North Yorkshire Council

Health and Adult Services

Executive Member Meeting

10^th October 2025

REPORT TOCorporate Director of Health and Adult Services (HAS) in consultation with the

Executive Member for Health and Adult Services

Section 75 Sexual Health Service

Purpose Of Report

This report seeks to gain support from HAS Executive:

· That the Director of Public Health in consultation with the Executive Member approves the extension of the S75 partnership agreement with York and Scarborough Teaching Hospitals Foundation Trust, for the delivery for specialist sexual health services across the county from April 2026.

1.0 Summary

1.1 The Sexual Health Section 75 (S75) Partnership Agreement between NYC and York and Scarborough Teaching Hospitals Foundation Trust (YSTHFT), established on 1 April 2022, for an initial term of four years, has entered the last 12 months of this term. The Agreement states that both parties must start to discuss the option to extend at the point that the agreement enters the last 18 months of the term.

1.2 Health and Adult Services Leadership Team (HASLT) previously approved that NYC look to utilise the first extension available, at the same value for a further four years. This is on the basis that the services provided by the Trust meets performance measures, can demonstrate high quality provision, operate within the budget, has provided savings, and continues to develop to meet the needs of the North Yorkshire population.

1.3 This includes a maximum 2.5% year-on-year uplift to the existing block contract arrangement. The Public Health Manager and Head of Finance have worked with the Trust to ensure the budget provides value for money to the Council.

1.4 This report asks for HASEX approval to extend the current contract for 4 more years from 1^st April 2026.

2.0 Background

2.1 Sexual and reproductive health is not just about preventing disease or infection. It also means promoting good sexual health in a wider context, including relationships, sexuality, and sexual rights. Good sexual health is a vital aspect of overall health and wellbeing. However, poor sexual health outcomes fall disproportionately on certain groups.

2.2 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) and 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.

2.3 On 1^st April 2022 following Executive approval NYC and YSTHFT entered a Section 75 Partnership for a possible 10-year period subject to extensions. The initial term was for a 4-year period. Implementation and adherence to the Section 75 is overseen by a joint Partnership Board chaired by the Director of Public Health.

2.4 Following an initial 4-year term, the Agreement allows for a 4+2 extension. It is the intention to utilise the 4-year extension from 1 April 2026 subject to agreement with the Trust.

3.0 Detail of Substantive Issues

3.1 The Public Health Manager and Head of Finance have worked with YSTHFT to understand the value for money of the contract. As a result of this work, the Public Health Manager and Head of Finance will continue to work with YSTHFT through existing contract management arrangements and joint Partnership board to keep track of costs.

4.0 Performance Implications

4.1 The existing provider 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 existing provider is performing to expectations and often above, delivering the Key Performance Indicators (KPIs) within the contract, and works closely with the Council to address any areas of concern that may arise. The current service is being delivered within the agreed budget.

4.2 The Partners prepare and deliver an annual Service Transformation and Development Plan which will operate for the entirety of the Agreement. The last three years plans have been delivered as outlined, with this years’ plan on track.

4.3 The Section 75 contains a Performance Monitoring Schedule to ensure that the Council is fully appraised on how the service is performing, areas for improvement and risks or opportunities. There are quarterly performance and financial monitoring reports to the Board. The performance is regularly presented to both Public Health and Health and Adult Services Leadership Teams and via corporate reports.

5.0 Policy Implications

5.1 This proposal supports Longer, healthier, independent lives (2022-25) Health and Adult Services Plan, Opportunities for everyone, everywhere and My time and experiences are valued priorities. This proposal fits with the Council Plan 2025-2029 ambition of ensuring the people of North Yorkshire are safe, healthy, and living well, as well as the North Yorkshire Joint Local Health and Wellbeing Strategy 2023-2030.

5.2 The integrated sexual health service supports the local population outcome which is that “all people in North Yorkshire experience good sexual health” as set out in the local strategic framework for sexual health.

6.0 Alternative Options considered

6.1 The alternative to extending the existing contract would be to undertake a full procurement exercise. This is not the preferred option given that there is a realistic option for extension of the current contract, which has a good track record of performance and is well-embedded in terms of partnership working and local delivery.

7.0 Financial Implications

7.1 The current annual service cost is £2,987,450 (£11,949,800 over 4 years).

7.2 With the 2.5% increase, the annual service cost paid by NYC will increase to £3,064,747 in year 5, rising to £3,308,426 in year 8 (£12,742,335 over 4 years).

7.3 The Out of Area (OOA) payment is forecasted for the 4 years of the contract, based on actual income generated by YorSexual Health seeing patients from other Local Authority areas. In the initial 3 years of the S75, this total has ranged from £91,200 to £106,176.

8.0 Legal Implications

8.1 The Local Authority is mandated as part of its public health statutory duties as stated in the Health and Social Care Act 2006 to ensure that comprehensive, open access, confidential sexual health services are available to all people in North Yorkshire (whether they live here or not).

8.2 Powers provided to local authorities and NHS bodies under Section 75 of the NHS Act 2006 and associated Regulations set out that a local authority and an NHS body can each delegate certain functions to the other, provided that the resultant arrangements are likely to lead to an improvement in the way those functions are exercised.

8.3 The Parties entered into a Section 75 Agreement under S75 of the NHS Act 2006. The extension proposed is permissible under the S75 Agreement, and Regulation 72 of the Public Contracts Regulations 2015.

9.0 Contribution to Council priorities

9.1 This proposal supports Longer, healthier, independent lives (2022-25) Health and Adult Services Plan, Opportunities for everyone, everywhere and My time and experiences are valued priorities. This proposal fits with the Council Plan 2025-2029 ambition of ensuring the people of North Yorkshire are safe, healthy, and living well, as well as the North Yorkshire Joint Local Health and Wellbeing Strategy 2023-2030.

10.0 Risk Management Implications

10.1 The NHS Agenda for Change pay award for 2025/26 was 3.6% and is unknown for future years, therefore pay costs cannot be accurately predicted. If the pay award is more than 2.5%, there will likely be an increased cost pressure and this will be addressed through continuing dialogue with the provider as set out above.

10. Given the increasing demand being placed on sexual health services, the increasing prevalence of sexually transmitted infections and termination of pregnancies, there is a risk to public health if service provision is reduced.

11.0 Human Resources Implications

11.1 No changes to service model are anticipated and so no staff consultation is required by YSTHFT.

12.0 Equalities Implications

12.1 An Equality Impact Assessment on the integrated sexual health service has been completed and is refreshed as new information becomes available.

13.0 Climate change implications

13.1 None known at this stage.

14.0 Reasons for recommendation/s

14.1 Continuing with the Section 75 Partnership Arrangement with York and Scarborough Teaching Hospitals NHS Foundation Trust will allow us to continue to work collaboratively to deliver a high-quality and well-regarded integrated sexual health service. This approach will facilitate the delivery of the required savings and ensure that the service delivers value for money and remains sustainable for at least the next six years.

14.1 The partnership arrangements will also strengthen the existing relationships with York and Scarborough Teaching Hospitals NHS Foundation Trust and allow greater scope and flexibility to explore future collaboration opportunities in the future.