PowerPoint Presentation - NHS Leicester City

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PowerPoint Presentation - NHS Leicester City Powered By Docstoc
					Feedback to Leicester City
          from
   Teenage Pregnancy
 National Support Team

    October 11th 2007
          To be covered today

•   Themes of Teenage Pregnancy
•   Overall Strengths
•   The Scale of the Challenge
•   Issues and Recommendations by Theme
•   Priority Actions
•   Summary of Support Offered
•   Plenary Session Discussion
•   NST Contact Details
Themes
     Themes of Teenage Pregnancy
•   Strategy
•   Data and Needs Assessment
•   Communication
•   Implementation
       •   Contraception/Sexual Health Advice and Services
       •   Delivery of SRE/PSHE
       •   Targeted work
       •   Workforce training
       •   Youth services
       •   Raising aspirations
       •   Work with parents
Overall Strengths
                Overall Strengths
Leadership, Commitment and Infrastructure
•   Renewed high level strategic and political commitment for
    teenage pregnancy from Local Authority, PCT and other
    partners with a recognition of the need to accelerate progress.
•   Enthusiasm and energy from front line workers for addressing
    teenage pregnancy
•   We commend the Teenage Pregnancy Co-ordinator‟s
    commitment and hard work in driving the agenda forward.
•   We endorse the repositioning of the Teenage Pregnancy
    Team within the Access, Inclusion & Participation Directorate.
•   The appointment of the Joint Strategic Commissioning Lead
    for Children and Young People is positive and well placed as
    Chair of Teenage Pregnancy and Parenting Partnership Board
    (TPPPB).
•   Some good joint working around teenage pregnancy with
    Leicestershire County.
               Overall Strengths
•   Strong and well established involvement of the voluntary and
    community sector.
•   We welcome the intention to maintain Teenage Pregnancy as
    an indicator in the Local Area Agreement (LAA).
•   The Local Strategic Partnership (LSP) have prioritised
    improving the achievement of children and young people.

Implementation
•   Good examples of local research and surveys e.g. De
    Montfort University and Voluntary Action Leicester.
•   Development of independent nurse prescribers able to fit Long
    Acting Reversible Contraceptive Implants.
•   Local Integrated Service Trial (LIST) has produced some early
    indication of positive results.
•   Some good examples of targeted work with vulnerable
    groups, including Nurture Groups in schools, Re-Ach, Stand
    Up & Speak Out.
                Overall Strengths
Implementation
•   There is huge investment in the Building Schools for the
    Future Programme (BSF).
•   The rate of increase of attainment at KS3 and 4 is better than
    national average.
•   Big Match Roadshow to match Not in Education, Employment
    or Training (NEETs) with offers of education, training or work
    placements.
•   Good support for teenage parents with dedicated joint funded
    posts e.g. the City PIPS (Parenting Information and
    Pregnancy Support) team.
•   Young peoples‟ active involvement through the Teenage
    Pregnancy Strategy e.g. Peer Education Programme.
Scale of the Challenge
                                         Leicester City Performance
                                         1998 baseline                                               2010
                                                                                                     target
                                    70
Under 18 conception rate per 1000




                                                                                                              Leicester UA
                                    60
                                                                                                              England
                                    50
                                                                                                              East Midlands

                                    40                                                                        LA 2004 target

                                    30

                                    20

                                    10

                                    0
                                    1997 1998 1999 2000 2001 2002 2003 2004 2005p 2006 2007 2008 2009 2010
                                                                     Year
       The Scale of the Challenge
•   In 2005, Leicester City had an under-18 conception rate of
    54.3 per 1000 females aged 15-17 – the 3rd highest rate in
    the East Midlands and 32% higher than the England average
    of 41.1 per 1000.
•   Leicester City has been given an ‘amber/red’ traffic-light
    rating based on comparing its actual under-18 conception
    trend against expected performance in 2005 to reach the
    2010 target.
•   There is a more than a sevenfold difference between the
    wards with the highest and lowest under-18 conception rates
    in Leicester City. Nearly half (45%) of the Local Authority‟s
    wards are „hotspots‟ with rates among the highest 20% in
    England.
•   Highly mobile population.
•   Short term funded projects and posts contribute to instability.
        The Scale of the Challenge
•   Recent organisational change within PCT and Local Authority
    has contributed to difficulties or delays in synchronising
    organisational effort around teenage pregnancy.
•   One of the lowest school attendance rates nationally and high
    levels of persistent absence.
•   High levels of free school meals.
•   Over 70% of pupils live in the areas that lie within the 30%
    most deprived nationally.
•   Almost 50% of pupils are from ethnic minorities.
•   Some of the lowest scores in the country for 5 year olds.
•   KS1 results falling over the last two years in reading, writing
    and mathematics.
•   Substantial regeneration with the potential to create
    employment opportunities.
•   Raising aspirations is a huge challenge.
               The issue is complex as there are a range of factors that are
               associated with whether a teenager becomes pregnant

