Interviews with Tina Holtby, Licensing Manager and Jemma Dann, Food Standards Officer
Chlamydia is now the most common sexually-transmitted infection (STI), with one in 10 young people under 25 infected. Chlamydia often has no symptoms, yet can lead to serious health problems and is the leading cause of infertility. It is spread through unprotected sex, but is quick and easy to treat with a course of antibiotics. There are two important messages that need to be communicated to young people. The first is the need for screening. The second is the need to use condoms and act responsibly at all times, especially if alcohol is involved.
The Licensing team at East Riding were approached by the primary care trusts (PCT's) Public Health team. They wanted to reach out to young people at licensed venues where they were likely to be gathered in large numbers. But they had difficulty in making contact with owners of licensed premises and persuading them to help with this promotional activity.
Reaching out to young people
The team thought that the Licensing team would already have contacts among and a working relationship with nightclub and pub owners, so a joint initiative was suggested. The Licensing team were happy to assist and spoke to nightclub and pub owners. They explained some of the background and what it was hoping to achieve.
Tina Holtby, East Riding Council's Licensing Manager, says:
"At first, the licensees were a bit reluctant as it was a very new concept for them to be involved with. And they did not want their premises to be perceived as having a problem with alcohol and sexual activity. But we persuaded some of them to give it a go and it worked very well."
It was decided to concentrate on three of the busiest night-time licensed premises in East Riding. Here, large numbers of young people meet up between midnight and three o'clock in the morning. The premises also had to have discreet toilet areas where urine samples could be given. Licensing staff arranged to visit nightclubs and pubs with a team of sexual health nurses on pre-arranged dates.
Health promotional work and Chlamydia testing in nightclubs
The Licensing team introduced the nurses to licensees and stayed with them onsite while they carried out their health promotional work. This included handing out packages of information about STIs and condoms and the offer of a Chlamydia screening test. This required a urine sample which was collected there and then. Contact numbers for the correct help and advice were also given. The team also took the opportunity to spread other all-important prevention and testing messages. These included information about drug misuse and responsible drinking.
Positive feedback
Holtby says:
"We received very positive feedback from the young people at the premises. They said things like: ‘I'd never dare go to my doctor about this [Chlamydia testing]', so we knew we had found a good way to reach these young people. Once the nightclub and pub licensees realised that the young people were keen to get tested, and not put off from coming to their venues, they were very willing to cooperate and get fully involved."
The joint team from Public Health and Licensing plan to return to the same venues periodically. For example, during the holiday season when many students have returned to East Riding from their universities. The team will also be visiting locations such as busy caravan parks during the tourist season.
Holtby has been surprised by how little awareness of sexual health issues there was among the younger customers, in particular of Chlamydia.
She says:
"We found that when they were given the opportunity, the young people did want to discuss the issues and learn more. What was really good was that some people came back to us and told us they had had positive tests and received treatment. They made it clear that, if it hadn't been for this initiative, they wouldn't have known of the dangers or got the treatment they needed."
Raising awareness
She says that the initiative has given her own staff more awareness of the issues and that when they go out on inspection visits, they are able to talk to licensees about their social responsibility to their customers. They also now have regular meetings with the licensees and carry out free training with them, on issues such as sexual health, drugs awareness and recognition of false IDs.
Holtby confirms:
"The work has been very successful to date, has improved customers' knowledge of the issues, improved partnership working with the trade and PCT and given licensing and the PCT an awareness of each other's roles and responsibilities. We received some good media attention on this joint work and a few months ago the PCT received an award for this partnership work."
Establishing links with the public health team
The Licensing team has also been involved in other health promotional activity, including establishing links with the Public Health team. This involved giving out information on units of alcohol and promoting responsible drinking. As licensing manager, Holtby sits on the partnership group. This is putting together a drug and alcohol strategy. It has also participated in a working group developing initiatives to promote responsible drinking. She sees all of this work as an important part of the council's regulatory function.
This is because education and advice to licensees has the potential to reduce situations where future enforcement action may have been taken. This is especially true in the management of responsible drinking. And she welcomes the opportunity to work with PCT colleagues and with colleagues from within the Safe Communities team.
Healthy eating working group
Aside from the obvious links with tobacco control and smoking cessation, other parts of the council's Regulatory services are also working on health issues. For example, the Food Services team has set up an Eating for Health Working Group. This has developed a Healthy Options Award for the area, setting out criteria which businesses must meet to get an award.
The working group has developed a new set of criteria specifically for takeaways. These include salt and fat reduction and putting fruit and vegetable options on their menus. The award is a joint initiative between Hull City Council, the East Riding of Yorkshire Council and the PCT. The PCT is providing funding for a dietician to visit and advise to food outlets.
Making healthier choices
Jemma Dann, the East Riding Council's Food Standards Officer chairs the Eating for Health Working Group. She explains that they are hoping the new award will lead to a widespread uptake of healthier options. This is particularly important for takeaways and other convenience food outlets.
"This is where children often buy their school lunches," explains Dann. "So it's really important that we target these outlets."
There is a wide range of multi-ethnic cooking on offer in the area, so she is developing guidance for the different ethnic takeaway businesses. This will advise on how they can meet the criteria for the award while working within their own cooking traditions.
The working group also carries out promotional and educational work. It attends events such as those for people over 50, people with learning disabilities and students. It gives out advice on food labelling, food safety and healthy eating. These are activities which are increasingly being seen as an important aspect of food standards.