Contact: Roger Street Tel: 023-8061-4179 [email protected]

1 Summary

1.1 Under the ten-year national Teenage Pregnancy Strategy established in 2000, each top-tier local authority was required to devise a local strategy and set targets to reduce the Under-18 teenage pregnancy rates and to reduce the social exclusion experienced by teenage parents. Hampshire County Council took on the responsibility from the three former Area Health Authorities to coordinate the local strategy in 2002/3 and a multi-agency Teenage Pregnancy Partnership was formed, supported by a Strategic Manager. Formal assessment by the national Teenage Pregnancy Unit ended in 2005 as local strategies became integrated into Children's & Young People's Plans, but we have received positive feedback from the Government Office, South East that the Hampshire Teenage Pregnancy Partnership is addressing the right priorities.

1.2 The provisional Under-18 conception rates for 2004 were released in February 2006 and show a 15.8% reduction from 1998 - this exceeds our nationally set target of a 10% reduction and we have been included in the group of authorities likely to reach their 2010 targets.

1.3 The indicator used nationally to measure social exclusion experienced by young parents is the percentage of young mothers age 16-19 in education, employment or training. The Connexions database is used for this purpose and indicates that as of 31 March 2006, 19% were in education, employment or training - our nationally set target for 2010 is 60%.

1.4 The Teenage Pregnancy Strategy supports:

1.4.1 Aim One of the Corporate Strategy (Maximising life opportunities) by developing and improving the provision of learning and childcare for teenage parents so that they can reach their potential in society.

1.4.2 Aim Four of the Corporate Strategy (Building strong and safe communities) by reducing teenage pregnancies with its propensity to lower birth weights and higher rates of infant mortality.

1.4.3 Aim Five of the Corporate Strategy (Improving Services) by reducing the prejudice often experienced by pregnant teenagers and teenage parents.

1.5 The Teenage Pregnancy Strategy supports:

1.5.1 Aim One of the Children Act 2004 (Be Healthy) by preventing unintended teenage pregnancies and reducing sexually transmitted infections, whilst contributing towards lowering the rates of infant mortality.

1.5.2 Aim Two of the Children Act 2004 (Staying Safe) by helping young people to develop healthy, fulfilling relationships.

1.5.3 Aim Five of the Children Act 2004 (Economic Well-being) by helping young parents to attain better qualifications and to improve their family income.

2 Background:

2.1 The United Kingdom has the highest teenage pregnancy rate in western Europe and following a report into the social outcomes of teenage pregnancy by the Social Exclusion Unit in 1999, a ten-year national strategy was developed with the twin goals of halving teenage pregnancy by 2010 and providing better support to teenage parents.

2.2 The strategy forms part of the overall approach to reduce social exclusion, linking particularly to the actions taken to reduce childhood poverty, reduce the number of young people not in education, training or employment and inequalities in health. There are natural links to the national HIV and Sexual Health Strategy (2001) and initiatives included in the White Paper, Choosing Health, (2004) and the National Service Framework for Children, Young People and Maternity Services (2004) .

2.3 Initially the former health authorities were responsible for local implementation of the strategy. Upon their abolition in 2002, the responsibility was transferred to each top-tier local authority which was required to establish a multi-agency teenage pregnancy partnership and to ensure there were effective arrangements for local co-ordination. Hampshire established its Partnership in late 2002 and appointed a strategic service manager in January 2003 to provide coordination.

2.4 A specific grant is given nationally in England to each top-tier local authority to support this work until March 2008. Hampshire County Council's excellent Comprehensive Performance Assessment rating means that this grant is no longer ring-fenced. However, in recognition of the effective partnership approach being undertaken locally, the Cabinet agreed to continue to fully passport the funding to the Hampshire Teenage Pregnancy Partnership in 2004-05 and this was confirmed by the (then) Children's Services Board for 2006-7.

2.5 The national Teenage Pregnancy Unit set three targets for Hampshire taking into account that the conception rates in Hampshire County Council were already below the national average in 1998:

2.5.1 A 45% reduction in the 1998 under-18 conception rate by 2010 with an interim 10% reduction by 2004.

2.5.2 Establishing a firm downwards trend in the under-16 conception rate by 2010.

2.5.3 60% of young mothers aged 16-19 to be in education, employment or training by 2010.