 Looked after children /                                       Poor educational
                                         Behavioural                                                 Sexual abuse in
 young people leaving care                                     attainment
                                         problems                                                    childhood
                       Disengagement
                       from school / poor                    Social
                                                             deprivation                                 Lack of confidence
                       attendance                                                                        in resisting pressure
                                                          Mental health                                  to have sex
        Emotional                                         problems
        well-being                 Low aspirations                                                               Cultural influence
                                                                   Low self-esteem
                                                               Peer influence
                                    Alcohol/substance                             More likely to             Ethnicity
                       Parental     misuse                   Teenage
                                                                                  have sex early
                       influence                            Pregnancy

          Teenage                                                                                        Less likely to use
          mother                                                                                         contraception
                                                 Poor and inconsistent
                                                 contraceptive use among
                                                                                                    Poor knowledge and skills
      Fear of
                              Lack of confidence young people                                       among young people in
      parents/carers
                              in mainstream health                                                  relation to sex, relationships
      finding out                                                          Lack of easy
                              services                                                              and sexual health risks
                                                                           access to
Parents and professionals                   Young people lack skills       contraception
lack confidence to discuss                  and confidence to make
                                                                                             Low knowledge levels among
sex and relationship issues                 and carry through
                                                                                             boys and young men
with young people                           positive choices
    Educational attainment has an impact on conception
    rates over and above the effects of deprivation




Deprived wards with higher educational attainment have lower teenage conception rates
                     2005 leavers who became parents within
                           12 months of leaving school.

16

14

12

10

 8

 6

 4

 2

 0
         No GCSE's          less than 5 GCSE's   5 or more GCSE's   5 or more A-C's st GCSE


54% left school with no GCSE’s a further 31% left school with less than 5 GCSE’s
                       … on sexual activity under 16


                      70%
                             60%
                      60%

                      50%            47%                     46%                            Males
     % sex under 16




                                                      41%
                                                                                            Females
                      40%

                      30%
                                                                              19% 20%
                      20%

                      10%

                      0%
                            no qualifications      w ith qualifications

                                      Leaving school at 16                Leaving school at 17+




Source: NATSAL 2000
                                            …and on non-use of contraception

                                      40%
                                                       34%                                                      Males
      % no contraception at 1st sex




                                               28%                                                              Females
                                      30%


                                      20%
                                                                        12%     11%
                                                                                                 6%     8%
                                      10%


                                      0%
                                              no qualifications      w ith qualifications

