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Report to: |
Lead Member for Adult Social Care and Health
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Date of meeting: |
4 June 2025
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By: |
Director of Adult Social Care and Health
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Title: |
Proposed consultation in relation to the future of the Circle Room Young Persons Sexual Health Clinic in Lewes
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Purpose: |
To seek approval to undertake a targeted consultation regarding the potential closure of the Circle Room Young Persons Sexual Health Clinic in Lewes. |
The Lead Member is recommended to:
2) note that a further report setting out the outcome of the consultation will be presented to the Lead Member once the consultation has completed.
1.1. The Circle Room young person’s sexual health service offers ‘drop-in’ sexual and reproductive health sessions for 3 hours per week, for people aged up to 25 years old. The provider is Foundry Health Care (Doctor Surgery and Medical Centre) and the service is based in Lewes. The drop-in services offered by Foundry Health Care at the Circle Room are sexual health consultation, contraception, Emergency Hormonal Contraception (EHC), condoms and Sexually Transmitted Infections (STIs) and HIV screening in Lewes.
1.2. The Circle Room drop-in service was originally implemented at School Hill Surgery in Lewes due to an identified lack of face-to-face services delivering the sexual health offer to young people in Lewes. The original purpose was to ensure provision was available to patients that were either not registered with or otherwise unable to access a GP Surgery to receive sexual health and reproductive services. Most of the young people attending the Circle Room drop-in service were originally non-registered patients.
1.3. Since this service was established, models of service provision and access to sexual health services have substantially changed and adapted. Since 2020, online services are now the main access point for East Sussex residents to access STI and HIV testing, EHC, bridging contraception and condoms. In addition, since 2023, community pharmacies also offer EHC and contraception. Consequently, comprehensive alternative service provision is now available, as well as highly trained and informed General Practitioners / clinicians who actively provide face to face sexual health services as part of their practice.
1.4. In addition, Foundry Health Care was formed by multiple GP practices merging. Analysis of 2024 data submitted by Foundry Health Care about the service users of the Circle Room drop-in services shows that there has been a significant shift in the cohort of service users accessing the services. Currently, only 25% (56 out 216) of those using the drop-in service at the Circle Room are non-registered patients (i.e. the original target cohort). 74% (160 out of 216) were registered with the Foundry Healthcare Practices. Of the non-registered patients, only 6 are East Sussex residents from various East Sussex locations; the remaining non-registered patients are non-East Sussex residents.
1.5 The contract with Foundry Health Care is due to end on 31 March 2026.
2. Supporting Information
2.1. The possibility of decommissioning the drop-in services at the Circle Room was initially considered as part of the Council’s Reconciling Policy, Performance and Resources (RPPR) process for 2025/26. De-commissioning the drop-in services would deliver a revenue saving of £45,000 per year. However, given the contract expiry date is 31 March 2026, any saving arising from the expiry of the contract will not be delivered in this financial year. This proposal was therefore not progressed as part of the main Adult Social Care and Health RPPR consultation process for 2025/26 but is now being progressed in-year to coincide with the contract expiry date and to ensure a full year saving for 2026/27 onwards if the proposal is agreed.
2.2. If the proposal to close the Circle Room goes ahead, existing users of the service will be able to access alternative sexual health services in East Sussex, such as the Councils’ online services or community pharmacies. In addition, as most existing users are registered with the Foundry Health Care GP Practices, they can also access these services via their GP as sexual health services are currently provided as part of the GP offer. A further alternative is to access specialist sexual health services in Brighton.
2.3. The Council is re-charged for any East Sussex residents accessing out of County specialist services, generally at a higher rate than our own alternative commissioned services. However, even if all 56 of the non-registered patients (based on 2024 data) had attended the specialist services in Brighton (rather than the Circle Room drop-in service in Lewes), this activity (assuming a full STI and HIV screen and new contraception) would have cost the Council considerably less than the annual contract value for the Circle Room. This indicates that any additional costs that may arise as a result of non-registered patients currently accessing the drop-in service in Lewes instead using an out of area specialist sexual health services (e.g. Brighton) will be less than the cost of continuing to fund the drop-in service. This is especially so given that, of the 56 unregistered patients, only 6 were East Sussex residents (the Council would only be re-charged for East Sussex residents accessing the specialist service).
Consultation and engagement about the proposal
2.4. Having considered the nature of the service, the cohort of users, the value of the contract and the likely impact of any closure, undertaking a full public consultation would likely be a disproportionate use of resources. However, it is important, given the potential service closure, that the Council undertakes some form of engagement to understand the views of service users and the impact the proposal would have on them. Consequently, a targeted consultation focussing on the users of the service is considered a proportionate approach. An Equality Impact Assessment will also be undertaken by the Council ahead of any final decision on the proposal.
2.5. The provider, Foundry Health Care, has been informed and is aware of the potential closure of the Circle Room drop-in services. In addition, the Council has notified Lewes District Council of the potential closure.
2.6. The Council has considered whether the proposed closure would have any impact on a future unitary authority, and it is considered at this stage that it will not. This will be considered further following the outcome of the consultation and in light of any representations from Lewes District Council.
3. Conclusion and reasons for recommendations
3.1. Given the Council’s current financial circumstances, the ‘best value’ duty to secure continuous improvement having regard to a combination of economy, efficiency and effectiveness and the Council Priority to ‘make best use of resources, now and in the future’, it is necessary that all the services commissioned by the Council are kept under review. It has been identified that the drop-in services at the Circle Room are potentially no longer as essential or cost effective as originally modelled given the shift in the cohort of users, as described above, and the range of suitable alternative services that are now available (including the face-to-face sexual health specialist service, the Council’s online offer, sexual health provision by local pharmacies and sexual health provision by GP practices, amongst others).
3.2. However, prior to making any decision about the future of the services provided at the Circle Room, it is important for the Council to engage with the affected service users to gather and understand their views. Given these services are accessed by a discrete section of the population, a full public consultation is not a proportionate use of resources. The Lead Member for Adult Social Care and Health is therefore recommended to agree that the Council undertake a targeted consultation to seek views about the proposed decommissioning of drop-in services at the Circle Room in Lewes. The outcome of the consultation will be reported to the Lead Member in due course, together with a recommendation on whether or not to proceed with the proposal.
MARK STAINTON
Director of Adult Social Care and Health
Contact Officers:
Tony Proom
Email: tony.proom@eastsussex.gov.uk
Telephone: 07773213045
Anna Merla
Email: anna.merla@eastsussex.gov.uk
Telephone: 07773213045