Positive About Young People and Their Potential

“Positive about young people and their potential”

Working together to improve Sexual Health and Wellbeing for young people in Salford 2010-2013

Salfords pledges on Teenage Pregnancy

As a result of working to make the changes outlined in this strategy, people in Salford can expect:

Strategic Priority: Develop Contraception and Sexual Health Services

Young people will have easier access to contraceptive services and a greater choice of contraceptive methods across Salford

Strategic Priority: Supporting young peoples sexual health and wellbeing through Primary Care

Improved support from General Practice for sexual health, increasing access and choices for young people in Salford

Strategic Priority: Support for pregnant young women, young parents and their children

There will be better support for pregnant young women, young parents and their children enabling young people in Salford to continue their education and make healthier life choices for them and their children

4.Strategic Priority: Prevention and supportive environments

Support agencies and parents will have greater skills and confidence in dealing with and talking about young people’s sexual health and contraceptive needs

Strategic Priority: Establish multi-agency service model

Young people in areas of greatest need in Salford will benefit from agencies working more closely and responsively to those needs

Strategic Priority: Media and communications

Improved communication and use of the media will inform young people, parents, carers and professionals of the developments and actions being taken to reduce teenage pregnancy in Salford

Strategic Priority:Relationship and Sex Education

Young people in Salford will benefit from improved Relationships and Sex Education in all schools in Salford giving them the information they need to negotiate and make choices about relationships and delaying parenthood

Strategic Priority: Early Years Environment

Young parents in Salford will benefit from improved support in all Children’s Centres giving their children the best possible start in life and improving their future health and educational prospects

Foreword

Action to reduce teenage pregnancy has been a Governmental priority for the past 10 years. The health and socio-economic effects highlighted in the Social Exclusion Unit Report on Teenage Pregnancy (1999) and the high rates relative to the rest of Europe supported the launch of a national Teenage Pregnancy Strategy and the adoption of national targets to reduce teenage pregnancy by 50% by 2010. However, despite concerted efforts progress on this target nationally has been modest, with considerable variations between comparator local authorities.

The Department for Children, Schools and Families (DCSF) has issued guidance to accelerate the strategy to 2012 and areas where progress has been stalled (including Salford) have been visited by Teenage Pregnancy National Support Teams (TP NST). The recommendations from the NST visit have been used to inform this strategy. Teenage pregnancy is a priority for Salford City Council and Salford PCT. It is included in the Children and Young People’s Plan, Salford’s PCT Strategic Plan and Salford’s Local Area Agreement.

Past responses to impacting on teenage pregnancy in Salford have been insufficient to achieve sufficient progress swiftly enough to improve the sexual health and wellbeing of young people in the city. This document sets out a strategic vision which fits with other key priorities in Salford and identifies actions needed by partners to accelerate and industrialise delivery. It should be used to inform and prioritise the future commissioning for services for young people to reduce under–18 conceptions and support teenage parents.

Contents

1Introduction

2What Teenage Pregnancy means in Salford

3What we know works in tackling teenage pregnancy

4Current activity and gaps

5Deliveryand Action Plan

6Governance

7Finance and Resources

8Appendix

9Further Reading

10Introduction

Summary

1.1Aim

The aim of the Salford Teenage Pregnancy and Parenthood Strategy “Positive about young people and their potential” is to:

“Reduce the conception rate in those under-18 and reduce the impact of this on social exclusion, educational attainment, social aspiration and the health and wellbeing of the mothers and children”.

This is an ambitious strategy which will have a wide-ranging impact and will produce positive outcomes for Salford’s young people and contribute to achievement of a range of public service targets set for Salford. The strategy provides the vision and way forward with prioritisation of actions for short-term and medium-term outcomes. It will require translation into an action plan and commissioning plans.

1.2Understanding Teenage Pregnancy and risk factors

The risk factors for teenage pregnancy show a relationship between deprivation and a range of related factors which increase the risk of teenage pregnancy. There are also a number of consequencesof teenage pregnancy, which themselves increase the risk of poor outcomes, such as low educational attainment, poverty and worklessness, poor health and infant mortality. This is explored in further detail in Section 2.2.1.

Successful prevention of teenage pregnancy involves a wider range of prevention initiatives that include raising aspiration, educational attendance andattainment and will not be achieved through Relationships and Sex Education and the provision of contraception alone.

1.3Process of Strategy Development in Salford

While preparing Salford Teenage Pregnancy and Parenthood Strategy “Positive about young people and their potential”young people, representatives from Education, Youth, Health and Social Services have been consulted and canvassed for opinions and thoughts on how to tackle Salford’s teenage pregnancy rates.