                                                        Leaving school at 16                Leaving school at 17+


Source: NATSAL 2000
Issues and Recommendations
    Issues and Recommendations
Strategy
•   We would recommend the establishment of a small executive
    board including Chief Executive of the PCT, Director of
    Children‟s Services, Director of Public Health and the strategic
    lead for teenage pregnancy. This group should be responsible
    for driving the teenage pregnancy agenda, performance
    managing the TPPPB and establishing a downward trend in the
    teenage pregnancy rate.
•   There is a need to establish a clear vision for teenage
    pregnancy in Leicester City. A visioning planning session for
    Chief Executives and senior strategic staff would be beneficial.
    An outcome of this could be a shared set of principles in
    relation to the objectives of the strategy. - The NST can help
    facilitate this.
•   Following the visioning process, we recommend a briefing
    session for all elected members to ensure they are supported
    to champion teenage pregnancy issues. – NST can help
    facilitate this.
    Issues and Recommendations
Strategy
•   There is a need to review the membership, function and level of
    seniority of the TPPPB and sub-groups to ensure representation from
    Headteachers/Principals, Governors, Learning Services, Access,
    Inclusion & Participation, midwifery, contraception and sexual health,
    Drug & Alcohol Action Team (DAAT), and Further Education
    Colleges. All members should prioritise their attendance. - NST can
    advise on roles and responsibilities.
•   The TPPPB should define the long term strategy, performance
    manage the action plan, monitor outcomes and make investment
    decisions leading into commissioning and governance. – The NST
    and RTPC can advise on this and provide support in developing
    a performance management framework.
•   Following an evaluation of the impact of short term funded
    interventions, partners need to address sustainability and
    mainstreaming.
•   Utilise existing local research to inform commissioning and service
    delivery e.g. the De Montfort evaluation.
    Issues and Recommendations
Strategy
•   The Teenage Pregnancy Executive Board and the TPPPB
    need to foster a philosophy of reducing teenage pregnancy
    being everybody‟s responsibility, and avoid over-reliance on
    the Teenage Pregnancy Coordinator to drive the agenda
    forward.
•   The Teenage Pregnancy Co-ordinator post needs to be placed
    at a sufficiently senior and strategic level to engage the
    commitment of senior colleagues and partners and integrate
    teenage pregnancy into the wider agenda. – RTPC and NST
    can provide advice.
•   We recommend identifying teenage pregnancy champions
    amongst elected members, Head Teachers, Principals and
    school/college governing bodies.
    Issues and Recommendations
Strategy
•   There needs to be consideration of the effective involvement
    of young people in the development, review and
    implementation of the Teenage Pregnancy action plan.
•   We welcome the commitment to maintain teenage pregnancy
    as an indicator in the Local Area Agreement.
    Issues and Recommendations
Data and Needs Assessment
•   There is a need to prioritise data collection and analysis and
    review the capacity to ensure that this happens.
•   Prioritise the development of a common data set for use by all
    partners based on the Teenage Pregnancy Unit (TPU) Data
    Toolkit and building on the recommended East Midlands
    teenage pregnancy data set. – NST can advise on this.
•   We would recommend the establishment of a data set for
    every school and college that includes, for example, up-to-
    date teenage pregnancy rates, terminations, ethnicity and post
    codes - to inform School Improvement, headteachers,
    principals, governors and the community. This should inform
    and support appropriate Sex and Relationship Education
    (SRE) and Personal, Social, Health & Citizenship Education
    (PSHCE) programmes in schools and colleges. – NST can
    advise on this.
    Issues and Recommendations
Data and Needs Assessment
•   There is potential for analysis combining data collected from
    different local agencies to inform the targeting of interventions
    e.g. combining Connexions, school level and other sources of
    data. – NST can provide support with this.
•   There is a need for an up-to-date local young people‟s sexual
    health needs assessment to identify the most vulnerable
    groups and hotspot areas. This should feed into the
    commissioning process on an ongoing basis. We recommend
    using the NST Sexual Health Needs Assessment „How to‟
    Guide. – NST can provide examples.
    Issues and Recommendations
Data and Needs Assessment
•   The TPPPB have plans which are positive, to implement work
    using the social marketing model in order to understand the
    needs of young people in Leicester City. This work needs to
    inform the commissioning of services for young people and
    especially the most vulnerable. - The NST can further
    support this work through the Social Marketing Unit in
    the National Consumer Council commissioned by DH.
    Issues and Recommendations
Communication
•   It is important to develop a comprehensive teenage
    pregnancy communication strategy. - NST can provide
    examples of communication strategies and comment on
    draft strategies.
•   There is a need for regular and systematic communication
    between the TPPPB, subgroups and those delivering and
    receiving services and interventions in a variety of
    professional and service user settings.
•   The communications strategy needs to include an effective
    reactive and proactive media handling strategy.
•   Clear and consistent messages need to be targeted at
    parents, carers and young people most at risk, including those
    in BME and faith communities.
    Issues and Recommendations
Communication
•   The communications strategy should include advertising the
    availability of sexual health advice, information and services to
    young people using different media and ensure materials are
    regularly updated.
•   We would recommend using the national TPU
    communications CD ROM “R U thinking campaign toolkit” to
    help communication of the local strategy and publicise the
    availability of national and local resources and services.
•   We would recommend making full use of the forthcoming
    national media roadshow (13th December 2007, venue to be
    confirmed by RTPC) to help with local implementation of the
    national media campaign.
    Issues and Recommendations
Implementation – Contraception/Sexual Health
Advice & Services
•   There is an urgent need to improve access to sexual health
    services for young people. There needs to be a clear
    Contraception and Sexual Health Joint Commissioning plan
    informed by a comprehensive needs assessment. - NST can
    provide support with this.
•   We acknowledge that there are a range of community based
    sexual health services for young people e.g. Community Safer
    Sex Projects, Choices, Beaumont Leys and St Peter‟s. We
    recommend that you review these as part of the
    commissioning plan and ensure a comprehensive range of
    services.
•   Services need to be delivered to „You‟re Welcome‟ quality
    standards, and with the flexibility to be delivered in a range of
