Open access sexual and reproductive health services are provided through an integrated service called SHiP (Sexual Health in Plymouth) and through contraception services from GPs and Pharmacies. These services currently cost approximately £2.8 million per year.
SHiP is provided by a collaboration of University Hospitals Plymouth (UHP) NHS Trust, Livewell South West, The Zone and the Eddystone Trust. The service provides sexual health advice and information, testing and treatment for STIs and all forms of contraception. It prioritises prevention and self-management and makes best use of new treatments and technologies. The service operates as part of a broader system of sexual and reproductive healthcare services commissioned by NHS Devon and NHS England that include abortion services, HIV treatment and care services, a Sexual Assault Referral Centre and cervical screening programme.
Rates of sexually transmitted infections (STIs) in Plymouth are high when compared to England averages and rates in nearest neighbour areas. The numbers of recorded infections are likely to be higher than reported as surveillance of STI diagnosis does not provide a full measure of prevalence because many infections are asymptomatic and undiagnosed.
The rate of teenage conceptions in Plymouth has fallen significantly in recent years from 54.7 per 1,000 females aged 15-17 in 1998 to 15.5 in 2020. Rates in Plymouth are slightly above the England average of 13.0.
In 2020 the total abortion rate per 1,000 female population aged 15-44 years was 18.1, which is slightly lower than the England rate of 18.9.
Late diagnosis is the most important predictor of HIV related morbidity and short term mortality. The estimated diagnosed prevalence of HIV in Plymouth is low. However, between 2019 and 2021 57.1% of new HIV diagnoses in Plymouth were late diagnoses (8 cases).
Whilst access to contraception in Plymouth is good, there has been disruption to provision during the COVID-19 pandemic. The provision has now returned to pre-COVID levels.
The recent outbreak of Monkeypox in the UK has resulted in increased workload for local sexual health services due to the need to respond to contact tracing and identification and the delivery of vaccinations as determined by national policy.
Sexual ill-health has been estimated to cost the NHS more than £700 million a year. The cost of treating STIs in England, Wales, and Northern Ireland has been calculated at approximately £165 million per year. The lifetime treatment costs for each new case of HIV infection is between £280,000 and £360,000. The cost of HIV care in the first year after diagnosis is twice as much for someone with a late diagnosis.
The cost of treating STIs in England, Wales, and Northern Ireland has been calculated at approximately £165 million per year (Health Protection in the 21st century, Understanding the burden of disease: preparing for the future. Health Protection Agency, 2005).
The lifetime treatment costs for each new case of HIV infection is between £280,000 and £360,000 (Health promotion for sexual and reproductive health and HIV: strategic action plan 2016-2019. Public Health England, 2016).
The cost of HIV care in the first year after diagnosis is twice as much for someone with a late diagnosis (NICE local government briefings HIV testing. NICE, June 2014).
Investing in sexual health services can deliver significant cost savings for the NHS and local authorities. Quality services and interventions that focus on prevention, screening and prompt treatment and partner notification can control disease, prevent unwanted pregnancies and avoid costly health complications and treatments.