Joint PCT Scrutiny Committee for Stevenage and North Hertfordshire
Wednesday 13th September 2006
Teenage Pregnancy Report
Investigation Into Teenage Pregnancy
Background
The joint PCT Scrutiny Committee consists of elected members of Stevenage Borough Council, North Hertfordshire District Council and Hertfordshire County Council. Under scrutiny powers delegated to it by the county council and resulting from the Health and Social Care Act 2001 the committee scrutinises the work of the Stevenage and North Hertfordshire Primary Care Trust.
Members set up three sub groups on 18 June 2003. That for the Children and Young People’s aspects of the PCT’s Local Delivery Plan was concerned about the local high levels of teenage pregnancy and decided to investigate this as a matter of priority. This is the report of that investigation.
The Government set up the Teenage Pregnancy Unit. Using 1998 as the baseline national targets were set that by 2010 the rate for under 18s would be halved; that a downward trend for under 16s would be firmly established; and the participation of teenage mothers in education and work would be increased to 60% in order to reduce the risk of social exclusion.
Scope
It soon became clear that while the services provided by the PCT would be the primary focus that only investigating those services would give a very incomplete picture. In the end the investigation ranged from the causes of high teenage pregnancy to support given to young mothers and their children.
Method
The investigation was grounded in hard evidence such as the levels of teenage pregnancy, deprivation and education attainment.
The panel established key lines of enquiry. The twenty structured questions covered the scale of the issue, trends, interventions and involvement and effectiveness.
A major event was held on 21st November 2005 at which an extremely wide range of agencies, voluntary groups and users gave evidence to the scrutiny committee’s young persons sub group. The approach was similar to a select committee and based on the key lines of enquiry with some supplementary questions. A detailed transcript of that event is available on request.
Further experiences were learnt through visits to the Young Mums Group and through a consultation event with young people at ThomasAlleyneSchool.
Colleagues in the Primary Care Trust provided invaluable support.
Evidence
1. The key statistic is that in 2001-2003 the teenage conception rate for Stevenage was 52.4 per 1,000 women aged 15-17 compared with 42.4 for England, 29.0 in Hertfordshire and 28.8 in North Hertfordshire. The Stevenage rate for 2004 alone was 47.6 but not too much reliance should be placed on district figures for single years.
2. In 2001-2003 the average number of teenage conceptions per year was 85.3 in Stevenage (256 in the period) and 60.7 in North Hertfordshire (182).
3. Over the three years conceptions in some council wards were St. Nicholas 52; Shephall 36; Bedwell 27; Baldock Town 24; Roebuck 21 and Letchworth South West 20.
4. Trends
District / 1996-1998 / 1997-1999 / 1998-2000 / 1999-2001 / 2000-2002 / 2001-2003 / % Variance between 1996-1998 & 2001-2003Stevenage / 54.0 / 54.2 / 52.3 / 53.6 / 54.5 / 52.4 / -2.97%
N. Herts / 27.4 / 29.6 / 30.1 / 27.8 / 27.1 / 28.8 / +5.11%
County / 31.7 / 31.9 / 31.8 / 30.9 / 30.4 / 28.9 / -8.84%
(Source: CSF District Profile. August 2006).
At the time the graph was plotted in August 2006 it was difficult to determine whether there are significant upward or downward trends or fluctuations in the districts.
5. The 2002-2004 statistics were published in September 2006. They showed a rate of 45.1 for Stevenage. That is a significant reduction from 52.4 in 2001-2003 and a long period with rates above 50. Although the Stevenage rate is still clearly the highest in Hertfordshire this was the greatest reduction in the County. See the table at the end of this paper.
6. Stevenage is the Hertfordshire district with the highest level of deprivation. It includes several Census Super Output Areas (SOAs) which are amongst the 10% most deprived in the county. Some are in Bedwell and Shephall. Some in the next range (to 20%) are in St. Nicholas and Roebuck as well as Bedwell and Shephall. Baldock Town, in North Hertfordshire, also has areas with relatively high levels of deprivation (Source IMD 2004).
7. The total numbers of conceptions to under 16 year olds in 2001-2003 were 43 in Stevenage and 33 in North Hertfordshire. They equate to rates of 8.7 per 1,000 female population aged 13-15 years in Stevenage and 5.1 in North Hertfordshire.
Much more evidence will be found in the scrutiny event transcript and the key lines of enquiry document.
Recommendations
1 (a) Recognise that achieving and maintaining a sustainable reduction in teenage pregnancy is a long term project, (b) Thus it is essential that statistics for local areas are available and monitored for many years so that trends are identified, evidence to assess the impact of interventions is collected, and appropriate further recommendations made.
2. Data on emergency hormonal contraception and spontaneous abortion is needed.
3. As it was discovered that many under 16s who become pregnant were told to leave school Hertfordshire County Council may need to address how to keep under 16s in education.
4. Investigate the quality of sex and relationship education.
5. Support the work of the County Teenage Pregnancy Board to raise standards of Sex and Relationship Education (SRE) in schools and other settings – including the college – by providing training and publishing teachers’ resources.
6. Training should be provided for school governors. County and District Councillors should encourage school governors to attend training / briefing sessions on SRE in schools.
7. School governors should discuss the reluctance of some schools to provide sex and relationship education.
8. Schools should consider examples of best practice.
9. The County Council should consider whether there should be financial incentives to provide high quality sex and relationships education in schools.
10. Support parents / carers to collaborate with their children’s schools on reviewing SRE resources and approaches and using similar approaches to extend their conversations with children.
11a. Extended schools may wish to provide learning opportunities for the community on sexual health matters and on personal and social skill building.