    settings e.g. through Extended Services, 14-19 sector, youth
    services, community pharmacies and general practice.
    Issues and Recommendations
Implementation – Contraception/Sexual Health
Advice & Services
•   We suggest integrating „You‟re Welcome‟ with the Information,
    Advice and Guidance (IAG) quality standards which will
    encourage multi agency working. –The Northwest is
    developing this. The NST can link Leicester City with this
    work.
•   All commissioned services need to have clear Service Level
    Agreements and be performance managed. Regular
    monitoring information needs to be provided to the TPPPB.
•   We welcome plans to involve young people, using existing
    groups, in service development, design, review and
    implementation, e.g. mystery shopper, patient panels. - NST
    can provide examples.
•   The NST understand that the PCT and UHL is about to
    purchase an IT system for the Genito-Urinary Medicine (GUM)
    and contraceptive services. This is essential for improving the
    reliability of data and therefore capturing the information
    required for accurate demand and capacity calculations.
    Issues and Recommendations
Implementation – Contraception/Sexual Health
Advice & Services
•   There is a need to ensure that the extensive Building Schools
    for the Future (BSF) programme is utilised to develop a range
    of venues for delivery of contraception and sexual health
    advice and services.
•   All pregnant teenagers and teenage mothers should be
    automatically referred to, and followed up by contraceptive
    services. - NST can provide examples
•   There is a need to ensure that the commissioning of
    termination services includes contraception advice and
    provision of a full range of contraceptives, including Long
    Acting Reversible Contraception (LARCs).
    Issues and Recommendations
Implementation – Delivery of SRE/PSHCE
•   Senior management in the Local Authority should provide
    clear, proactive direction and support to schools to deliver
    quality PSHCE and SRE with confidence.
•   The partnership groups, including the 14-19 Partnership Group
    and the Education and Improvement Partnership, offer a good
    mechanism for working with secondary schools and colleges.
•   There is an over reliance on the Healthy Schools Coordinator
    for the delivery of the Healthy Schools Programme. Healthy
    Schools is a key delivery mechanism for SRE/PSHCE and this
    aspect should be actively promoted and supported through all
    schools and by every partner.
•   There needs to be clear management and lines of
    accountability for the National Healthy Schools Standard
    (NHSS) and SRE staff.
    Issues and Recommendations
Implementation – Delivery of SRE/PSHCE
•   A comprehensive review of all SRE provision is needed to
    ensure the wide range of SRE initiatives complement each
    other, to develop practice and policy frameworks, to develop a
    forward plan which utilises existing routes to schools/college
    including Learning Services, NHSS, drug and alcohol
    education. - NST can provide support.
•   As part of the review, the capacity to support SRE should be
    looked at, including the capacity of the SRE consultant and
    how SRE is being promoted by all agencies who support
    schools, including Learning Services.
•   School nurses should play an integral role in the delivery of
    SRE in line with national guidance. There is a need to review
    the capacity of school nurses to fulfil this important role and
    ensure that they have received training and development
    opportunities to achieve this. - The NST can provide
    examples of prevention work through schools nurses
    from other areas.
    Issues and Recommendations
Implementation – Delivery of SRE/PSHCE
•   We recognise that there are a number of local SRE policies,
    e.g. Youth Services, Connexions, Children in Care. We
    recommend that a Leicester City-wide SRE approach
    incorporating policy, training and schemes of work, is
    developed for schools, post 16 provision and all agencies
    working with young people to ensure consistency and quality
    standards. This should incorporate existing local and national
    guidance. – NST and RTPC can help with this.
•   In accordance with government guidance, all SRE should be
    culturally appropriate and all policies consulted upon with
    parents and carers. – NST can provide examples from other
    areas.
•   We suggest that it is important to formally recognise and
    celebrate local examples of good practice.
    Issues and Recommendations
Implementation – Targeted Work
•   There is some evidence of work with Black and Minority Ethnic
    (BME) groups and refugee and asylum seekers. This needs to be
    developed further e.g. SRE with faith communities, addressing
    female genital mutilation, forced marriage. – NST can offer advice.
•   There is a need to understand conception rates in vulnerable groups,
    such as Children in Care and Care Leavers, in order to plan targeted
    SRE and sexual health services and the prevention of second and
    subsequent pregnancies. – NST can offer advice.
•   There is a need for a consistent co-ordinated approach to early
    identification of young people at risk. Risk indicators for preventing
    teenage pregnancy need to be incorporated into the Leicester City
    Common Assessment Framework (CAF). – NST can offer advice.
•   There is a need to ensure that the Lead Professional addresses
    teenage pregnancy issues.
•   There is an opportunity through the development of LIST to develop
    targeted preventative work to address reducing teenage pregnancy.
    Issues and Recommendations
Implementation – Workforce Training
•   All those working with young people, including the voluntary
    sector and faith communities, should have ongoing skills
    training in relation to talking about sex and relationships to
    young people, ranging from basic sexual health awareness
    and signposting training to more advanced training for those
    working with the most at risk groups. This should be integrated
    into the corporate workforce strategy and should be mandatory
    where appropriate. - NST can provide models of training
    including tiered training.
•   There is a need to review and develop the capacity of the
    contraception and sexual health services workforce to deliver
    universal and targeted access for young people.
    Issues and Recommendations
Implementation – Youth Services
•   Youth services have an important contribution to make in
    terms of raising aspirations, building self-esteem and focusing
    on positive activities for young people through Integrated
    Youth Support Services.
•   We support the review of the Youth Service including planning
    for Integrated Youth Support Services (IYSS) and Targeted
    Youth Support (TYS). This should specifically address the role
    of youth services to deliver the Teenage Pregnancy Strategy
    and clearly define expectations, roles and responsibilities to
    ensure a consistent approach across the city.
•   A more joined up approach between Youth Services,
    Connexions and the Voluntary and Community sector is
    needed to reduce teenage pregnancy.
•   There is a need to co-ordinate and build upon the good
    examples of positive engagement and participation of young
    people.
  The issue is complex as there is a range of factors that are
  associated with whether a teenager becomes pregnant