2.6 These targets are shared by the South Central Connexions Partnership which covers Hampshire and the Isle of Wight. The target for reducing the under-18 conception rate is included in the corporate performance review, best value and Children's Services Department's performance assessment. It is also included in the performance assessment of the Primary Care Trusts and Joint Area Reviews.

2.7 National research has indicated that Children Looked After and Care Leavers are groups that are particularly vulnerable to teenage pregnancy. The Partnership's work contributes towards efforts to improve PAF indicators on the health of Children Looked After and the education, employment and training of Care Leavers.

2.8 The Hampshire Teenage Pregnancy Partnership's membership includes representatives from: Children's Services: Youth Service, Early Education and Childcare Unit, education & social care (which currently hold the chair), Connexions, each Primary Care Trust (who chair the eight local multi-agency teenage pregnancy implementation teams around the county), Housing Officers, Supporting People, voluntary sector, colleges, Learning and Skills Council, Youth Offending Team, Healthy Schools and a young mother.

3 Performance assessment for report for 2005-6

3.1 The national Teenage Pregnancy Unit and Government Office, South East ceased formally assessing local Partnership's performances in 2004/5 and progress is now monitored through the two key indicators of Under 18 conception rates and proportion of young mothers age 16-19 in education, employment or training. These are included within the Joint Area Review and most of assessments listed in 2.6 above.

3.2 The latest available data for Under 18 conception rates indicates a 15.8% drop in Hampshire since the baseline year of 1998 to 30.2 conceptions per thousand young women age 15-17 in 2004. This compares to 11% drop nationally in England to a rate of 41.5 and a 11.4% drop for the South East of England to 33.5. Hampshire has been included in the list of authorities on track to reach its 2010 target. (NB The delay in publishing the data results from the time taken for the Office of National Statistics to collate the required birth and abortion data.)

3.3 The latest available data for Under 16 conception rates in Hampshire is 5.3 conceptions per 1000 young women age 13-15 in 2003 which shows a14.5% reduction from 1998. This compares to an English national 2003 rate of 7.9.

3.4 Both the Under 18 and Under 16 rates vary from year-to-year but there is an overall downwards trend in both, compared to 1998.

3.5 It has been agreed with the Government Office, South East to use the percentage of mothers age 16-19 in education, employment or training against the number of births to young mothers age Under 20 in Hampshire in the preceding year, as the performance indicator for measuring the social inclusion of teenage parents. As of 31 March 2006, this was 19%.

3.6 The Partnership completed a 2005-6 Annual Report and agreed a 2006/7 Action Plan which were submitted to the Government Office, South East for information and we have been advised that our priorities are in line with their expectations.

4 Sex & Relationships Education:

4.1 An extensive multi-agency Sex & Relationships Education (SRE) training programme has been delivered with over 800 practitioners involved in some form of training since 2004. The programme comprises Tier One and Tier Two courses with linked modules covering a range of issues e.g. SRE and faiths, cultures & ethnicity; Working with young men on SRE; Sexuality & SRE. Links have been developed with training on drug and alcohol issues, and a new training module is being planned to link into training on mental health issues and emotional well-being provided by the Child and Adolescent Mental Health Service.

4.2 Eight local SRE Forums have been developed for teachers and agencies working in the secondary sector to improve the quality of SRE in schools and there is joint delivery of the accredited Personal, Social & Health Education (PSHE) Certificate for teachers and nurses with the school Personal Development Learning Inspection/Advisory Team. Work to improve SRE in Primary Schools, particularly around approaches to puberty issues, self-esteem and friendships is being developed jointly with the national Healthy Schools Partnership.

4.3 Each school consults with its parents, pupils and community before adopting its SRE policy which makes it difficult to ensure any uniform standard of quality or content. Curriculum time is often under pressure and much of SRE remains an optional topic for schools to cover, particularly the non-scientific aspects e.g. relationships, sexuality, abortion, which young people regularly cite as aspects they would like to be covered in school. Members of the UK Youth Parliament have been campaigning locally and nationally to include more SRE within the national curriculum. Teaching SRE can be challenging and unfortunately, few teachers entrusted with this responsibility have been given the time to access appropriate specialist training. The involvement by school nurses in SRE lessons has reduced or stopped in several areas due to staffing reductions necessary for Primary Care Trusts to meet their budget recovery plans.

