'Perverse incentive' fear over sexual health service commissioning

The open access nature of sexual health services means the local authorities which will commission them from April 2013 will have a perverse incentive not to do so well, according to a sexual health charity leader.

Sexual health services to be commissioned by local authorities
Sexual health services to be commissioned by local authorities

Ruth Lowbury, chief executive of the Medical Foundation for AIDS and Sexual Health, voiced her concerns at a Westminster Health Forum event about health and wellbeing boards in central London on Thursday.

Responsibility for commissioning sexual health services will transfer from PCTs to local authorities as part of the NHS Act reforms in April 2013.

Ms Lowbury said: ‘Sexual health is the largest single ringfenced clinical area that switches to local authorities. They are going to have to commission clinical services. Sexual health has traditionally been open access, meaning local authorities will be commissioning services provided not just for their local population but for anybody who chooses to go there. Potentially there is a perverse incentive not to commission very well.’

Ann Goodwin, project manager for the Public Health England transition team, said: ‘I know there are issues. Local authority baselines are for registered populations and open access is about bigger populations. That is being looked at in terms of funding. I’m afraid I can’t currently give you the reassurance you’re looking for.’

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