11b. Primary Care Trusts should be included amongst the lead agencies for extended schools and community plans as more of their services are likely to be delivered from those venues.
12. Include sexual health clinic in clusters of secondary schools as part of the extended schools agenda, this should reduce the problems associated with going to existing “public” clinics.
13. Issues from this report which go wider than the PCT and Children’s and Young People’s Strategic Partnership (the Children’s Partnership Trust) will be directed to the Local Strategic Partnerships (LSPs). Some issues may be raised with Government ministers.
14. Future provision – notably family planning and GUM - must remove the need to queue in public.
15. Support schools to prepare pupils appropriately in ways of responsibly accessing independent sources of information, help and advice.
16. The recent appointment of a support worker is noted but more must be done for boys and young men.
17. Encourage schools to review and adapt their SRE programmes in consultation with pupils so that they are equally relevant to both genders.
18. Encourage mainstream schools to provide more learning opportunities for pupils to find out about the abilities and talents of young people who are differently abled e.g. use wheelchairs so that they are more inclusive towards them.
19. Agencies using the Young Mums Group should contribute to the financing of that group.
20a. Key agencies must review the resources available to meet targets on teenage pregnancy reduction and to provide support for young mums-to-be, teenage parents and their children.
20b. Resources should be targeted on areas with greatest need.
21. Review the provision at Wellfield Court and North Road in Stevenage.
22. Young people should be able to influence provision. A conscious effort is needed. A range of methods to engage young people will be needed. The County topic group should be asked to talk to more young people.
23. Investigate the positive contribution employers could make to aspiration and self-esteem.
24. Investigate how after school clubs in secondary schools could promote emotional health and well-being including aspiration and self-esteem.
25. Continue work with younger age children to raise aspirations and self esteem. Support those moving onto secondary education and support for those with low attainment. Increase access to non academic training and post 16 education.
26. Investigate the extent to which the children of teenage mothers become teenage mothers themselves.
27. Investigate the frequency and impact of second pregnancies on teenage mothers and their families.
28. Further investigate the links between housing policy and teenage pregnancy.
Dissemination
1. Initially to the Primary Care Trust. The PCT should have an opportunity to respond to the findings and recommendations.
2. Secondly to Children’s, Schools and Families at Hertfordshire County Council as many of the recommendations relate to schools.
3. Other agencies mentioned in the report e.g. the college and employer organisations.
4. Those organisations who participated in the investigation.
5. The Local Strategic Partnerships that cover Stevenage and North Hertfordshire.
6. The County Scrutiny Committee Teenage Pregnancy Topic Group.
Supporting Documents.
1. The event transcript (and addendum).
2. Key lines of enquiry document.
3. Teenage Pregnancy Next Steps: Guidance for Local Authorities and Primary Care Trusts on Effective Delivery of Local Strategies (DfES 2006).
Author: Jim Brown
Senior Social Policy Officer
Stevenage Borough Council
01438 242914
Ref: End of project report – teenage pregnancy.
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Paper Tabled At Meeting – Latest Available Teenage Pregnancy Rates For Districts In Hertfordshire
Under 18's conception rates1998-00 / 1999-01 / 2000-02 / 2001-03 / 2002-04
Area of usual residence / Number / Rate / Number / Rate / Number /
Rate
/ Number / Rate / Number / RateBroxbourne / 169 / 39.2 / 173 / 38.7 / 188 / 40.7 / 173 / 36.1 / 186 / 37.8
Dacorum / 243 / 32.0 / 211 / 27.6 / 206 / 26.6 / 203 / 25.9 / 197 / 24.9
East Hertfordshire / 139 / 21.3 / 124 / 19.0 / 142 / 21.2 / 149 / 21.4 / 167 / 22.8
Hertsmere / 164 / 33.1 / 189 / 37.9 / 173 / 33.6 / 164 / 30.6 / 150 / 27.1
North Hertfordshire / 194 / 30.1 / 177 / 27.8 / 172 / 27.1 / 182 / 28.8 / 182 / 28.5
St Albans / 148 / 22.3 / 136 / 20.4 / 133 / 19.6 / 129 / 18.8 / 143 / 20.7
Stevenage / 234 / 52.3 / 252 / 53.6 / 265 / 54.5 / 256 / 52.4 / 220 / 45.1
Three Rivers / 138 / 29.6 / 119 / 25.3 / 121 / 25.9 / 112 / 23.4 / 122 / 25.0
Watford / 155 / 38.2 / 150 / 37.5 / 133 / 33.2 / 114 / 28.0 / 110 / 26.4
Welwyn Hatfield / 164 / 31.0 / 176 / 33.7 / 175 / 33.1 / 174 / 32.7 / 178 / 32.6
N.B. Rates are per 1000 female population aged 15-17. 2002-04 data are provisional. Sources: Office for National Statistics and Teenage Pregnancy Unit
Single Year Rates for Hertfordshire, East of England Region and England - For Comparison
2003 / 2004
Hertfordshire / 27.9 / 27.4
East of England / 33.3 / 32.8
England / 42.1 / 41.5
Conception Data Explained
ONS conception statistics are compiled from birth registrations and abortion notifications, and are the most accurate and robust data available to monitor
trends in teenage pregnancy. Conception statistics measure the actual date of conception, and not the date of the birth or abortion resulting from a conception.
As conception statistics are partly compiled from birth registrations there is an inevitable time lag in their release. Birth registrations can be done up to six
weeks after birth so information on conceptions leading to birth may not reach ONS until up to 11 months after the date of conception. ONS require a further
Three months to compile the statistics so data are released 14 months after the period to which they relate. ONS release quarterly information for counties but
not for districts.
Version: 2002-2004 Provisional. Shared 8 September 2006
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