4.4 In February 2006, the Partnership launched its Delay training programme for practitioners, geared to helping them with practical strategies for working with young people, which encourage them to delay their sexual activity until they feel they are ready. A county-wide project is under way which will result in posters and leaflets being published, giving young people's ideas on how to resist pressure to have unwanted sexual activity before they are ready.

4.5 The Partnership has been working with the local branch of Parentline Plus, a national voluntary organisation to promote their Time to Talk campaign which supports parents to talk to their children about sex and relationships. Training is given to parenting course tutors on strategies which they can pass on to parents to help with this potentially difficult area.

4.6 Most of the Under 18 conceptions are to young women age 16-17 and the Partnership is encouraging and supporting colleges and training providers to be pro-active in delivering SRE and promoting appropriate services. A conference is planned for 31 October 2006 and in-house staff training has been provided for some colleges.

4.7 Research has shown that young people who are not fully involved in education, employment or training, homeless young people, young offenders and young people in care/care leavers are particularly vulnerable to teenage pregnancy/parenthood. The Partnership has supported the Youth Service, Youth Offending Team, South Central Connexions and former Social Services to develop their SRE policies. Practitioners from these agencies are accessing SRE training, along with Borough Council community wardens, Housing support workers, foster carers and mentors working with Children Looked After and Care Leavers.

4.8 When establishing the local strategy, several young people with Special Educational Needs complained that they received little SRE and a number of teachers asked for more support. Several conferences and training sessions for practitioners have been organised and new resources given to schools. Working with health colleagues and the Healthy Schools Partnership, in-house training has been given to several staff teams.

5 Information on Services

5.1 The Partnership has actively promoted the national information website, www.ruthinking.co.uk and support telephone line to young people, updating information on local services on a regular basis. National campaign materials have been widely distributed and are on display is schools, colleges and venues used by young people. The national materials link in to a national radio and media advertising campaign geared to young people.

5.2 Working with Connexions, localised pull-out information leaflets have been produced covering a wide range of services, including those related to contraception and sexual health. South Central Connexions have confirmed that they now have SRE information in 184 of their information outlets across their area.

5.3 Localised referral flowcharts and checklists have been produced for practitioners working with young parents and young women who think they may be pregnant. These have been supplemented by posters and leaflets for young women about what to do if they think they might be pregnant.

5.4 Generic publicity has been devised and adopted for the eight condom distribution schemes and seven pharmacy emergency contraception schemes which exist in the county so that young people can recognise and access services as they move around the area.

5.5 The new approach to the Health Reviews of Children Looked After now routinely includes contraceptive and sexual health issues as appropriate. Information on contraceptive and sexual health services is now included in Care Leaver packs.

6 Improved access to services

6.1 Young people regularly express their concern over the level of confidentiality provided by services - this was illustrated once more by the consultation undertaken with young people for the Targeted Youth Support Pathfinder Project in Test Valley. Free training and resources have been offered to GP practices around the county, though the take-up remains patchy. Working with the Healthy Schools Partnership and Governor Services, training was offered to school governors on the need for a school confidentiality policy and the process for its development. A guide has been written and will be circulated to all schools in September, along with training materials which can be used in-house. The launch of the revised Health of Children Looked After and the Sexual Health & Education policies for social care staff produced a number of significant issues around confidentiality issues, medication, information-sharing and recording which are being addressed.

6.2 Working with the former Hampshire Area Child Protection Committee, an Interim Protocol for reporting Under-18 sexual activity was agreed which aims to help practitioners identify child protection issues in the context of the Sexual Offences Act, 2003. This has been used in the training of staff involved in providing contraceptive and sexual health services to young people. Following the publication of the national revised Working Together to Safeguard Children document (2006), a revised Protocol will be considered by the new Hampshire Safeguarding Children Board.

6.3 Specialist health services for young people have generally been maintained around the county in spite of financial pressure within the local NHS economy, though in a number of cases they have been reduced to one nurse on duty with a limited range of treatments available. Connexions and the Youth Service continue to support young people's health drop-ins around the county.