Looked after children /                                 Poor educational
                                    Behavioural
young people leaving care                               attainment
                                    problems
                     Disengagement
                     from school / poor               Social
                                                      deprivation
                     attendance
                                                    Mental health
       Emotional                                    problems
       well-being             Low aspirations               Low self-esteem
                                                         Peer influence
                               Alcohol/substance                           More
                     Parental misuse                   Teenage
                                                                           have s
                     influence                        Pregnancy

         Teenage
         mother
                                            Poor and inconsistent
    Issues and Recommendations
Implementation – Raising Aspirations
•   It is important for the Local Strategic Partnership and all
    partners to emphasise the interconnectedness between
    teenage pregnancy, improving aspirations of young people
    and the agenda for economic regeneration. This could be
    incorporated in the local Community Cohesion Strategy
    through the Community Strategy.
•   Lack of aspiration needs to be addressed through all
    strategies currently targeting young people and parents and
    carers.
•   Young people should receive consistent messages from all
    professionals to raise their aspirations.
•   There is an opportunity to use Social & Emotional Aspects of
    Learning (SEAL) in secondary schools as a vehicle for
    developing this area of work.
    Issues and Recommendations
Implementation – Work With Parents & Carers
•   The Leicester City Parenting Strategy and existing parenting
    programmes need to incorporate SRE so that parents and
    carers feel confident to address young peoples‟ sexual health
    issues.
•   We recommend that Children‟s Centres, Early Years and
    Extended Services prioritise education for parents and carers
    on how to talk to their children and young people about SRE,
    prevention of teenage pregnancy and raising aspirations.
•   The good work on support to teenage parents needs to
    continue with a strong focus on prevention of second
    pregnancies.
Priority Actions
                  Priority Actions
Strategy
•   Establish a small executive board; review the membership,
    function and level of seniority of the TPPPB; and the
    positioning of the Teenage Pregnancy Coordinator post. –
    RTPC and NST can provide advice.
•   Following an evaluation of the impact of short term funded
    interventions, partners need to address sustainability and
    mainstreaming.

