Agenda item

6.1

Sue Greig and Amy Buddery from the Children, Young People and Families (CYPF) Public Health Team, Sheffield City Council, provided an update on teenage pregnancy statistics in the City. 

6.2

Ms. Buddery reported that Sheffield was on track to meet the targets set for 2020. She added that there had been a decline in the number of teenage pregnancies, which was encouraging but that the number of young people under the age of 16 choosing to deliver their babies had increased. She added that Sheffield was the third best performer in terms of core cities for reducing the number of teenage conceptions, but she added that the maternity rate had increased, and the abortion rate had also dropped.  She outlined some of the vast inequalities across the City, highlighting statistics in particular postcodes to show the differences which existed. 

6.3

She went on to report that there would be a new integrated model for the delivery of sexual health services  which would come into effect from 1 January 2014, which  would see sexual health services delivered via a One Stop Shop approach. There were currently   two main centres, at the Genito-Urinary Medicine (GUM) centre at the Hallamshire Hospital, and the Central Health Clinic on Mulberry Street. This would form part of a hub and spoke model, with these two centres as the hubs, and a series of community outreach sites to complement them. 

This new model would provide an increased choice of access for young people, either in the community, or in a more ‘anonymous’ city centre setting, depending on what they preferred. The model would also see work continue with colleagues in the School Nurse team, Community Youth Teams and GP practices across the City.  She emphasised that this was a priority area of work for the Local Authority.

6.4

Members of the Committee raised questions and the following responses were provided:-

·                       It was agreed that it would be beneficial to examine the wider surroundings of a young person’s situation, not just the postcode where they lived. This could take into consideration the welfare benefits received, employment, family history and education. Ms. Buddery confirmed that she was already involved in an extensive piece of work of this nature with the University of Sheffield, which was examining wider factors such as these and the correlation to teenage pregnancy.

·                       There were  a number of theories of why the number of abortions had declined in the under 16s, with factors such as young people not having the confidence to access services, and therefore presenting themselves too late to have a termination. There were also concerns around young people’s aspirations.

·                       It was confirmed that there were no exact figures for the number of repeat terminations, particularly for the under 18s, but it was suspected that the number was fairly low. It was agreed that there needed to be more robust data-sharing arrangements in relation to this.

·                       It was confirmed that all young women accessing sexual health services were offered contraception proactively. This was in the form of Long Acting Reversible Contraception (LARC), alongside other methods.

·                       There were concerns that the centre at the Hallamshire was not ‘young person’ friendly, but Ms Buddery emphasised that this was just one venue where young people were able to access services.

·                       She confirmed that the Hallamshire site offered specialist ‘young people only’ clinics and staff working there included specialist Doctors and Nurses trained in working specifically with young people.

·                       The Mulberry Street Clinic had always been traditionally very young person focused and the sexual health service had plans underway to further develop the young people’s offer at the city centre site.

·                       The new integrated service was being delivered by Sheffield Teaching Hospitals, which was why it would be hosted at the Hallamshire site, not the Children’s Hospital. There was also close working with the Jessop’s Wing, and specialist Saturday youth clinics were delivered by the Mulberry Street Clinic.

·                       There were concerns that sex education for young people with Special Educational Needs was not fit for purpose, and it was agreed that this would be considered as part of the peer led citywide review of the provision of Personal, Social and Health Education (PSHE), including sex and relationship education, which was being led by the CYPF Public Health Team.

·                       Members were concerned that the service was on track to meet targets currently, and that by reorganising the service this might potentially damage the progress made. Ms Buddery confirmed that the plans had been made in line with national recommendations, and that integrated services had been in operation in Newcastle for four years, which were working extremely well. The service would also be performance managed to ensure that delivery progressed as expected and sexual health outcomes were achieved.

·                       It was confirmed that not all schools proactively delivered a comprehensive timetabled programme of sex and relationship education, but that sex and relationship toolkits were available for both primary and secondary schools.  A plan to undertake a citywide peer led review of PHSE to include sex and relationship education had been presented to both the City Wide Learning Body and the Children’s Health and Wellbeing Partnership Board, and both committees had endorsed this.

·                       There was an emphasis on the importance of safeguarding and data-sharing, and it was confirmed that further work was required to understand the pathways which existed to support women having multiple births and repeat abortions. It was highlighted that any vulnerable women identified during pregnancy were offered enhanced access to LARC on Jessop’s Wing.

·                       Statistics for teenage pregnancy were currently received via the Office for National Statistics and via local sexual health services, which had been used to inform the report.

·                       It was agreed that more work was needed to help give young people the courage and confidence to access services at the right time, and to raise self-esteem and aspirations.

·                       It was noted that the teenage pregnancy rate for Looked After Children was three times higher than the national average the last time it was investigated.

·                       Members were interested to see how many babies delivered resulting from teenage pregnancy went on to become adopted.

·                       It was noted that there was joint work happening across South Yorkshire already in relation to sexual health, and that some services could be commissioned jointly in the future.

·                       There were concerns that the sexual health service were sending out letters inviting people for Sexually Transmitted Infection screening when they may not be potentially ‘at risk’ but Ms Buddery confirmed that an age group would be targeted for a particular campaign, i.e. chlamydia screening which aims to offer screening in people aged 15-24 years, just as over 50s would be targeted for breast screening, etc, and that it was often a ‘blanket’ approach. Ms Buddery highlighted the fact that she was working with the sexual health service to identify which interventions were the most cost effective, as sending out mail outs may not be an approach used for the future. 

·                       Members congratulated the service on the excellent results achieved.

6.5

RESOLVED: That the Committee:-

(a)       notes the contents of the report now considered;

(b)       welcomes the new approach towards an integrated service;

(c)        offers its congratulations to the service for the excellent work achieved and requests that the Policy and Improvement Officer writes to the service on behalf of the Committee to congratulate them;

(d)       requests information to be sought from Social Care teams to assess how many teenage pregnancies result in adoption;

(e)       requests a full breakdown of the City by area with the numbers of teenage pregnancies in each Ward;

(f)        requests a report back on the wider factors surrounding teenage pregnancy resulting from the work carried out with the University of Sheffield;

(g)       requests that a review be conducted into the quality of sex and relationship education currently provided for young people with Special Educational Needs; and

(h)       requests a further report to the Committee in June 2014, to assess the progress of the new integrated service.