Sexual health in North Yorkshire
According to the World Health Organisation (WHO), sexual health is “a state of physical, emotional, mental and social well‑being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”
Sexual and reproductive health goes well beyond the medical model of the treatment of disease and is a key part of our identity as human beings together with the fundamental human rights to privacy, a family life and living free from discrimination. It covers the provision of advice, guidance, training and services around relationships, counselling, full range of contraception, testing and treatment of sexually transmitted infections including HIV, pregnancy and abortion. The provision of sexual health services can vary across the country, delivered by a wide range of providers, including acute hospital trusts, community services, general practice, community pharmacy, the voluntary, charitable and independent sector.
Sexual health is a public health priority for several reasons. Sexually Transmitted Infections (STIs) continue to rise over the previous 10 years. The most recent Office for National Statistics (ONS) data highlights that the percentage of conceptions leading to abortion has reached the highest proportion on record. Additionally, Relationship and Sex Education became mandatory in schools, with refreshed guidance in place from September 2026. Young peoples’ sexual health is becoming an increasingly salient focus due to concerns about young peoples’ exposure to and influence of pornography and other harmful online material, which led to the introduction of the Online Safety Act (2025).
Sexual health, reproductive health and HIV needs vary according to factors such as age, gender, sexuality, ethnicity, mental wellbeing, sensory difficulties, education and literacy, and cultural factors. However, there are certain core needs common to everyone including high-quality information and education to enable people to make informed decisions, a reduction in stigma and discrimination, and access to high-quality services, treatment and interventions.
The consequences of poor sexual health and reproductive health are preventable and include unplanned pregnancies, infections including HIV, cervical and other genital cancers, pelvic inflammatory disease and infertility, psychological consequences, stigma, and poorer educational, social and economic opportunities. There are notable inequalities in access and outcomes in relation to sexual health, reproductive health and HIV, which must be addressed if meaningful improvements in population outcomes are to be achieved.
Commissioning responsibilities
Since 1 April 2013, Local Authorities have been mandated to ensure that comprehensive, open access, confidential sexual health services are available to all people who are present in their area (whether resident in that area or not). The requirement for Genito-Urinary Medicine (GUM), Contraception and Sexual Health (CaSH) services to be provided on an open access basis is stipulated in the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013. In practice, this means that Local Authorities commission the follow sexual and reproductive health services:
- contraception
- STI testing and treatment
- sexual health aspects of psychosexual counselling
- sexual health specialist services
- HIV social care
- wider support for teenage parents.
In March 2025, it was announced that NHS England would be abolished, with its responsibilities being subsumed by the Department of Health and Social Care and Integrated Care Boards. The impact of this change is not yet clear, but the current division of responsibilities, as outlined in the HIV Action Plan (2025), is as follows:
To meet this regulation the Public Health team commissions a fully Integrated Sexual Health Service, currently provided by York Teaching Hospital NHS Foundation Trust; branded as YorSexualHealth. YorSexual Health are committed to multi-agency working for the benefit of all people who use the service. Further links and resources for professionals can be found here.
A Strategic Framework for Sexual Health
In line with the World Health Organisation’s definition of sexual health, a strategic framework for sexual health in North Yorkshire has been developed. The framework recognises that sexual Health is not the responsibility of any one organisation or service.
The local system is set out in the diagram below; action is needed by all partners in the local sexual health system in order to achieve the vision.
Sexual Health in Primary Care
Primary Care provide an element of the wider sexual health service commissioned by NYC Public Health which contributes to the overall delivery of the local sexual health system. These contracts are delivered by participating GP practices and Pharmacies in North Yorkshire.
General Practice
Targeted Primary Care for GPs are services are provided in addition to contraceptive services which are already delivered as part of their General Medical Services (or PMS) contract managed by NHS England.
Providers opting to deliver services as part of the North Yorkshire Council Approved Provider List must deliver all services within the ‘Sexual Health Basket’. These include:
- LARC (Long–acting reversible contraception) service to women of all ages – subdermal implant (SDI) or intra-uterine system / intrauterine device (IUS/IUD)
- Chlamydia screening service to under 25-year-olds (as part of the National Chlamydia Screening Programme)
- Free condoms to under 25-year-olds
- Provision of sexual health information to service users
This provision aims to increase availability of LARC, contribute to improved uptake of LARC and ensure the fitting of post-coital IUD for emergency contraception is more widely available. In addition, the GP provision aims to improve access to ‘self-administered’ chlamydia screening kits to under 25-year-olds, increase the number of test samples returned for analysis, encourage partner notification, screening and treatment, promote the use of condoms and encourage safer sex practice.
Community Pharmacy
The Targeted Primary Care Sexual Health Service for Community Pharmacies are provided by participating pharmacies in North Yorkshire under the Approved Provider List. The providers opting in to deliver this service must deliver all services within the ‘Sexual Health Basket’. These include:
- Provision of Chlamydia screening kits to under 25-year-olds (as part of the NCSP – national chlamydia screening programme)
- Free condoms to under 25-year-olds
- Provision of sexual health information to service users
This provision aims to increase the awareness of and access to sexual health services, especially among young people. The targeted work also aims to improve access to ‘self-administered’ Chlamydia screening kits and increase the numbers of test samples returned for analysis in addition to other service objectives.
This service is provided in addition to the pharmacy contraception service (PCS), commissioned by NHS England as part of the Pharmacy First programme, which includes provision of emergency hormonal contraception (EHC).
This provision aims to increase availability of LARC, contribute to improved uptake of LARC and ensure the fitting of post-coital IUD for emergency contraception is more widely available. In addition the GP provision aims to improve access to ‘self-administered’ chlamydia screening kits to under 25 year olds, increase the number of test samples returned for analysis, encourage partner notification, screening and treatment, promote the use of condoms and encourage safer sex practice.
