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					                TACKLING TEENAGE PREGNANCY IN LINCOLNSHIRE




       Local Implementation of the National Strategy for Social Inclusion

                                   from April 2001 to March 2010




                                               20 March 2001




C:briefcase/tacklingteenagepregnancystrategy                                1
CHIEF OFFICERS COMMITMENT
This Strategy represents a significant commitment of human and financial
resources to reducing teenage conceptions and the resulting health and social
consequences.

The commitment is made freely by the key agencies and individuals with a
significant contribution to make to this agenda.

We, the lead Chief Officers nominated by Government for the delivery of this
strategy, commend this strategy to the Teenage Pregnancy Unit and agree to
support the delivery of the work programme described.




Mr R Jeavons                                   Mr M Bukowski
Chief Executive                                Director of Social Services
Lincolnshire Health Authority                  Lincolnshire County Council




C:briefcase/tacklingteenagepregnancystrategy                                    2
CONTENTS

                                                                               Page

PART ONE:                   STRATEGY OVERVIEW 2001 to 2010

Section One:                Introduction and Context                           4

Section Two:                Strategic Overview                                 5

Section Three:              Stock take of Needs and Services                   11

Section Four:               Delivering the Strategy                            17

Section Five:               Media and Communications                           19

Section Six:                Improving Prevention and Education Services        20

Section Seven:              Improving Contraceptive, Advice and Information    23
                            Services

Section Eight:              Improving Support for Teenage Parents              26


PART TWO :                  ACTION PLANS: 2001 to 2004


Section One:                Introduction and Purpose                           29

Section Two:                Action Plan for Improving Prevention and           30
                            Education services from April 2001 to March 2004

Section Three               Action Plan for Media and Communication            32
                            from April 2001 to March 2004

Section Four                Action Plan for Improving Contraceptive            34
                            Advice and Information Services from
                            April 2001 to March 2004

Section Five                Action Plan for Improving Support Services for  35
                            Teenage Pregnancy from April 2001 to March 2004

Section Six                 Source and Application of Funds in Delivering      38
                            The April 2001 to March 2004 Action Plan




C:briefcase/tacklingteenagepregnancystrategy                                          3
STRATEGY OVERVIEW: 2001 to 2010

Section One:                Introduction and Context
1.       Introduction

1.1      This document describes the strategic approach and work programme of
         the key partner agencies in Lincolnshire in addressing the health and
         social problems associated with teenage pregnancy.

1.2      The two key elements of the strategy are:

1.2.1 preventing unplanned pregnancy amongst young people during their
      teenage years, particularly before the age of 18 years;

1.2.2 supporting young people who do become pregnant to continue their
      education and training and reach their full potential as parents and
      participants in society.

1.3      These plans are a distillation of the action required of Lincolnshire
         agencies by the national strategy. They reflect the local situation around
         teenage conceptions and address the particular problems of service
         delivery in the County.

1.4      The document provides brief information on the extent of the problem in
         Lincolnshire and the services currently provided together with an analysis
         of what needs to be improved over the coming ten years.

1.5      An overall ten year plan of action and a detailed action plan for the three
         years from April 2001. A report on activities undertaken in 2000/2001 is
         available separately.


2.       Context

2.1      In June 1999, the newly formed Social Exclusion Unit published the
         “Teenage Pregnancy Report” which examined the cause and effect of
         conceptions in young people’s teenage years.

         It highlighted that teenage pregnancy is a major cause of long term
         disadvantage and inequality in the physical, social and economic health of
         young parents and their children.




C:briefcase/tacklingteenagepregnancystrategy                                           4
2.2      It is also clear from the report that low expectations, poor educational
         attainment and low incomes are determinants, as well as effects, of
         teenage pregnancy.

2.3      The Social Exclusion Unit Report heralded the formation of the Teenage
         Pregnancy Unit (TPU) which is the cross-governmental unit responsible
         for achieving the outcomes defined in the national strategy.


Section Two:                          Strategic Overview

3.       Engaging Local Stakeholders

3.4      This local plan is required by the TPU and its production was jointly led by
         Lincolnshire Health Authority and Lincolnshire County Council Social
         Services Directorate. Its development was greatly supported by a multi-
         agency steering group with core membership from the following agencies:

         Lincolnshire Careers and Guidance Service
         Lincolnshire and Rutland Connexions Service
         Grantham College of Further Education
         Sure Start
         Lincolnshire Training and Enterprise Council
         Boston and Skegness Primary Care Group
         South Lincoln Primary Care Group
         Lincolnshire County Council: Directorate of Education and Cultural
         Services and Lincolnshire Development
         Lincolnshire Healthy Schools

3.5      During the process of developing the strategy a broad range of other
         agencies and individuals participated in lively debate. These included:

         Young parents from the Platform Skegness Project
         Young people accessing County Reintegration Services
         Homestart
         Lincolnshire Healthcare NHS Trust
         United Lincolnshire Hospitals Healthcare NHS Trust
         Lincolnshire Statutory and Non Statutory Youth Services
         Head teachers
         Lincolnshire Youth Offender Service
         Primary Care Trusts
         Parent Teacher Associations
         Lincolnshire HIV and AIDS Voluntary Group




C:briefcase/tacklingteenagepregnancystrategy                                            5
4.       Local Planning and Co-ordination

4.1      The history of local planning and co-ordination of teenage pregnancy
         programmes in Lincolnshire has been ad hoc, often being managed as an
         add-on to officers existing roles.

4.2      There is, however, a robust tradition and practice of multi-agency co-
         operation in the County and this led to the early formation of a strong local
         steering group for this programme area. This group has been supported
         by a designated senior manager of Lincolnshire Health Authority.

4.3      The Steering Group was the hub for the development of this local strategy
         and will continue to be key in ongoing monitoring, review and forward
         planning. The Steering Group requires more officer support than is
         currently available to maximise the effectiveness of local strategy.

4.4      From April 2001 the Group will be led by an agreed senior manager and
         supported by a dedicated Co-ordinator. The Figure One below illustrates
         the structure which will be in place in April 2001 to drive the
         implementation of local strategy.

Figure One: Lincolnshire Teenage Pregnancy Implementation Infrastructure


                                    National Teenage Pregnancy Unit
                                          The NHS Executive
                                    The Social Services Inspectorate



                                        Lincolnshire in Partnership



     Teenage Pregnancy Steering Group                      Senior Manager Champion



                                                      Teenage Pregnancy Co-ordinator



4.5      Lincolnshire in Partnership (LIP) is a strategic partnership group attended
         by all County agency chief officers; chief officer representation of District
         Councils and the Chairman of the Lincolnshire Housing Forum.




C:briefcase/tacklingteenagepregnancystrategy                                             6
4.6      The Steering Group will be led by senior officers of the LIP agencies,
         supported by key ‘experts’ with key roles in delivering the action plan
         agreed with LIP and Teenage Pregnancy Unit.

