PUBLIC health bosses are drawing up a new plan for sexual health services in York - but warn that budgets are so tight they may have to settle for sharing with North Yorkshire.

City of York Council is responsible for sexual health services, and from 2019 needs a new provider to run HIV prevention, sexual health promotion, open access genitourinary medicine and contraception services.

Public health staff have set out the four areas that need improvement in York - late HIV diagnoses, STI testing and diagnosis rates, chlamydia screening and under 18 pregnancies.

The new contract will initially run for three years, and is worth £1.74 million annually, but the city council’s public health chief Sharon Stoltz has warned it will be “a challenge” for any provider to deliver a comprehensive service on that budget.

Speaking at a health scrutiny committee meeting, Ms Stoltz said that budget doesn’t allow for any growth despite what they know about York’s population of young people - who are the largest users of sexual health services.

“Our first preference is a bespoke service that works for York but, because of the risks, our fall back - if we are not confident the market can respond to what we need within the budget available - is to do a joint commissioning with North Yorkshire,” she told councillors.

Working with the county council would give services a larger population and larger budget, but would mean York had less influence over how the new services run, she said.

However, Ms Stoltz said they had checked on how other councils had commissioned new services, and believe York will be able to get the contract it wants within its £1.74 million budget.

At the meeting, Ms Stoltz also said her department was already talking to health services in York as sexual health is a shared responsibility between the council and other agencies.

“If we get this wrong there are cost implications for the NHS,” Ms Stoltz added.

Papers prepared for the meeting show that any bids the council gets to run the new service will be assessed on an 80 per cent quality and 20 per cent cost basis.

Ms Stoltz said that because of the client group using sexual health services, they may be able to roll out things like online triage and postal testing kits - something that has been done successfully in other parts of the country.

The new contract proposal could be approved by the council’s ruling executive in July, and the tender documents then published in October following UK and EU laws.

The initial three-year contract could be extended for up to four more years, but Ms Stoltz told the health committee they would be monitoring performance through those years, and asking for extra cash if it is needed.

She added: “If, after we award a contract, I am not satisfied, or risks emerge further down the line, we would be raising that with executive and putting a case forward for growth monies.”

The report also shows that York gets just £37 a head in public health funding, which is lower than the £55 national average.

The public health grant York gets from central government is also falling by around 2.6 per cent a year from 2016/17 to 2019/20, and spending on sexual health services in the city has already fallen from £2.4 million a year when responsibility passed from the NHS to the council, to £1.79 million in 2017/18.