A nine month consultation and development process initiated by NHS Salford’s Director of Public Health has raised the profile for this NHS and Local Authority owned target. This strategy represents a significant shift in local thinking, seeking resources and interventions equal to the scale of the problem. The Teenage Pregnancy Executive provides strong senior level leadership across the NHS and Local Authority for implementation and governance of the Strategy.

1.4Strategy ethos

The challenge to Salford and the ethos behind this strategy is to ensure that everyone including young people, parents, public, private and voluntary sector organisations recognise their role within Positive about young people and their potential. We wish to emphasise that everyone who comes into contact with young people in their everyday work can make a positive contribution to the future of young people in Salford and unless proven explicitly otherwise, you and your organisation are involved in preventing teenage pregnancy.

1.5Recognition of competing priorities

Positive about young people and their potential also recognises that resources are finite in Salford and each organisation has delivery of core services that are equally essential. The strategic vision and intent of this document concerns adjustment to existing core services and identifies where additional resources are required. Teenage pregnancy is a multi-faceted issue that requires a multi-agency response. In understanding this and the connection of work between agencies, all partners will begin to shape an environment which promotes positive choices. All partners must commit to maximising the positive contribution of their work and ensure their actions do not have a negative impact.

1.6Strategic alignment

This is an ambitious strategy which will have a wide-ranging impact and will produce positive outcomes for Salford’s young people and contribute to achievement of a range of public service targets set for Salford including: child health, healthy schools, obesity, physical activity, drugs and alcohol, mental health and social care outcomes.

The strategy provides the vision and way forward with prioritisation of actions for short and medium outcomes.

1.7Strategic objectives

This Strategy operates alongside the delivery of and developments in children’s services, for example;

The role of education to support children and young people to attend and achieve and to support and develop the health and well-being of children and young people
Tackling child poverty
The provision of support for looked after children, young people and care leavers
Opportunities to work with young people in ways which are likely to impact positively on a wide range of outcomes.

The strategy takes a long term perspective changing behaviours and social norms in Salford that will reduce teenage pregnancy and support teenage parents. The Strategic Objectives of Positive about young people and their potential are:

Place young people and young parents influence at the centre ofthe planning, delivery and monitoring of services.

Commission and ensure delivery of accessible, high quality contraception and sexual health services for young people under-18 and teenage parents

Ensure that young people, including those recognised as vulnerable or at risk, can easily access services, are assessed and, where appropriate, are able to progress to other services which support the reduction of risk factors and help increase protective factors

Use community-based approaches to ensure that wider support to prevent teenage pregnancy and support for parenthood is available by working with parents/carers; siblings of pregnant young women and young fathers.

Commission and ensure delivery of high quality support services for pregnant young women, young parents and their families including assertive outreach for those who don’t attend or engage.

Devise and commission a workforce development programme to incrementally enhance the skills, specifically of the children and young people’s workforce on prevention of teenage pregnancy and support for young parents, having a wider impact on all services.

Develop and deliver a media and communications policy and programme which are flexible to young people’s needs and provide relevant information via appropriate media and technology to a wide range of stakeholders, particularly young people and young parents.

Ensure that You’re Welcome and young parent friendly standards are adopted by all services involved in implementing the Teenage Pregnancy strategy, monitored by The Local Authority, NHS Salford and young people.

Develop and quality assure a Relationships and Sex Education programme within Personal, Social and Health Education in all schools and Pupil Referral Units and in other settings

1.8Delivery arrangements and governance

Positive about young people and their potentialis governed by the Health and Wellbeing Board and will be programme managed by the Teenage Pregnancy Executive. A supporting document Positive about young people and their potential: Action Plan 2009/12 provides details for each action that will be taken to deliver the strategic vision and objectives of Positive about young people and their potential. The Teenage Pregnancy Executive will use this document to oversee; support and performance manage the lead partner in delivery of each action. See Section 6.

The Teenage Pregnancy Executive will report to the Children and Young Persons Partnership Board, Think Healthy Living Board and ultimately to Salford Strategic Partnership. The action plan will be reviewed annually.

1.9The vision that is Positive about young people and their potential

Teenage pregnancy impacts on the health and wellbeing of young people and their children. It is both a cause and consequence of social exclusion and a continuing cycle of deprivation.