4.7      The Teenage Pregnancy Coordinator will be based within the joint Health
         Authority and Local Authority Healthy Communities Department.

4.8      Young people have been involved in informing the development of local
         strategy in two key ways:

4.8.1 formal surveying of students of a sample of secondary schools to
      determine the drivers behind their attitudes and behaviour,

4.8.2 focus groups, particularly with young parents, through existing service
      providers and informal support groups.

4.9      Parents are being engaged in a unique piece of joint research by the
         Health Authority, Connexions and the County Education Authority to
         ascertain their support needs. The findings of this research will be
         available to more fully inform the 2002 review of action plans.

4.10     Whilst the ethnic minority population of Lincolnshire is much smaller than
         the national average, it is just as diverse.

4.11     Development work will need to be undertaken in 2001/2002 to establish
         the extent of the difficulties experienced by young people across all
         minorities.

4.12     Initial work has already begun to engage the travelling communities and
         the small but vulnerable population of exchange students from the republic
         of China.


5.       The Vision

5.1      The vision of the Steering Group is that by the end of the ten year life of
         the strategy:

         the young people of Lincolnshire will have the knowledge, the ability, the
         motivation and the confidence to plan parenthood, with the vast majority
         waiting beyond their teenage years. We also see the large majority of
         teenage parents choosing to continue their education, training or
         employment as part of an individually tailored and accessible support
         package.




C:briefcase/tacklingteenagepregnancystrategy                                           7
6.       Strategic Goals

6.1      The key strategic goal of this strategy is to reduce the number of young
         people who become pregnant before they are aged 18 years.

6.2      For those young people who do become pregnant, the strategy seeks to
         minimise the long term social, economic and health consequences of the
         pregnancy.

6.3      Table One below provides numerical targets, where these exist, together
         with milestones for the life of the strategy.

Table One: Strategic Goals and Milestones
Strategic Goal 1             To reduce the rate of conception amongst under
                             18 year olds in Lincolnshire by 50% by 2010 from
                             41.5 per 1000 to 21 per 1000 15 to 17 year olds.
Milestones                   To reduce the rate of conceptions in 15 to 17
                             year olds by 15% by 2004 from 41.5 per 1000 to
                             35.3 per 1000 15 to 17 year olds.

Strategic Goal 2                               To set a firm downward trend in conceptions in
                                               women aged 13 to 15 years by 2010.
Milestones                                     To level off the projected increase in conceptions
                                               in women aged 13 to 15 years by 2004.

Strategic Goal 3                               To increase the proportion of teenage parents
                                               who achieve Lincolnshire average household
                                               income within ten years.
Milestones                                     To reduce non-attendance at schools of young
                                               women who become pregnant by 50% by 2004.

                                               To reduce the proportion of young parents not
                                               engaged in learning to the average of their peers
                                               by 2006.



7.       Critical Linkages

7.1      It is evident that the strategic goals described above may not be achieved
         by a single agency. The Steering Group has a key responsibility for
         ensuring that all agencies and programmes which may impact on the
         success of this strategy are taken into account and influenced.




C:briefcase/tacklingteenagepregnancystrategy                                                       8
7.2      Other policy programme leads are fully appraised of the action required for
         the delivery of this strategy. Evidence of close collaboration of the
         Teenage Pregnancy Steering Group may be found in the following plans:

         Lincolnshire’s Vision for Health Improvement
         Lincolnshire Vision In Focus
         Lincolnshire Healthy Schools Proposal
         Lincolnshire Connexions Pilot Business Plan
         Lincolnshire County Council Education Development Plan
         Lincolnshire County Council Behaviour Support Plan
         Lincolnshire’s Childrens’ Services Plan
         Lincolnshire Youth Service’s Service Action Plan
         Lincolnshire Youth Offending Team Operational Plans
         Supporting People Development Plans
         Quality Protects Action Plan
         Sure Start Boston Plans
         Sure Start Lincoln Birchwood Plans
         Sure Start East Lindsey
         Sure Start West Lindsey
         Coastal Regeneration Partnership SRB 5 Programme
         Mid Lincolnshire Action Partnership SRB 5 Programme
         Lincoln City Regeneration partnership SRB 6 Programme
         Lincolnshire Health Authority’s Strategic Framework for Sexual Health

7.3      A period of change for housing authorities and landlords has reduced the
         level of engagement to date of these key agencies. This will be a key
         focus for the enhanced local co-ordination function from April 2001

7.4      As this Strategy develops throughout its ten year life, continuous feedback
         between key steering groups will become a critical feature.

7.5      The NHS community in Lincolnshire is drawing to a close a long review
         and development process which will result in dramatic modernisation of
         services in 2001 and beyond

7.6      The implementation of that review will become the vehicle for many of the
         changes in contraceptive service provision required to meet the needs of
         young people.




C:briefcase/tacklingteenagepregnancystrategy                                         9
8.       Principles and Values

8.1      Each of the agencies and professions involved in the development and
         delivery of this strategy are informed by their own codes, standards and
         values. To enable clarity in communication, the Steering Group has
         agreed the following principles and values to guide its work:

8.1.1 unplanned pregnancy and parenthood in their teenage years is
      undesirable for the young people of Lincolnshire,

8.1.2 the human rights of young people and their children are paramount in all
      services commissioned and provided in pursuance of the strategy,

8.1.3 the development and operation of services in pursuance of this strategy
      should involve young people to the fullest possible extent,

8.1.4 the pursuance of the strategy is a balance between the responsibility of
      individuals to make appropriate choices and the responsibilities of the
      agencies to create an environment where relevant information is easily
      accessed and young people are offered support with the decision making
      process.

8.1.5 the interventions described in the strategy are targeted equally at young
      men and young women as partners in teenage pregnancy.


9.       Review and Development

9.1      The Steering Group will retain the key responsibility for monitoring and
         review of the Strategy in partnership with those implementing local
         initiatives.

9.2      Steering group member agencies will be assigned lead responsibility for
         subsets of the work programme and will account to their own agencies’
         performance management systems as well as the Steering Group.

9.3      The Steering Group is closely observing a Lincolnshire Drug Action Team
         (DAT) pilot project. The project is evaluating the benefits to delivery of
         establishing service level agreements between key agencies and the DAT.
         Should the encouraging start to the project prove to have real benefit then
         a similar model is proposed to enhance and clarify accountability for
         delivery of this strategy.

9.4      The Steering Group will performance manage implementation of the
         strategy and report to LIP.




C:briefcase/tacklingteenagepregnancystrategy                                        10
Section Three: A Stock Take of Needs and Services

10.      Introduction

10.1     This Section of the Strategy summarises local intelligence about the
         nature and extent of teenage pregnancy and outlines the services
         currently available to young people.

