Policy context
Scottish Government policies
The Scottish Government launched a Sexual health and blood borne virus action plan: 2023 to 2026 in November 2023, building on frameworks and action plans described below. The action plan describes the current priorities, which encompass:
(1) access to services for: sexually transmitted infections and blood-borne virus testing, contraception, longer acting reversible contraception, post-partum contraception, post-abortion contraception, progestogen-only pill provision in pharmacy without prescription.
(2) young people having access to clear, accurate sexual health and contraceptive advice, allowing them to make informed choices about their reproductive choices and sexual health.
(3) developing the definition of sexual well-being and its key indicators, which will be used to produce baseline data for Scotland’s sexual well-being.
(4) Hepatitis C elimination in Scotland by the end of the 2024/25 financial year.
(5) elimination of HIV transmission in Scotland by 2030.
To support women’s sexual health, the Women’s Health Plan (WHP) was published in 2021 by the Scottish Government, and the policies described in WHP work in tandem with Sexual health and blood borne virus action plan to fully address women’s needs and health inequalities in sexual health in Scotland. To do so, the plan focuses on the following priority areas:
(1) ensuring women who need it have access to specialist menopause services for advice and support on the diagnosis and management of menopause.
(2) improving access for women to appropriate support, speedy diagnosis and best treatment for endometriosis.
(3) improving access to information for girls and women on menstrual health and management options.
(4) improving access to abortion and contraception services; and (5) ensuring rapid and easily accessible postnatal contraception.
The Sexual Health and Blood Borne Virus Framework Update, covering the 2015-20 period and building on the work done between 2011-2015, was published in September 2015. It provided a joined-up approach to tackling poor sexual health and blood borne viruses (SHBBV) in Scotland and set out five high-level outcomes:
(1) fewer newly acquired blood borne virus and sexually transmitted infections, and fewer unintended pregnancies.
(2) a reduction in the health inequalities gap in SHBBV.
(3) people affected by blood borne viruses lead longer, healthier lives with a good quality of life.
(4) sexual relationships are free from coercion and harm.
(5) a society where the attitudes of individuals, the public, professionals and the media in Scotland towards SHBBV are positive, non-stigmatising and supportive.
Healthcare Improvement Scotland sexual health standards
In January 2022, Health Improvement Scotland published ten standards (following the original standards published in 2008) that are designed to improve access to sexual health care and reduce inequalities in outcomes by providing benchmarks for good sexual health care and helping services to identify areas for improvement.
HIV and PReP in Scotland
On 10th April 2017 Scotland became the first of the UK nations to approve the provision of pre-exposure prophylaxis (PrEP) by the NHS to prevent HIV. The Scottish Medicines Consortium (SMC) announced that the drug Truvada® was deemed a cost-effective treatment to prevent the transmission of HIV and was to be made available through the NHS in Scotland. PrEP began to be offered through sexual health clinics across Scotland in July 2017. Glasgow Caledonian University is currently developing the world’s first national PrEP online service with the intention of rolling it out across Scotland.
On 1st December 2020, the Scottish Government announced their plan to eliminate HIV transmission by 2030.
Further information can be found here
Access to contraceptive pill without prescription
Following a successful trial in the Lothian and Tayside areas, in November 2021, the Scottish Government approved a scheme that will allow community pharmacies to give out three-month supplies of the progestogen-only pill without prescription. It is hoped this will help to bridge the gap between emergency contraception and long-term contraception. Further information can be found here.
Early medical abortion at home
In October 2017, the Chief Medical Officer announced that Scottish Government had approved home use of the second of two medications used in early medical abortion (up to 9 weeks + 6 days gestation), effective immediately. This will be permitted where (a) the pregnant woman has attended a clinic where she has been prescribed mifepristone and misoprostol to be taken for the purposes of termination of her pregnancy; and (b) the pregnant woman has taken mifepristone (the first medication, which ends the pregnancy) at that clinic and wants to carry out the remaining treatment at home. This change aims to improve quality of care, by offering flexibility to women who wish to complete an early abortion at home. Further details can be found here (551KB).
Due to the COVID-19 pandemic, from March 2020, Scottish Ministers approved the patient's normal place of residence in Scotland as a place where the first drug (mifepristone) could be administered. This was followed by a consultation and an evaluation of early medical abortion at home (EMAH), which showed that the effectiveness and acceptability of the current models of EMAH in Scotland and the work packages all indicate that the benefits of the current model outweigh any risks.
Access to free menstrual products in educational settings
In November 2020, MSPs unanimously approved the Period Products (Free Provision) (Scotland) bill. The bill mandates that: Period products should be available to anyone who needs them, free of charge; Education providers must make period products available free in on-site toilets; Public bodies have a duty to provide period products free. Scotland thus became the first country in the world to make period products free to all.
Further details:
Period Products (Free Provision) (Scotland) Act 2021
Equally Safe
Scotland's strategy to eradicate violence against women was first published in 2014 and updated to its current version in 2016 (with additional contributions from children’s organisations). It was developed by the Scottish Government and the Convention of Scottish Local Authorities (COSLA) in association with a wide range of partners from public and third sector organisations. The aim of the strategy is to work collaboratively with key partners in the public, private and third sectors to prevent and eradicate all forms of violence against women and girls.
Further information:
- Equally Safe National Strategy
- Equally Safe Delivery Plan
- Relationships, Sexual Health and Parenthood resource: A national resource for relationships, sexual health and parenthood (RSHP) education for children and young people has been launched in Scotland. The resource can be used in early learning settings, schools, colleges and community-based learning. It is organised to sit within Curriculum for Excellence.
Previous policies that underpin current activities:
- Respect and responsibility: Strategy and action plan for improving sexual health was published by the Scottish Government in 2005. This strategy focused on self-respect, respect for others and building strong relationships and a range of actions were set out to enhance sexual health promotion, education, and service provision. NHS Quality Improvement Scotland (NHS QIS) was tasked with taking forward the development of clinical standards in relation to sexual health services provided by or secured by NHS Scotland. The importance of improving detection and diagnosis of HIV in non-HIV specialties (including Primary Care) was highlighted in improving the detection and diagnosis of HIV in non-HIV specialties (including Primary Care), published October 2007.
- An HIV Action Plan in Scotland, December 2009 to March 2014 was published in November 2009 and aimed to prevent HIV transmission and to provide high quality treatment and care to all those who require it.
- A second phase of this strategy was published in 2008 and saw the focus shift towards achieving cultural and behavioural change. This second phase details actions across four broad themes: knowledge and awareness; leadership, co-ordination and performance management; standards and service provision; and young people.
- The Hepatitis C Action Plan (Phase II) was designed to improve all services applicable to the prevention of, and design and care of persons with, hepatitis C. In July 2019, the Minister for Public Health, Sport and Wellbeing announced the Scottish Government’s commitment to effectively eliminate hepatitis C in Scotland by 2024.
- The Scottish government has also produced guidance for professionals on Healthy Relationships and Consent.
