Southend City Council is refreshing its approach to teenage pregnancy with a host of new initiatives to help prevent conceptions and the impact on health inequalities that comes with it.
‘Plateau in falling rates prompted action’
Teenage parents have worse outcomes across a range of measures from mental health to educational attainment.
Over the last 18 years the under 18 conception rate across England has fallen by almost 60 per cent, but young people in England still experience higher teenage birth rates than their peers in Western European countries.
And by 2019 it had become clear there had been a plateau in teenage pregnancy rates and levels of teenage conception in Southend. It prompted public health to carry out a deep-dive review of the issues and the creation of a Teenage Pregnancy Prevention Group.
The group is chaired by Councillor Helen Boyd and includes a range of different services, such as the family nurse partnership, Better Start Southend, specialist health visitors, children services, the young people and families public health service, the access and inclusion team, early help, sexual health, commissioners and health improvement practitioners as well as NHS colleagues.
Ms Brennan-Douglas said: “We decided to go back to basics and look at the evidence base on prevention. We were guided by Public Health England’s Teenage Pregnancy Prevention Framework.”
This suggests key areas to consider when tackling teenage pregnancy, such as targeted prevention for young people at risk, support for young parents, access to advice and contraception in non-health settings and training for health and non-health professionals.
Ms Brennan-Douglas said: “The data was a great starting point. We went through our caseloads and reassessed the data to see what trends we were seeing. We had started to see more cases in our older age groups, the late teens and particularly those who had been in care or were not attending school full-time. We began focussing on the support that was being provided to them.
“We still have further work to do to address wider commissioning gaps and improve the offer to children and young people outside of mainstream education settings.”
How the new provider is playing its part
The review also coincided with the arrival of a new sexual health and reproductive health provider - Brook Southend – and together the working group and Brook have partnered to begin to set up targeted projects to address some of the weaknesses that were found.
Brook is going to launch a training programme for staff working with children and young people, particularly children who are looked after by the council. Staff will be taught about how to have brief interventions, conversations about healthy relationships and about caring for your sexual health and wellbeing. A condom distribution scheme is also in place to signpost people for support and emergency contraception.
Ms Brennan-Douglas said: “The aim is to offer some training to everyone, but we do want to see some staff become key ambassadors in each team. The aim is to get the wider team – anyone who works with children at risk - more engaged and involved in addressing teenage pregnancy.”
Training will also be provided for foster carers at Brook-hosted information evenings to make them comfortable and confident about discussing relationships, sex and contraception and where to signpost young people for help.
Another element of the work will involve reviewing the relationships and sex education (RSE) that is on offer. The review by the working group found there was a variability in the current offer and access to RSE for children and young people on reduced timetables, moving between schools, in alternative education, home schooled and / or missing large amounts of school.
On top of that there is now the added impact of the pandemic, said Ms Brennan-Douglas. “We know RSE was not a priority and there is a cohort of young people who have missed out on relationships and sex education.”
Children with personal education plans will now be asked about their RSE to ensure that looked after young people are accessing high quality RSE in school settings. Work with the Children in Care Council has also influenced this approach and the development of the wider programme of work.
Moves are also being made to improve the way young parents are supported. A professionals network for young parents has been established and is meeting informally at the moment, but the aim is to start better coordinating the services that work with these young parents.
Ms Brennan-Douglas said: “You can sometimes have four, five or six services going in – housing, health visitors, the youth offending team, early help – but no-one coordinating the work. It is only when a social worker is involved that you get a plan and the coordination. That is not good for the young person.”
Ms Brennan-Douglas believes the work that is taking place will put Southend in a stronger position moving forward. “We feel we are back in the driving seat with a stronger focus on prevention. It should help us make progress in getting teenage pregnancy rates down again and reducing the inequalities children and young people face.”
Erin Brennan-Douglas, Senior Public Health Principal, Southend City Council: firstname.lastname@example.org