10.2     A more detailed analysis underpins this section and is available from the
         Teenage Pregnancy Co-ordinator.

11.      The Extent of Teenage Conceptions

11.1     Young people in Lincolnshire experience lower rates of conception than
         the average for England and Wales and these rates have been relatively
         stable over the two previous periods for which data are available. Table
         Two illustrates the local profile.

Table Two: Under 18 Conceptions; 1992 to 1994 and 1995 to 1997

Area                                           Rate per 1000 15 to 17 year old women
                                               1992 to 1994              1995 to 1997
England and Wales                                            47.1                     46.9
Lincolnshire                                                 41.6                     41.5
Three year rolling averages are used to calculate rates to even out the variance in each year
caused by the small numbers of actual conceptions.

11.2     This overall rate masks considerable variations and a number of electoral
         wards in the County seem to warrant particular attention.

11.3     These wards have been identified as having conception rates amongst 15
         to 17 year olds in the three years 1995 to 1997 more than 50% higher than
         the national average. On closer examination, no reliable pattern emerges
         below ward level. This is largely due to the very small numbers of
         conceptions making up the rates, even in a high prevalence area like
         Boston the rate only represents one or two conceptions a year.

11.4     There is some correlation between wards with high teenage pregnancy
         rates and other indicators of deprivation. This correlation is not altogether
         consistent however and further investigation of other factors like ethnicity
         and educational attainment is required.

11.5     As well as clustering in particular geographical areas, a commonality in the
         high rate groups identified from the data was disrupted home life,
         particularly where some time had been spent in residential social care.




C:briefcase/tacklingteenagepregnancystrategy                                                    11
11.6     Based on the intelligence to date the following wards are prioritised for
         action by the Steering Group.

           District Council                    Wards

           Boston Borough Council              Central
                                               Old Leake

           East Lindsey                        Friskney
                                               Chapel St. Leonards

           West Lindsey                        Gainsborough East
                                               Gainsborough West

           Lincoln City Council                Carholme
                                               Minster
                                               Park
                                               Abbey

           North Kesteven District Council     Sleaford South
                                               Metheringham
                                               Sleaford West
                                               Waddington East
                                               Billinghay

           South Holland District Council      Spalding Central
                                               Holbeach Town

           South Kesteven                      Witham Valley

11.7     A particular exercise was undertaken to investigate any links between
         teenage conception rates in geographical areas and service availability.

11.8     There was no regular pattern discernible from area to area. Surprisingly,
         higher rates of teenage conception were more likely to occur in areas with
         easier availability of sexual health services. This is partially explained by
         the other characteristics of these areas: largely urban with above average
         indices of deprivation. It also reflects the deliberate deployment of
         resources in areas of higher need.


12.      The Outcome of Teenage Conceptions

12.1      A particular trend in the outcome of pregnancies amongst local young
         people is evident from analysis. Over the six year period 1992 to 1997
         young people who became pregnant were more likely to reach maternity.



C:briefcase/tacklingteenagepregnancystrategy                                         12
12.2     This trend is not yet fully understood but has particular impact on the
         delivery of the social inclusion goals of this strategy. Initial indicators from
         work with young parents indicates key factors as being: late confirmation
         of pregnancy limiting options; familial and social acceptance of teenage
         parenthood and moral concerns about termination of pregnancy.


13.      Summary of Service Availability

13.1     The most critical issue associated with service availability for the young
         people of Lincolnshire is the sparsity of the population and their
         subsequent distance from services.

13.2     The majority of young people in the County live in and around towns, but a
         significant minority live in rural areas where services are not available
         without significant travel.


14       Young Persons Contraceptive Services

14.1     Lincolnshire has a significant number of outlets for contraceptive and
         sexual health advice. The majority of these services are provided for
         general population use by primary health care teams.

14.2     All outlets see people on the basis of need and competency to make
         informed choices, not on age, although a growing number of services are
         dedicated to meeting the needs of younger people.

14.3     Additional services are provided by NHS Trust managed young persons
         advice centres, family planning clinics and genito urinary medicine clinics.
         Table Three illustrates the spread of NHS Trust service provision
         throughout the County. The total service hours available at present is 432
         hours per month.

14.4     Approximately 84 hours of this time are dedicated to services for young
         people, excluding the considerable proportion of adult service time
         occupied by people aged below 19 years.

14.5     A growing number of service outlets using other models are becoming
         available and these include youth service general advice services and
         other ‘one stop shop’ ventures; outreach services to high prevalence areas
         or vulnerable populations like travellers; school based advice sessions and
         community pharmacy drop in services.




C:briefcase/tacklingteenagepregnancystrategy                                           13
Table Three: NHS Trust Managed Sexual Health Clinics in Lincolnshire
PCG                  Location                  Number of clinic hours per month
                                               G.U.M.        FP            Young Peoples
                     Grantham Hospital                47.5             7.3                 0
Mid-Kesteven         Grantham Health Clinic              0           10.5                  0
                     Sleaford Health Clinic              0           10.5                  0
                     Sleaford Youth Centre               0               0             17.3
                     Pilgrim Hospital *               45.5               0                 0
Boston &             Boston Health Clinic                0           15.2              21.7
Skegness             Skegness Hospital                17.3 Pilot    8.7                    0
                                                             Other 15.2
S. Holland       Spalding H. Clinic                      0           15.2
                 Holbeach H. Clinic                      0               0                 2
Welland          Stamford H. Clinic                      0             7.0                 0
                 Alford                                  0               0               4.3
                 Caistor                                 0               0               6.5
East             Horncastle H. Centre                    0             4.3                 0
Lindsey          Louth Hospital                     Spectrum Pilot = 19.5                4.3
                 Mablethorpe H. Clinic                   0             4.3               4.3
North West       Gainsborough                          8.7             5.4               8.7
Lincoln          Market Rasen                            0               0               6.5
                 Lincoln County Hosp *                78.0               0                 0
Lincoln S.       Portland House                          0               0               8.7
                 Newland Health Centre                   0              43                 0
Total Service Hours Available per Month              216.5          131.4              84.3

14.6     Significant gaps exist in some geographical areas with relatively high rates
         of teenage conception. This was particularly evident in the Spalding area
         of South Holland District Council.

14.7     Primary health care teams are significant providers of sexual health
         services in Lincolnshire and geographical sparsity lend additional
         importance to the role of key professionals like school nurses, general
         practitioners and community pharmacists.

14.8     It is crucial that these services, often the first point of contact for young
         people beginning their sexual lives, are high quality and user friendly. The
         cross-over with broader sexual health service strategies of local
         organisations are crucial and the action plan for services describes a
         range of activities designed to support primary care based service
         delivery.

