Background Funding of sexual health services will move from PCTs to local authorities, so there is an urgent need to understand the current spend on sexual health (SH), and implement existing evidence to deliver cost-effective services.

Aims The aims of this project are to estimate the spend on, and demand for, sexual health services in the South West region, to support local commissioners in evaluating their spend, to identify priorities for investment using local data, and to enable preparations for transferring commissioning responsibility to the local authority.

Methods Data collection templates were developed to capture the commissioning spend and relevant sexual health data needed to estimate outcomes including the total spend per trust and the spend per adult. This was supplemented by routine data. Each area was analysed separately, and averaged across the South West.

Results Overall the total SH spend in the South West was £46.4 million in 2010/2011, excluding HIV treatment. Over half was allocated to GUM and SRH attendances. Chlamydia screening activities accounted for 8% of the total spend. The average SH spend per person aged 15–44 years was £24 (range £14–£38). There were 142 293 chlamydia screens carried out at an average cost of £27 per screen and 8,825 chlamydia diagnoses costing £437 per positive identified. There were substantial increases in the availability of long-acting reversible contraceptives and the availability of over the counter emergency contraception during the study period.

Discussion There was large variation between PCTs in the relative spend on different services according to local organisation and their progress towards full integration of sexual health services. Areas with higher spend tended to have higher burden of disease, and were more likely to be urban. This project brings together the total spend on sexual health and population need and will help PCTs in their transition to local authority funding.