Sexual Health Services   Lucy Emmerson
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  • 1. On-site sexual health services in education settings
  • 2. What are they?
    • Outreach from local agencies
    • Extension of the school nurse role
    • Clinic in a box
    • Mobile health buses
    • Part of holistic health services
    • C-card scheme delivered in education settings
    • Chlamydia screening in education settings
  • 3. What are they?
    • Advice and referral
    • Pregnancy testing
    • Contraception: EHC, condoms, pills, LARC
    • Chlamydia and gonorrhoea testing
    • More barriers accessing testing and contraception than accessing advice
  • 4. How common are they?
    • Survey carried out by the Sex Education Forum
    • Completed by Teenage Pregnancy Coordinators
    • Sample of 70% of local authorities for schools survey
  • 5.
    • 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
  • 6.  
  • 7. 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)
  • 8. 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
  • 9.  
  • 10. 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
  • 11. 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?
  • 12. 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
  • 13. In the media 2007
  • 14. 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)
  • 15. 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
  • 16. 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?
  • 17. Involving young people
    • Health needs assessment
    • Consultation – school council and focus groups
    • Youth-led research
    • Branding
    • Promotion
    • Location
    • Peer mentors / service advocates
    • Evaluation
  • 18. 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
  • 19. Resources
    • Sex Education Forum web resources: www.ncb.org.uk/sexualhealthservices
    • Email networks
    • Forthcoming resource pack
    Contact Lucy Emmerson Senior Development Officer Sex Education Forum 8 Wakley Street London EC1V 7QE Email: lemmerson@ncb.org.uk Tel: 0207 843 1164
  • 20. 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.