14.9     The majority of teenage sexual health services in the County are still
         delivered through NHS and general practice premises. The deterrent
         effect of this mode of service delivery is well documented and other sites
         for advice include schools, youth centres, combined one stop shops and
         community centres.




C:briefcase/tacklingteenagepregnancystrategy                                          14
14.10 Despite the broad spread of service provision and shifts to more
      acceptable outlets, some young people do not access services.

14.11 Three different projects are testing a variety of outreach and peripatetic
      activities to engage these young people. Two of these, in Boston and
      Lincoln are focused on reaching disaffected young people in high
      prevalence areas. The third is being run in partnership with the Mid
      Lincolnshire Action Partnership as an economic regeneration project for
      young people who ‘drop out’ of education into substance misuse, teenage
      pregnancy or crime.


15.      Services to Support Pregnant Teenagers

15.1     A key issue in analysis of this element of service provision was the trend in
         pregnant teenagers in Lincolnshire towards parenthood. The analysis
         centred on services which enabled young people to confirm their
         pregnancy as early as possible and advise them on the options available
         to them following confirmation.

15.2     Late confirmation of pregnancy has been identified as a significant factor
         in progression to parenthood in work with young people.

15.3     Service availability analysis suggests that pregnancy testing is readily
         available free in general practice and the sexual health clinics identified
         above and at a cost in community pharmacies. Further work is required to
         ascertain what is deterring young people from using these services early
         in their suspected pregnancies.

15.4     When a pregnancy is confirmed, the County Council Reintegration Officer
         is involved so that a support plan for continued education may be
         establsihed as early on as possible.


16.      Services to Support Teenage Parents

16.1     A range of services are available across the County to support young
         parents. Initial analysis identifies that although some examples of good
         practice exist, the pattern of service provision is patchy.

16.2     There is a reasonable correlation of service availability to areas of high
         teenage conceptions in the some of the towns, notably Boston and
         Skegness and the City of Lincoln. Other areas of high prevalence are not
         well served.




C:briefcase/tacklingteenagepregnancystrategy                                          15
16.3     Services range from generic youth service organisations which provide
         guidance and supprt through to services dedicated to the needs of
         pregnant young people.

16.4     Table Four provides a brief overview of the support services available to
         Lincolnshire’s young parents. It categorises services for clarity into
         housing and parenting support services and educational or economic
         reintegration services.

Table Four: Services which Support Teenage Parents in Lincolnshire
Service                              Coverage       Objectives
Housing and Parenting
Support Services

Lincolnshire Youth                   County         Provide individual curricula and
Service                                             guidance and support.
Birchwood Youth Centre               Lincoln        Provides parenting education and
                                                    support to under 25 year old women.
Alford Youth Advice                  Alford         Provides parenting education and
Centre                                              support to under 25 year olds.
Lincoln Youth Matters                Lincoln        Provides informal support to all young
                                                    people, including young parents.
                                                    Provides specific personal development
                                                    work with young men.
Sure Start                           Boston         Provide support services which give
                                     Lincoln        children under the age of 4 years the
                                     Coastal        best possible start in life.
                                     West Lindsey
Home Start                           Gainsborough   A volunteer based service offering home
                                     Lincoln        based support to young parents.
                                     Sleaford
                                     Louth
                                     Stamford
Platform Skegness                    Skegness       Provide support to lone and teenage
Platform Boston                      Boston         parents in their parenting role.
Family Centres                       Lincoln        Provide support and training to
                                     Grantham       vulnerable parents.
                                     Skegness
                                     Boston
                                     Gainsborough
Lincolnshire TEC                     County         Provides accrediited parenting
                                                    preparation training for teenage parents
South Lincolnshire and               Grantham       Midwife and health visitor run support
Lincoln DistrictHealthcare           Lincoln        groups for teenage parents.
NHS Trust                            Market Rasen




C:briefcase/tacklingteenagepregnancystrategy                                               16
Education or Economic
Reintegration Services
Local Education Authority            County       Facilitates flexible packages of support
Reintegration Service                Under 16s    to reintegrate teenage parents into
                                                  learning.
NCH Action for Children              County       Work with 16 to 21 year olds making
                                                  the transition from social care to
                                                  independent living.
Lincolnshire and Rutland             County       Provide personal advisers to all young
Connexions Pilot                                  people aged 13 to 19 years.


17.      Review and Revision

17.1     This service analysis is a snap shot in time and agencies are already
         responding to the findings of early analysis.

17.2     Throughout the life of the strategy, regular analyses of service spread will
         be undertaken and reprioritisation of geographical and population areas
         undertaken.


Section Four:               Delivering the Strategy

18.      Strategic Planning

18.1     The planning systems for the delivery of this strategy are complex due to
         the multiple interfaces required with the planning and commissioning roles
         of key agencies.

18.2     Strategy implementation will be executed through local partnerships, with
         a variety of activities and initiatives throughout the County. Local
         initiatives will provide feedback to the steering group, which will undertake
         a co-ordination or evaluation role.

18.3     The Co-ordinator will take a key role in the facilitation of activity and in the
         provision of appropriate support to staff involved in local implementation
         and to members of the steering group. The co-ordinator will assist and
         promote appropriate liaison or partnership working.

18.4     The Co-ordinator in liaison with the steering group will provide a
         performance management lead for the strategy. Monitoring of progress
         against key targets and objectives will ensure early identification of any
         risks or difficulties arising within the programme.




C:briefcase/tacklingteenagepregnancystrategy                                            17
19.      Risk Assessment

19.1     Lincolnshire Health Authority and Primary Care Groups and Trusts are
         preparing to implement a fundamental change in the way sexual health
         services are provided in the County. The Framework for these changes
         reaffirms local commitment to the delivery of high quality, user sensitive
         services.

19.2     A range of services which were developed from within the Homestart
         initiative are due to reach critical stages of their strategies for exit from
         national funding in the first year of this strategy. Evidence is emerging that
         these are key, trusted providers of support to young people before, during
         and after pregnancy. There is significant risk to the continuity of these
         services.

19.3     It is acknowledged that difficulties can arise when projects are dependent
         on time limited or one off funding and consequently emphasis will be
         placed on development proposals that can be shown to be sustainable
         and with clear funding mechanisms.


20.      Achieving the Strategy

20.1     The national strategy is broken up into key areas of activity which, when
         added together will deliver the strategy as a whole. This local strategy has
         been structured in the same way.

20.2     The key areas of action are:

         Media and communication
         Improving sex and relationships education
         Improving sexual health and advisory services
         Improving support for teenage parents

         The following parts of the document are dedicated to each of the latter
         three elements in turn. Media and communications are dealt with in this
         Part as they overarch the entire strategy.

20.3     A key issue in delivering the programme described in the strategy is the
         management of multiple accountability systems for relevant agencies.
         The Lincolnshire Steering Group is awaiting the outcome of trials by DAT
         of service level agreements between the Group and member agencies.




