 30-day consultation beginning on 7 October 2019 and ending on 6 November 2019. It is hoped that the consultation and related feedback will enable formal agreements to be in place from 1 April 2020.

Consulting with stakeholders

The consultation document and questionnaire will be available on the North Yorkshire County Council Partnerships and YorSexualHealth (brand name of York Teaching Hospitals NHS Foundation Trust current sexual health provider) websites, so any member of the public can comment on the proposals. Hard copies of the consultation document can be obtained by contacting nypublichealth@northyorks.gov.uk.

After the consultation closes

Consultation responses and feedback will be collated and reviewed by North Yorkshire County Council and York Teaching Hospitals NHS Foundation Trust. At the end of the consultation period both organisations will review the feedback and produce a summary report showing the themes and issues raised. This will be reported to North Yorkshire County Council Executive and York Teaching Hospital NHS Foundation Trust Board before a final decision is reached. All consultation responses will be treated in confidence and will be kept securely for one year from the closure of the consultation, then destroyed. A summary of the consultation responses and next steps will be available to view online or please contact us using one of the methods outlined above to request details.

References