Data
•   There is a need to prioritise data collection and analysis and
    review the capacity to ensure that this happens. This is
    particularly important for schools and colleges. – NST can
    advise on this.
           Priority Actions cont…
Implementation
•   Develop a Contraception and Sexual Health Joint
    Commissioning plan informed by a needs assessment with
    clear SLAs and a performance management framework to
    ensure a comprehensive range of services delivered to
    „You‟re Welcome‟ quality standards. - NST can provide
    support.
•   Senior management in the Local Authority should provide
    clear, proactive direction and support to schools to deliver
    quality PSHCE and SRE with confidence.
•   Review all SRE provision to ensure the wide range of SRE
    initiatives complement each other, to develop practice and
    policy frameworks, to develop a forward plan which utilises
    existing routes to schools/college including National Healthy
    School Standard, drug and alcohol education. - NST can
    provide support.
                  Priority Actions
Implementation
•   School nurses should play an integral role in the delivery of
    SRE in line with national guidance. Review the capacity of
    school nurses to fulfil this important role and provide training
    and development opportunities to achieve this. - The NST can
    provide examples of prevention work with schools
    nurses from other area.
•   The review of the Youth Service including planning for
    Integrated Youth Support Services (IYSS) and Targeted
    Youth Support (TYS) should specifically address the role of
    youth services to deliver the teenage pregnancy Strategy and
    clearly define expectations, roles and responsibilities to
    ensure a consistent approach across the city.
•   It is important for the Local Strategic Partnership and all
    partners to emphasise the interconnectedness between
    teenage pregnancy, aspirations and economic regeneration -
    incorporate in the local Community Cohesion Strategy.
Summary of support
     Summary of the Support Offered
Strategy
•   There is a need to establish a clear vision for teenage pregnancy in
    Leicester City. A visioning planning session for Chief Executives and senior
    strategic staff would be beneficial. An outcome of this could be a shared set
    of principles in relation to the objectives of the strategy. - The NST can help
    facilitate this.
•   Following the visioning process, we recommend a briefing session for all
    elected members to ensure they are supported to champion teenage
    pregnancy issues. – NST can help facilitate this.
•   Review membership, function and level of seniority of the TPPPB and sub-
    groups to ensure representation from Headteachers/Principals, Governors,
    Learning Services, Access, Inclusion & Participation, midwifery,
    contraception and sexual health, Drug & Alcohol Action Team (DAAT), and
    Further Education Colleges. All members should prioritise their attendance. -
    NST can advise on roles and responsibilities.
•   The TPPPB should define the long term strategy, performance manage the
    action plan, monitor outcomes and make investment decisions leading into
    commissioning and governance. – The NST and RTPC can advise on this.
•   The Teenage Pregnancy Co-ordinator post needs to be placed at a
    sufficiently senior and strategic level to engage the commitment of senior
    colleagues and partners and integrate teenage pregnancy into the wider
    agenda. – RTPC and NST can provide advice.
     Summary of the Support Offered
Data
•   Prioritising the development of a common data set for use by all partners based on the
    Teenage Pregnancy Unit (TPU) Data Toolkit and building on the recommended East
    Midlands teenage pregnancy data set. – NST can advise on this.
•   We would recommend the establishment of a data set for every school and college
    that includes, for example, up-to-date teenage pregnancy rates, terminations,
    ethnicity, post codes, to inform School Improvement, headteachers, principals,
    governors and the community. This should inform and support appropriate SRE and
    PSHCE programmes in schools and colleges. – NST can advise on this.
•   There is potential for analysis combining data collected from different local agencies to
    inform the targeting of interventions e.g. combining Connexions and school level data.
    – NST can provide support with this.
•   There is a need for an up-to-date young peoples sexual health local needs
    assessment to identify the most vulnerable groups and hotspot areas. This should be
    considered as an ongoing process to feed into the commissioning process. We
    recommend using the NST Needs Assessment Guide. – NST can provide examples.
•   The TPPPB plans to implement work using the social marketing model in order to
    understand the needs of young people in Leicester City are positive. This needs to
    inform the commissioning of services for young people and especially the most
    vulnerable. - The NST can further support this work through the Social Marketing
    Unit in the National Consumer Council commissioned by DH.
     Summary of the Support Offered
Communication
•   There is a need to develop a comprehensive teenage