C:briefcase/tacklingteenagepregnancystrategy                                          18
Section Five:               Media and Communications

21       Local Media Strategy

21.1     The local media and communications strategy for teenage pregnancy
         breaks down into three key areas: creating an environment which supports
         the aims of the strategy; ensuring young people know what services and
         support are available to them and influencing the choices young people
         make by marketing key messages and ideas.

21.2     Key lessons from the research which informed the national campaign have
         been incorporated into the plan. These include:

21.2.1 simplifying the service information by moving to single brands

21.2.2 avoiding authoritarian branding of programmes

21.2.3 maximising the use of ‘private’ sources of information, particularly for
       young men.

21.3     Implementation of these lesson, together with maximising the local benefit
         of the national campaign will require proactive management of
         communications and media.

21.4     The Teenage Pregnancy Coordinator will have primary responsibility for
         implementing the strategic communication plan and managing the
         Steering Groups reactions to enquiries and local issues.

21.5     The strategic programme attached to each of these key areas is described
         under the appropriate heading below and the action plans outlined in Part
         Two identify the key actions to be taken on media and communication
         during the 2001 to 2004 period.

21.6     Creating an environment which supports the aims of the strategy by:

21.6.1 Proactively communicating via local media the proven benefits of open
       discussion of sexual health matters with young people.

21.6.2 Providing evidence based guidance on appropriate and effective policy to
       key policy makers including: elected members of local authorities;
       governing bodies of schools and colleges and social and business
       leaders.

21.6.3 Challenging poor practice and offering support to enable improvement in
       practice across statutory and non statutory organisations.




C:briefcase/tacklingteenagepregnancystrategy                                      19
21.7     Ensuring young people know what services and support are available to
         them by:

21.7.1 Simplifying the branding of contraceptive services to a single County
       brand.

21.7.2 Undertaking a stock take of services, using the findings to offer service
       improvement advice and to produce a directory of quality approved
       services.

21.7.3 Offering all approved services a central advertising function using the
       Regional ‘Crush 0n-U’ brand.

21.7.4 Advertising services through local young persons service outlets and
       media.

21.8     Influencing the choices young people make by marketing key messages
         and ideas by:

21.8.1 Utilising national media campaigns and materials to drive attitude change.

21.8.2 Linking the media and communications programme for teenage pregnancy
       with economic and social development marketing which seeks to raise the
       expectations and aspirations of local people.


Section Six:                Improving Prevention and Education Services

22.      The Vision for Sex and Relationships Education

22.1     Good quality sex and relationships education (SRE) is essential to the
         development of young people into well rounded adults.

22.2     The Lincolnshire vision during and beyond the life of the 10 year strategy
         is straightforward:

22.2.1 All Lincolnshire young people, regardless of gender, sexual orientation,
       ability or ethnicity will have access to high quality sex and relationships
       education which is consistent between home, school, health services and
       youth services.

22.2.2 All decisions Lincolnshire young people take about their sexual health will
       be taken on the basis of accurate information and a strong sense of self
       esteem.




C:briefcase/tacklingteenagepregnancystrategy                                          20
22.3     Within the first three years of this strategy every school will provide SRE
         programmes which are consistent with DfEE Guidance and supported by
         parents.

22.4     Lincolnshire’s parents will feel able to discuss matters of sexuality frankly
         with their children.

22.5     Lincolnshire’s young people will know what action to take in the event of
         an incident or accident which puts them at risk of unwanted conception.

22.6     The inequitable emphasis on young women will be reduced as specific
         training and development programmes are developed to ensure the needs
         of specific, currently under provided groups, are catered for. Particular
         emphasis will be placed on young people with special needs and learning
         difficulties; boys and young men and children and young people at
         particular risk like young offenders.


23.      Implementing Department for Education and Employment Guidance
         on Sex and Relationships Education through the Healthy Schools
         Programme.

23.1     Considerable emphasis has been placed on developing whole systems
         approaches to improving the health of school communities. This
         programme has been running as a local ‘Heart Shield’ award scheme.

23.2     There is a renewed commitment to this approach in seeking accreditation
         to the National Healthy School standard. The Lincolnshire programme has
         developed quality standards for sex and relationships education across all
         key stages which comply with DfEE and Department of Health guidance.

23.3     The achievement of these standards will be mandatory for all schools
         working towards accreditation. All schools in Lincolnshire will have
         achieved these standards within three years and progress will be
         monitored by support and assessment visits.

23.4     Schools are unlikely to attain their aspirations in this critical area without
         support. The Healthy Schools Team will support and facilitate a number of
         approaches to ensure DfEE guidance is implemented. These will include:
         dedicated training for school policy makers; training for teachers in the
         implementation of SRE; parents evenings to gain support for programmes
         and develop the parents role in the programme.

23.5     Schools working towards these standards will have access to local
         networks to enable peer support; and bring healthcare professionals and
         educationalists together.



C:briefcase/tacklingteenagepregnancystrategy                                             21
23.6     Within the Healthy Schools Programme, the sex and relationships element
         will be supported by a dedicated curriculum adviser.

23.7     Partnerships between schools and local statutory and non-statutory
         organisations have been evaluated for their added value to schools’
         programmes. These partnerships currently provide additional support to
         half of the secondary school pupils in year seven each year.

23.8     These partnerships will be further developed during the life of the strategy
         to give all young people access to this valued additional support.

23.9     Parents will become increasingly involved in shaping policy and practice in
         schools to aid their own active participation in the sex and relationships
         education.

23.10 In addition to supporting the implementation of high quality curriculum
      around SRE, schools will be supported to review existing and develop new
      sex & relationship policies in consultation with the whole school
      community.

23.11 During the life of the strategy non-attendance at school as a result of
      pregnancy will disappear except where all parties agree separation is in
      the best interests of the teenage parents.


24.      Involving and Supporting Governors, Parents and Other
         Professionals

24.1     A whole systems approach to implementing high quality SRE within a
         comprehensive personal and social education programme cannot be
         achieved without the active participation of parents, governors and other
         health and social care professionals.

24.2     Specific development programmes will be run over the life of the strategy
         to support schools to develop partnerships including:

24.2.1 training for governors to support them in meeting their legal
       responsibilities in respect of SRE.

24.2.2 recruiting, training and supporting a multi-agency team to facilitate delivery
       in Healthy School locality networks, individual schools and across the
       County.

24.2.3 training developed and delivered to enhance parental involvement,
       including corporate parents, and promote shared responsibility for SRE.



C:briefcase/tacklingteenagepregnancystrategy                                         22
24.2.4 developing SRE curricula in non-school service providers which reinforce
       key messages and skills including youth services, Connexions, substance
       misuse services and criminal justice agencies.

24.2.5 training for support agencies and individuals working in partnership with
       schools to ensure quality assure provision.

