Sexual Health Services Lucy Emmerson

Sex Education Forumwww.ncb.org.uk/sef

On-site sexual health services in education

settings


What are they?

Outreach from local agenciesExtension of the school nurse roleClinic in a boxMobile health busesPart of holistic health servicesC-card scheme delivered in education settingsChlamydia screening in education settings


What are they?

Advice and referral Pregnancy testingContraception: EHC, condoms, pills, LARCChlamydia and gonorrhoea testing

More barriers accessing testing and contraception than accessing advice


How common are they?

Survey carried out by the Sex Education Forum Completed by Teenage Pregnancy CoordinatorsSample of 70% of local authorities for schools survey


Between a quarter and a third of secondary schools in the sample have on-site sexual health services (28.7%) – 627 schools

16% of services in schools are specialised – providing a wide range of contraception

Considerable regional variation: highest North East and South West, lowest North West and London

Wide variation between neighbouring authorities


Where are they?

• High concentration in some rural areas (Northumberland, Rutland and Staffordshire)

• Low concentration in other rural areas (Lancashire, East Sussex)

• High concentration in some urban areas (Bristol, York, Portsmouth)

• Low concentration in other urban areas (Birmingham, Liverpool)


School profile

• Slightly lower prevalence in all girls (14%) and all boys (10%) schools than co-ed (28.7%)

• 17 faith based schools have on-site sexual health services

• Services in special schools and independent schools also mentioned

• 2% of services accessible by over 16s only


What about PRU services?

• 34.4% of PRUs in the sample have on-site sexual health services

• Smaller sample as some areas did not provide data

• Higher proportion of specialised services than in schools (27% compared to 16%)

• High level in Yorks & Humber, low level in East Midlands

• No clear distribution patterns


Do on-site services work?• Evidence that better access to contraception leads to reduction in

teenage conceptions (Santelli, 2007)

• Evidence that SRE and access to services reduces teenage conception rates (DfES, 2006)

• Investment over time: not helpful to link existing conception data with current prevalence of on-site services

• Services in education settings are one piece of the jigsaw

• Evidence of high usage of services by vulnerable young people (UWE, 2008)

• Challenges in evaluation: variation between services – what should the indicators be?


Barriers to development

• Difficulties agreeing confidentiality protocols: school/health

• Lack of capacity and difficulties in recruiting specialised staff

• Funding needed to extend pilot projects

• Preference for a community-based approach

• Concerns about parental objection

• Concerns from schools: heads and governors


In the media 2007


Headlines June 2008

“School sex clinics fuel debate on promiscuity” (Observer)

“Three cheers for the news that nearly one in three secondary schools are now running sexual health clinics for pupils”

(Miriam Stoppard, The Mirror)

“Give kids guidance… not just the pill” (Sun)


Looking ahead

• Survey included open questions about plans for future development

• Respondents from 40 local authority areas indicated plans for future development

• 16 of the school services were being opened in the period Sept 07 – Jan 08

• Some areas started with pilot and now rolling out to further schools


Questions

In school or near school? How far is too far?

Sexual health or general health?

How specialised?

A menu of options… when to compromise?

How can onward referral be tracked?

Targeting resources or work with the willing?


Involving young people

Health needs assessmentConsultation – school council and focus groupsYouth-led researchBrandingPromotionLocationPeer mentors / service advocatesEvaluation


Recommendations

1. Local authorities to take a strategic and coordinated approach to service development in schools

2. Support school governors and heads to understand the benefits of on-site service provision

3. Enable professionals to share practice

4. Develop tools to maximise service effectiveness

5. Build on the evidence base

6. Track progress

7. Celebrate success


Resources

Sex Education Forum web resources: www.ncb.org.uk/sexualhealthservices

Email networks

Forthcoming resource pack Contact

Lucy EmmersonSenior Development Officer

Sex Education Forum8 Wakley Street

LondonEC1V 7QE

Email: [email protected]: 0207 843 1164

http://www.ncb.org.uk/sexualhealthservices


References click icons for web link…

DfES (2006) Teenage Pregnancy Next Steps: Guidance for local authorities and primary care trusts on effective delivery of local strategies.

Salmon, D and Ingram, J (2008) An Evaluation of Brook Sexual Health Outreach in Schools. Bristol: Centre for Public Health Research, University of the West of England.

Santelli, J and others (2007) Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use’, American Journal of Public Health (January), vol. 97, no. 1: 150-6.

Sex Education Forum, (2008) National mapping of on-site sexual health services in education settings: provision in schools and pupil referral units in England, NCB.

http://www.ncb.org.uk/dotpdf/open_access_2/sef_mappingsurvey_08.pdf

http://hsc.uwe.ac.uk/net/research/brooksexualhealthoutreach.aspx

http://www.ajph.org/cgi/content/abstract/AJPH.2006.089169v1

http://www.everychildmatters.gov.uk/resources-and-practice/IG00145/

Sexual Health Services Lucy Emmerson

Education

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