    pregnancy communication strategy. - NST can provide
    examples of communication strategies and comment on
    draft strategies.
Implementation
•   There is an urgent need to improve access to sexual health
    services for young people. There needs to be a clear
    Contraception and Sexual Health Joint Commissioning plan
    informed by a comprehensive needs assessment as current
    provision for young people is limited and fragmented. - NST
    can provide support with this.
•   We suggest integrating „You‟re Welcome‟ with the Information,
    Advice and Guidance (IAG) quality standards which will
    encourage multi agency working. –The Northwest is
    developing this. The NST can link Leicester City with this
    work.
     Summary of the Support Offered
Implementation
•   We welcome plans to involve young people, using existing groups, in
    service development, design, review and implementation, e.g.
    mystery shopper, patient panels. - NST can provide examples.
•   All teenage mothers, pre and post natal, should be automatically
    referred to, and followed up by contraceptive services. - NST can
    provide examples
•   A comprehensive review of all SRE provision is needed to ensure the
    wide range of SRE initiatives complement each other, to develop
    practice and policy frameworks, to develop a forward plan which
    utilises existing routes to schools/college including National Healthy
    School Standard (NHSS), drug and alcohol education. - NST can
    provide support.
•   School nurses should play an integral role in the delivery of SRE in
    line with national guidance. There is a need to review the capacity of
    school nurses to fulfil this important role and ensure that they have
    received training and development opportunities to achieve this. -
    The NST can provide examples of prevention work with schools
    nurses from other areas.
     Summary of the Support Offered
Implementation
•   We recognise that there are a number of local SRE policies, e.g.
    Youth Services, Connexions, Children in Care. We recommend that
    a Leicester City-wide SRE approach incorporating policy, training
    and schemes of work, is developed for schools, post 16 provision
    and all agencies working with young people to ensure consistency
    and quality standards. This should incorporate existing local and
    national guidance. - NST and RTPC can help with this.
•   In accordance with government guidance all SRE should be
    culturally appropriate and all policies consulted upon with parents
    and carers. – NST can provide examples from other areas.
•   There is some evidence of work with Black and Minority Ethnic
    (BME) groups and refugee and asylum seekers. This needs to be
    developed further. e.g. SRE with faith communities, addressing
    female genital mutilation, forced marriage. – NST can offer advice.
•   There is a need to understand conception rates in vulnerable groups,
    such as Children in Care and Care Leavers, in order to plan targeted
    SRE and sexual health services and second pregnancy prevention. –
    NST can offer advice.
     Summary of the Support Offered
Implementation
•   There is a need for a consistent co-ordinated approach to
    early identification of young people at risk. Risk indicators for
    preventing teenage pregnancy need to be incorporated into
    the Leicester City Common Assessment Framework (CAF). –
    NST can offer advice.
•   All those working with young people, including the voluntary
    sector and faith communities, should have ongoing skills
    training in relation to talking about sex and relationships to
    young people, ranging from basic sexual health awareness
    and signposting training to more advanced training for those
    working with the most at risk groups. This should be integrated
    into the corporate workforce strategy and should be mandatory
    where appropriate. - NST can provide models of training
    including tiered training.
  Plenary Session Discussion
• Local Authority and PCT to comment

• Questions to clarify feedback points

• Comments on Feedback

• Any comments on our process

• Next steps
               Teenage Pregnancy National Support Team Contacts



                         National Delivery
Avril Howarth                                         avril.howarth@dh.gsi.gov.uk                 07776 244 485
                         Manager



                         Associate Delivery
Sarah Carter                                          sarah.carter@dh.gsi.gov.uk                  07884 473 182
                         Manager




Dane Wiig                Project Officer              dane.wiig@dh.gsi.gov.uk                     020 7972 3051




         NST Office address :     Room 221                    Director‟s Office address   Cathy Hamlyn
                                   Wellington House                                       Room G18, Richmond House
                                   133-155 Waterloo Road                                  Whitehall
                                   London SE1 8UG                                         London SW1A 2NS
                                   Fax 020 7972 4700                                      Fax: 020 7210 5438

				
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