24.2.6 developing frameworks for schools to appropriately engage other schools
       professionals like school nurses.

24.3     The Action Plan in Part Two describes the detailed action plan in
         pursuance of this strategy between April 2001 and March 2004.


25.      Reviewing Progress

25.1     The Healthy Schools Programme relies, to a large extent, on generic
         support and inspections systems for monitoring individual school’s
         progress towards the standards. The following systems will be in place in
         as supplements to these routine programmes:

25.1.1 bi annual audit of the quality and quantity of SRE input to young people
       with the young people concerned.

25.1.2 regular feedback from routine assessments and reviews to inform future
       County development in the Education and Health Partnership.


Section Seven: Improving Contraceptive, Advice and
               Information Services
26.      The Vision for Sexual Health Services

26.1     Providing services for young people with the combined level of
         accessibility and anonymity is difficult due to the geographical distance
         between much of the population and key service centres.

26.2     The innate conservatism of Lincolnshire society presents particular
         difficulties for young people who may be relatively isolated from other
         influences.

26.3     Despite these difficulties the County has a strong history of dedicated
         service provision for young people.




C:briefcase/tacklingteenagepregnancystrategy                                         23
26.4     Our vision for services as we develop this strategy is:

26.4.1 For all young people in Lincolnshire to have easy access to advice,
       information and contraception presented in an informal and supportive
       way, by appropriately trained or experienced people. For services to be
       provided by multi-agency teams in partnership with young people and their
       families, available at the appropriate time to enable them to make
       informed life choices.

27.      Quality and Quantity

27.1     A large and growing number of service outlets of various description
         currently provide teenage advice services.

27.2     The spread of service available now offers at least two modes of service
         delivery to young people in high prevalence areas. In Boston for example,
         young people may choose from general practices, several adult sexual
         health clinics and a youth service run one stop shop.

27.3     A key priority for this strategy is to take a quality assurance approach to
         services to ensure a young persons first experience of preventative
         services is not their last. Young people will be central to this process.

27.4     The Steering Group will therefore monitor demand across areas and
         recommend sites for new outlets, and closure of wasteful ones. This will
         not be the primary focus however.

27.5     National standards guidance will be adapted to meet the needs of local
         services and rigorously applied to existing and proposed services.

27.6     Additional, guaranteed service provision will be developed out of hours, at
         weekends and public holidays via accident and emergency departments,
         community pharmacies and general practice on call systems. These will
         focus predominantly on advice and provision of emergency contraception.


28.      Better Targeting

28.1     Local needs assessment identifies areas of the County where there is a
         high prevalence of teenage conception. Many of these areas are already
         well served with services but are not meeting young peoples’ needs.

28.2     The at risk populations need to be viewed other than geographically and
         service developments will focus on low income, low aspiration populations
         in the fenland areas in the East and South of the County; on young people
         in local authority care and on the travelling population.



C:briefcase/tacklingteenagepregnancystrategy                                           24
28.3     A key access improvement in some areas has been the provision of
         weekend clinics. This provision is not well used routinely but becomes
         invaluable over longer service breaks like public holidays.

28.4     Particular emphasis will be placed on providing service modes which
         encourage under represented parts of the population from attending.
         Target groups will be young men, especially those from social care and
         offending background and travellers.


29.      Higher Value Service Contact

29.1     Due to the pattern of life and geographic isolation of many Lincolnshire
         young people they have to go to extraordinary lengths to access services.

29.2     Many of them are bussed long distances from communities with only basic
         services and bussed immediately back after the school day.

29.3     Much will be done through the legitimising of their access to services by
         the media and communications programme in this strategy. In the
         meantime, young people will be encouraged to make the effort required to
         access services if they are of high value.

29.4     The primary route for achieving added value for young people will be
         through integrating service streams. Contraceptive services will be more
         attractive when combined with other sexual health services and broader
         social services like careers guidance, general health services, benefits
         and housing advice an so on.

29.5     Gretaer emphasis will be placed on developing school based services, like
         existing school drop ins, to improve access for young people from rural
         hinterlands.


30.      Monitoring and Review

30.1     The Action Plan in Part Two describes action in detail for the first three
         years of this programme.

30.2     The Steering Group will commission regular, young person centred
         monitoring of service provision




C:briefcase/tacklingteenagepregnancystrategy                                          25
Section Eight: Improving Support for Teenage Parents

31.      The Vision

31.1     The Steering Group’s vision is that in ten years time all teenage parents in
         Lincolnshire will have access to:

31.1.1 parenting education and support including formal education and training;
       high quality flexible child care and facilitated support networks.

31.1.2 flexible continuing education, training and employment opportunities
       supported by affordable childcare.

31.1.3 ready access to support packages in a range of suitable accommodation.


32.      A Poor Starting Place

32.1     The provision of support services for pregnant young people is patchy,
         depending on the stage of parenthood the young person presents at.


33.      A Range of Services

32.2     Services will be required by young people at a number of stages in their
         pregnancy, labour and parenting. The strategy identifies action for service
         improvement at four key stages:

32.2.1 Young people need to be able to confirm whether they are pregnant or not
       at the earliest possible stage of the pregnancy to allow themselves, their
       parents or carers and service providers the maximum amount of time to
       weigh up the options.

32.2.2 On confirming their pregnancy, impartial counselling services need to be
       available without delay to assist the young person to understand their
       options and make informed decisions about their future.

32.2.3 Whether the young person decides to continue to maternity or not,
       appropriate service provision and after care need to be available from
       professionals with particular skills in working with young people.

32.2.4 Planning for parenthood should begin at the earliest stage possible to
       maximise the chance of setting up a support model which is optimal for the
       young persons circumstances. This would be much supported by a
       consistent key worker approach to pregnant young people




C:briefcase/tacklingteenagepregnancystrategy                                       26
32.3     Mediation services may be required to resolve the potential conflicts
         between key stakeholders and particularly if the father is to be afforded a
         proper input to decisions.


33.      Ensuring Early Diagnosis of Pregnancy and Access to Termination

33.1     A range of opportunities already exist for young people of any age to
         access free pregnancy testing. These include all young persons advice
         centres, adult family planning services and some general practices.

33.2     Additional outlets should be made available for free testing for young
         people who are particularly prone to delay testing in Lincolnshire. Outlets
         should be chosen where appropriately qualified staff are on hand to give
         advice and referral information. The first outlet development will be
         community pharmacists.

33.3     Pregnancy counselling is currently available at young persons advice
         centres, general practices, adult family planning clinics and some non-
         statutory sector outlets. All of these outlets should have direct referral
         access to termination services.

33.4     The NHS in Lincolnshire currently offers free termination services for
         100% of young women presenting. This service will continue, specifically
         protected for young women aged below 20 years.