This Strategy seeks to promote a Salford where choice, opportunity and aspiration are first and foremost in the lives of young people. This Strategy is supported by the document“Working together to improve Sexual Health and Wellbeing for young people in Salford action plan 2010-2013” which contains eight strategic priorities:

Develop Contraception and Sexual Health Services
Supporting young peoples sexual health and wellbeing through Primary Care
Support for pregnant young women, young parents and their children
Prevention and supportive environments
Establish multi-agency service model
Media and Communications
Sex and Relationship Education
Early Years Environment

2 What Teenage Pregnancy means in Salford

Summary

Salford is not likely to meet the 2010 target to achieve a 50% reduction in under-18 conceptions, as measured from the 1998 baseline. The trend data shows that the rate of teenage conceptions is marginally increasing, following a reduction in 2001-2. Salford’s position for teenage pregnancy is linked to the levels of deprivation as there is a known correlation.

Table 1

Performance required to meet 50% reduction target

However, other local authorities with similar deprivation indices have succeeded in making more significant improvements, for example; South Tyneside teenage pregnancy rates have fallen by 14.2% between 1998 and 2007.

The high levels of teenage pregnancy in Salford has significant implications for its young people and for future generation as is demonstrated through the evidence of the impact on young people, both through unwanted conceptions and teenage parenthood.

The levels of teenage pregnancy also have an impact on the wider community and the perception of very young parenthood as normal, along with the concurrent health and socio-economic impact.

Evidence shows that having children at a young age can damage young women’s health and wellbeing and severely limit their education and career prospects. Studies show that children born to teenagers are more likely to experience a range of negative outcomes in later life, and are up to three times more likely to become a teenage parent themselves.
Department for Education and Skills, 2007

The Government’s and local public sector’s recognition of the adverse impact of teenage pregnancy is demonstrated through national and local targets. This adverse impact needs to be translated to the wider Salford community to break the cycle of deprivation and meet the original objectives of reducing social exclusion.

2.1 National and local targets

The Department for Children, Schools and Families and the Department of Health have shared responsibility for the target to halve under-18 conception rates by 2010 against a 1998 baseline.

At a local level, the Primary Care Trust and local authority are jointly responsible for achieving this national indicator (NI 112) as part of Public Service Agreement 14 (Department for Communities and Local Government, 2007), through delivery of the local area agreement and NHS Operating Plan.

The target for the under-16 conception rate is to reduce the rate per 1000 (based on female population aged 13-15).

A further target relevant to teenage pregnancy is to increase to 60% the proportion of teenage mothers in education, training or employment to reduce their risk of long term social exclusion.

2.2.1 Identifying risk of teenage pregnancy or parenthood

There is strong evidence which identifies the individual risk factors that can increase the likelihood of teenage pregnancy and parenthood. These include:

Being from an unskilled manual background (social class V)
Living in an area with a high level of deprivation
Having a mother who had no qualifications
Having a mother who was a teenage mother
Having low self-esteem
Scoring below average on measures of educational achievement
Leaving school at 16 without any qualifications

Being in, or having been in, care
Ethnicity which is ‘Black Caribbean’, ‘Mixed White and Black Caribbean’, ‘Other Black’ or ‘White British’ (categories from 2001 Census)
Being a girl who is sexually active under 16
Having poor use of contraceptives
Having had a previous abortion or pregnancy
Having a Mother with low educational aspirations for her daughter

(National Statistics (2004) Census 2001 table: C0069 Mothers under-19 at birth)

2.2.2 Impact on children of teenage mothers

Children of teenage mothers have a 63% increased risk of being born into poverty compared to babies born to mothers in their twenties.

Children of teenage mothers are more likely to have accidents and behavioural problems. However, the fact that teenage mothers were more likely to suffer from anxiety and depression seemed to be at the root of this, rather than teenage parenthood per se (Berrington et al, 2007).

Child benefit claimant data shows that 49% of teenage mothers live in the most deprived 20% of Super Output Areas.

2.2.3Multiple risk factors

Young women experiencing five risk factors (daughter of a teenage mother; father’s unskilled social class; conduct disorder; social housing and poor reading ability at age 10) have a 31% probability of becoming a mother under-20 years of age, compared with a 1% probability for someone experiencing none of these risk factors.

Young men with the same risk factors had a 23% probability of becoming a young father (under age 23), compared to 2% for those not experiencing any of these risk factors.

2.2.4Living in care

Research has shown that by the age of 20, 25% of young people who had been in care were young parents and 40% were mothers(Barn R, Andrew L, Mantovani N 2005).

The prevalence of teenage motherhood among looked after young women under-18 is around three times higher than the prevalence among all girls under-18 in England (NHS Salford, 2009a)

2.2.5Education

The likelihood of teenage pregnancy is far higher among those with poor educational attainment, even after adjusting for the effects of education. A survey of teenage mothers showed that disengagement from education often occurred prior to pregnancy, with less than half attending school regularly at the point of conception (Hosie and Dawson, 2005).