SEXUAL HEALTH
Gay men should be offered HPV vaccine says JCVI
The HPV vaccine should be offered to gay men, the Joint Committee on Vaccination and Immunisation has recommended. Sam McCaffrey reports.
T
he human papillomavirus is linked to 5% of all cancers and the vaccine has been given
to schoolgirls in the UK since 2008 to protect against cervical cancer.
But HPV also causes cancers of the throat, anus and penis as well as causing genital warts, and men who have sex with men are at high risk of HPV infection. They receive little indirect protection from the highly successful HPV vaccination programme in adolescent girls, a report from the Joint Committee on Vaccination and Immunisation (JCVI) says.
When recommending the vaccine for girls, the JCVI recommended against vaccinating boys as the committee thought “high coverage in girls would provide herd protection to boys,
and that vaccination of boys would generate little additional benefit to the prevention of cervical cancer, which was the main aim of the programme”.
But the JCVI’s latest report recommends offering the jab at sexual health clinics to men who have sex with men, aged between 16 and 40.
It says: “Although such a programme would be very likely to prevent HPV-associated cancers in men who have sex with men, the model had indicated that an even more substantial benefit could be realised from the prevention of ano- genital warts.”
Shirley Cramer, the chief executive of the
Royal Society for Public Health, said: “While extending the vaccination to men who have sex with men is a positive step, we implore the committee to reach a decision and introduce a vaccination for all boys.
“Vaccinating men who have sex with men still leaves a significant proportion of the population at risk of HPV and vaccinating all girls and boys is the only way forward.”
The committee will conduct a full analysis of the merits for vaccinating adolescent boys in 2015.
FOR MORE INFORMATION
W:
www.gov.uk/government/groups/ joint-committee-on-vaccination-and- immunisation
Public Health England launches new guide to commissioning for sexual health
Duncan Selbie, chief executive of Public Health England, explains the requirements of whole system commissioning. Sam McCaffrey reports.
C
ommissioning responsibilities for sexual health, reproductive health and HIV
have undergone major changes with the health and social care reforms. Now located across NHS England, local authorities and CCGs, the transition presents commissioners with opportunities as well as challenges.
In September, Public Health England launched a guide to highlight the best way to commission these services. ‘Making it work: a guide to whole system commissioning for sexual health, reproductive health and HIV’ is designed to help commissioners ensure that “service users experience integrated, responsive services that deliver the best outcomes”, according to PHE.
The best way to do that, says the guide, is for commissioners to “collaborate, cooperate and coordinate”.
It is designed to complement existing guidance and highlights the importance of putting service users and their needs at
the heart of commissioning to ensure they experience integrated, responsive services, and emphasises the importance of tackling the wider determinants of health.
“Whole system commissioning requires a commitment to meticulous collaboration, an alignment of values and principles, an agreement on processes and mechanisms and a willingness to work differently,” says Duncan Selbie, chief executive of PHE, in the foreword.
He adds: “There will not be one way to do this. Local areas will design the structures that best suit them, through both formal arrangements and other collaborative approaches. The guide also describes models of existing and emerging practice, which we hope will provide valuable insights – not only for commissioners but also for providers, clinicians, patients and the public.”
The guide sets out 12 key principles for best practice commissioning. These include:
• Putting people at the centre of commissioning and basing decisions on assessed needs
• Drawing on the expertise of clinicians and service users, together with the public’s views
• Collaborating to make the best use of limited resources to improve outcomes • Maximising opportunities to tackle the wider determinants of health
Kate Folkard, PHE project lead and programme manager, said: “It is for commissioners to understand and use the levers and mechanisms of the current system to best effect to make collaborative commissioning of sexual health, reproductive health and HIV services a reality. This guide brings together the latest advice and experience to help them do this.”
FOR MORE INFORMATION
W:
www.gov.uk/government/publications/ commissioning-sexual-health-reproductive- health-and-hiv-services
national health executive Nov/Dec 14 | 89
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