33.5     Referral systems will be established which ensure follow up of all women
         attending for termination by contraceptive service providers.


34.      Key Worker Support for Young Parents

34.1     A multi agency protocol will be developed for all education, social and
         health care staff to use on having suspicion of pregnancy disclosed by a
         young person.

34.2     A key worker service will be provided for all pregnant young people by
         appropriately skilled personal advisers from the Connexions Service.
         They will coordinate the input of the various agencies required to construct
         a personal package for each individual.

34.3     The Education Authority Reintegration Officer, supported by schools
         inspectorate will establish a mechanism for all schools to report on
         pregnancies amongst their statutory school aged students. Support
         packages will be targeted at maintaining the young person in school until
         they need to prepare for the birth and enabling continued learning.



C:briefcase/tacklingteenagepregnancystrategy                                           27
34.4     Young people will be primarily encouraged to continue their learning in
         school, were they are of an appropriate age.

34.5     Systems will be in place for young people who do not wish to continue in
         school to continue the planned course of their educational career.


35.      Peripatetic Systems

35.1     In order for the disruption of education and training to be minimised, where
         the new parent may be a long way from service centres a flexible package
         of distance learning; IT based learning and home tuition will be available.

35.2     The availability of high quality childcare is poor in Lincolnshire, as
         evidenced by a recently commissioned audit . Even where parents have
         significant financial resources and independent transport there are serious
         difficulties in some areas.

35.3     The Steering Group wishes to pilot a system of support in higher
         prevalence areas which combines education and vocational support with
         child care provision in a mobile facility.

35.4     Projects in a small number of higher prevalence areas utilise facilitated
         self help groups to provide support to young parents. These peer based
         programmes will be rolled out.

35.4     A separate strategy exists in Lincolnshire for the development of child care
         and the Steering Group has already begun pursuing the particular needs
         of young parents through these fora.


36.      Monitoring and Review

36.1     The Steering Group had agreed the detailed action plan for the first three
         years of this programme, which can be found in Part two of the Strategy.

36.2     The actions and milestones will be monitored closely as this crucial
         element of the Strategy is starting from the weakest position.




C:briefcase/tacklingteenagepregnancystrategy                                          28
PART TWO:                   ACTION PLANS FOR 2001 TO 2004

Section One: Introduction and Purpose

1.       Introduction

1.1      In order to plot progress towards the strategic aims identified in Part One a
         series of shorter, more detailed action or implementation plans will be
         produced.

1.2      These plans are presented in easy to read table format and identify tasks,
         lead agencies, resources, time frames and monitoring milestones.

1.3      The plans contained within the next pages represent actions agreed
         between April 2001 and March 2004; the first three years of the local
         strategy.

1.4      The plans assume that national funds, from the Teenage Pregancy Unit,
         will be available to support implementation and coordination through the
         three year period.

2.       Monitoring and Review

2.1      The Steering Group will monitor delivery of the action plans by receiving
         exception reports from lead agency representatives.

2.2      Wherever possible, operational and resource difficulties will be resolved at
         the Steering Group although a relatively small number of measures will be
         referred to Lincolnshire in Partnership for Chief Officer intervention.

3.       Abbreviations explained

         BSPCG              Boston and Skegness PCG
         C                  Connexions: Lincolnshire and Rutland
         HS                 Healthy Schools
         LEA                Local Education Authority
         LHA                Lincolnshire Health Authority
         LHCT               Lincolnshire Healthcare NHS Trust
         LHF                Lincolnshire Housing Forum
         SSD                Social Services Directorate
         TPSG               Teenage Pregnancy Steering Group




C:briefcase/tacklingteenagepregnancystrategy                                         29
Section Two:                Action Plan for Improving Prevention and Education Services from April 2001 to
                            March 2004

Actions                                                Start   Milestones                                Lead
                                                       Date                                              Agency
                                                               Description               Delivery Date
  1      Develop and implement methodologies for       04.01   Draft policy produced     09.01           HS
         involving and consulting young people.                Methods piloted           01.02           C
                                                               Methods adopted           04.02
  2      Developing audit tools to enable schools to   09.01   Draft tools produced      01.02           HS
         conduct audits of existing SRE provision.             Tools piloted             04.02
                                                               Implemented in schools    09.02
  3      Training on delivery of SRE for teachers      09.01   Training packages         Ongoing         LEA
         delivered and evaluated                               produced
                                                               Six courses delivered     Ongoing
                                                               per year
  4      Identify and disseminate appropriate          04.01   Resources identified      07.01           LEA
         resources suitable for use with Key Stages            Pilot with young people   09.01
         1 to 4.                                               Dissemination             11.01
  5      Revise policies in respect of SRE for young   04.01   Draft policy produced     05.01           SSD
         people looked after.                                  Consultation completed    12.01
  6      Establish policies for young people in        09.02   Draft policy produced     11.02           TPSG
         schools to access confidential advice from            Consultation completed    03.02
         appropriate staff.
  7      Establish a framework for schools and         01.03   Draft framework           07.03           TPSG
         other young persons agencies to                       produced
         appropriately manage pregnant teenagers               Consultation completed    12.03
         in line with DfEE guidance.




C:briefcase/tacklingteenagepregnancystrategy                                     30
Actions                                                Start   Milestones                                Lead
                                                       Date                                              Agency
                                                               Description               Delivery Date
  8      Develop systems to monitor and evaluate       06.02   Methodology produced      09.02           LEA
         the quality of SRE programmes in terms                Methods tested            01.03
         learning outcomes.                                    Methods disseminated      04.03

  9      Agree ‘key worker’ systems for young          09.01   Draft protocols           07.02           C
         people and their families upon pregnancy.             produced
                                                               Protocols implemented     06.03
 10      Develop and implement training for elected    01.02   First courses delivered   09.02           HS
         members of local authorities and governors
         on effective SRE.
 11      Develop standards and guidelines for non-     01.03   Training delivered        09.03           HS
         schools organisations participating in SRE.
 12      Audit support service provision and           05.01   Directories produced      09.01           C
         produce professional and young persons                                                          HA
         directories of services.
 13      Develop non-schools SRE curricula which       09.02   Draft curricula           04.03           TPSG
         reinforce practice in schools                         produced
 14      Develop additional targeted packages in       09.01   Package produced          01.02           SSD
         high prevalence communities including                 2 young people piloted.   04.02
         baby simulator programmes.




