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Austerity and sustainable sexual and reproductive health care
  1. Rudiger Pittrof*
  1. * Corresponding author
  1. Ulrike Sauer
  1. Elana Covshoff
  1. Consultant in Community Sexual Health and HIV, Department of Sexual and Reproductive Health, Guy's and St Thomas’ NHS Foundation Trust, London, UK; Rudiger.Pittrof@gstt.nhs.uk
  2. Consultant in Sexual and Reproductive Health, Lead for Brent Contraceptive Services, Brent Contraceptive Services, Central and North West London NHS Foundation Trust, London, UK; ulrike.sauer@nhs.net
  3. SHRINE Programme Manager, Guy's and St Thomas’ NHS Foundation Trust, London, UK; elanacovshoff@gmail.com

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English sexual and reproductive health (SRH) services are commissioned by local authority councils from their public health budget. Their allocations are predicted to shrink by up to 50% by 2017.1

To show that SRH care is good value for money it has to generate net earnings or net savings for those commissioning services. Clinical commissioning groups (CCGs) and NHS (National Health Service) trusts gain little from preventing uncomplicated pregnancies because they generate a net income from these pregnancies. SRH commissioners do not fund maternity care, abortion services, paediatric care or services for children and as a result do not benefit from any savings created from prevention initiatives. In order to have sustainable services we need to work with those who will have a net savings as a result of our care. New funding could come from two sources: (1) NHS or mental health trusts and (2) social services.

Most SRH services in England are now also integrated with hospital-based genitourinary …

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