C:briefcase/tacklingteenagepregnancystrategy                                        31
Section Three: Action Plan for Media and Communications from April 2001 to March 2004

Actions                                                Start   Milestones                             Lead
                                                       Date                                           Agency
                                                               Description            Delivery Date
 15      Develop and implement a programme of          12.02   Outline programme      03.03           LHA
         work with local media outlets serving 35 to           developed from
         55 year olds about the determinants and               national campaign
         impact of teenage pregnancy.                          Features appear        06.03
 16      Communicate with parents in partnership       09.01   Healthy Schools        Ongoing         HS
         with Schools and the Healthy Schools                  Newsletter
         Team the benefits of easy access to                   Parents evenings       Ongoing
         information and advice for young people.
 17      Comprehensively rebrand teenage health        09.01   New brand agreed       12.01           LHCT
         services across the County under a single             New materials          03.02
         Lincolnshire brand.                                   produced
                                                               First advertising      06.02
                                                               completed
 18      Audit support service provision and           01.01   Process agreed         03.01           TPSG
         produce professional and young person                 Directories produced   05.01
         relevant directories of services.
 19      Ensure regular updating of national           09.00                          Ongoing         TPSG
         helpline and web databases and focus
         marketing on Sexwise as the Lincolnshire
         sign posting service.
 20      Support the continuation of the regional      04.01   Media plan developed   06.01           TPSG
         Crush website and use this brand for all              Brand materials        08.01
         media work rather than service                        produced
         organisations’ brands.




C:briefcase/tacklingteenagepregnancystrategy                                    32
Actions                                               Start   Milestones                               Lead
                                                      Date                                             Agency
                                                              Description              Delivery Date
 21      Support the implementation of the national   07.00   National programme       Ongoing         TPSG
         media programme with local information.              fully disseminated.
 22      Support the marketing of development         04.01   Have teenage             Completed       LHA
         programmes and ‘Lincolnshire Pride’                  conception on the
         programmes.                                          agenda of economic
                                                              development
                                                              Develop joined up        Ongoing
                                                              projects
 23      Develop baby simulator sessions as part of   09.01   Project protocols        01.02           SSD
         SRE in high prevalence schools and social            established                              HS
         care settings.                                       Road tested with first   04.02
                                                              two young people




C:briefcase/tacklingteenagepregnancystrategy                                     33
Section Four:                         Action Plan for Improving Contraceptive, Advice and Information Services
                                      from April 2001 to March 2004

Actions                                                  Start   Milestones                               Lead
                                                         Date                                             Agency
                                                                 Description              Delivery Date
 24      Implement NHS guidance on the role of           09.01   Guidelines               09.01           BSPCG
         health professionals in the provision of                disseminated
         contraception for under 16s.                            Training provided        10.01
 25      Develop service standards across all tiers      01.02   Standards produced       04.02           BSPCG
         of service for teenagers.                               and consulted upon.
 26      Map existing primary care services and          09.01   Map produced             12.01           BSPCG
         rebrand those which meet standards.                     New materials            03.02
                                                                 produced
                                                                 First advertising        06.02
                                                                 completed
 27      Establish additional teenage advice           01.02     Sutton Bridge and Long   06.03           LHCT
         centres in geographical areas of high                   Sutton centre open
         prevalence
 28      Establish further non-clinical and integrated 10.01     Boston One Stop Shop     04.02           BSPCG
         service sites                                           open
 29      Develop guaranteed out of hours and           01.02     Protocols agreed with    04.02           LHA
         public holiday provision of advice and                  A&E, community
         emergency contraception                                 pharmacists and GP on
                                                                 call cooperatives
                                                                 New arrangements         08.02
                                                                 implemented and
                                                                 advertised




C:briefcase/tacklingteenagepregnancystrategy                                      34
Section Five:                         Action Plan for Improving Support Services for Teenage Parents from April
                                      2001 to March 2004

Actions                                                  Start   Milestones                               Lead
                                                         Date                                             Agency
                                                                 Description              Delivery Date
 30      Improve access to free pregnancy testing        04.01   Service starts           04.01           LHA
          for young people in high prevalence
          communities through community
          pharmacies.
 31      Ensure rapid access to key worker               01.02   Connexions Advisers      02.02           C
         arrangements for young people                           appointed
         discovering pregnancy.
 32      Establish referral systems between              05.01   Protocols agreed         09.01           BSPCG
          termination services and other services.               First young people       01.01
                                                                 referred.
 33      The Education Authority reintegration           09.01   Revised reporting        09.01           LEA
         officer, supported by schools inspectorate              system agreed
         will establish a mechanism for all schools              First data submissions   04.01
         to report on pregnancies amongst their
         students.
 34      Support packages will be targeted at            04.01   Guidance produced for    07.02           LEA
         maintaining the young person in school                  schools
         before and after the birth.                             Packages available       09.02




C:briefcase/tacklingteenagepregnancystrategy                                       35
Actions                                               Start   Milestones                             Lead
                                                      Date                                           Agency
                                                              Description            Delivery Date
 35      Proper recognition of support requirements   04.02   Engagement of          06.01           LHF
         of teenage parents will appear in all                Lincolnshire Housing                   TPSG
         housing authority plans                              Forum in Steering
                                                              Group
                                                              Revised plans with     04.02
                                                              appropriate action
                                                              produced




C:briefcase/tacklingteenagepregnancystrategy                                   36
Section Six:                Source and Application of Funds in Delivering
                            the April 2001 to March 2004 Action Plan

 Action                Description             Amount              Source
  Point                                         £ pa
1,2,3,4,8,      Materials and training           5,500 Healthy Schools Funds
10,11                                           21,300 LEA Standards Funds
                Dissemination events             2,500  Local Implementation Fund
                                                   n/a Human resources
5,9             Change management                  n/a SSD Development Officer
                Dissemination events             9,500 Children’s Fund
6,7             Change management                  n/a Teenage Pregnancy Coordinator
12              Change management                  n/a Teenage Pregnancy Coordinator
                Dissemination events            10,250 Local Implementation Fund
13              Produce materials               12,500 Local Implementation Fund
                                                       Youth Services
14,23           Produce materials                2,500 Lincolnshire Health Authority
                Purchase Simulators              7,000
15,21,22        Paid advertising                12,000 Local Implementation Fund
                Feature coverage                       Teenage Pregnancy Coordinator
16              Newsletter                       6,300 Healthy Schools Funds
                dissemination
                Parents evenings                       Human resources
17,20           Design and                      25,000 Local Implementation Fund
                production services
                Advertising                     12,000
18              Undertake audit                    n/a Human resources
                Produce and                     10,000 Local Implementation Fund
                disseminate
                directories
24,25,26        Training events                  9,500 Boston and Skegness PCG
                PMS Pilots                       5,000 Local Implementation Fund
27,28,29,       Service costs                   32,500 Boston and Skegness PCG
30,32                                                  Lincolnshire Rural Action Zone
                                                       Long Sutton Market House Trust
                                                       Lincolnshire Health Authority
31              Service costs                   75,000 Lincolnshire and Rutland
                                                       Connexions
33,34           Service costs                   35,000 LEA Standards Funds




C:briefcase/tacklingteenagepregnancystrategy                                            38