6.4 Each PCT has a designated nurse for Children Looked After and these posts have made a significant impact in helping Children Looked After to discuss contraception, sexual health and relationship issues, supporting them to speak to their parents/carers and to access to specialist services where required. Increasing numbers of residential home staff, foster carers, social workers and leaving care mentors have been accessing the SRE training and are able to better support young people in our care.

6.5 Several young people's health drop-ins have been established on, or near school sites around the county offering support on a wide range of issues which can worry young people. The models vary and most involve support from health, Youth Service and other agencies. Staunton Park Community School in Havant has been working with the local health services to develop the Health Place where pupils and young people from the community can access support from counselling to quit smoking and a range of health issues.

6.6 The pharmacy emergency contraception scheme has now been fully extended around the county through all seven Primary Care Trusts. This enables young women, (and in some cases, all women), to access free emergency contraception from a trained pharmacist, subject to a confidential interview which covers child protection issues and other concerns.

6.7 Research indicates that young people are more likely to use condoms if they use them the first time they have sex. The community condom schemes, which enable young people to access free condoms following appropriate advice and training, have been further developed around the county and publicised under the title of Get it on. Increasingly colleges, training agencies and practitioners from a wide range of agencies who work with vulnerable young people are becoming more involved in the scheme.

6.8 Pregnant young women are often late to access support services which can result in later abortions or poorer health outcomes for both themselves and their baby. The Partnership is working to improve access to free pregnancy testing with appropriate support to the young woman.

7 Education, employment and training

7.1 The Education Welfare Service has been liaising with schools and other agencies to assist pupils who decide to continue their pregnancy, or those who become parents to remain involved with their education. On 31 May 2006, 22 pupils in Hampshire's schools were known to be continuing their pregnancy, of whom 73% were in regular attendance, whilst 16 were mothers of whom 68% were studying, (including those with EOTAS support at home), 13% on maternity leave and 19% not attending. 22 of these 38 pupils are in Year 11. The Partnership worked with the former Education Department to publish and circulate guidance to schools on how to reintegrate a pregnant pupil or school-age parent. A Reintegration Fund was created to support schools to take a flexible approach and positive levels of attainment have been recorded where grant applications were made.

7.2 The national Care to Learn scheme provides young parents under 20 with childcare funding whilst they are in publicly funded education, training or involved in volunteering schemes. The Partnership has been working hard to promote the scheme to young parents and to help overcome barriers which vary from feeling they are abandoning their baby if they go off to study, to availability of childcare provision and appropriate learning opportunities. On 31^st March 2006, there had been 60 applications for funding by young parents in Hampshire during the current academic year - a rise from 46 a year before. In January 2006, the proportion of mothers Under 19 making Care to Learn applications in Hampshire was slightly better than other local authorities referred to as our statistical neighbours. (NB The eligible age rose to under 20 in April 2006.) A significant number of young parents will use informal childcare provided by their family network which is not eligible for Care to Learn funding but this still indicates that much more needs to be done to encourage and support young parents to re-enter education and training.

7.3 Working with the Learning & Skills Council, the Teenage Pregnancy Partnership has been trying to develop more training opportunities geared to young mothers and a Young Mums 2B course has just commenced in Havant, based at the Sharps Copse Children's Centre.

8 Support for young parents

8.1 Three specialist Connexions Personal Advisers are joint-funded with Connexions and located in local health services, whilst a fourth is fully funded by Connexions - these are all in the higher rate districts of Hampshire and have proven successful in helping young parents to overcome a wide range of issues and to support them into education, employment or training.

8.2 Young mothers under 20 tend to avoid health services and parents groups due to fear of stigmatisation and prejudice. Young parent groups have been formed around the county in most areas where there are higher numbers - these are usually supported by a mix of staff from Health, Youth Service, Connexions and local voluntary organisations. The groups focus on informal education around parenting and self-esteem issues whilst supporting individuals with housing, benefits, relationships and other problems. Work is under way to link these groups to the developing Children's Centre and Parenting Strategies, both of which will have a focus on work with young parents.

8.3 The Partnership produced both Young Father and Young Mother information packs which have been circulated widely via midwives and other agencies - following a successful evaluation, these will be amended and a new batch produced.

9 Housing

9.1 In common with other groups of vulnerable young people in Hampshire, housing remains a major issue for many young parents. Working with the district housing authorities, the Partnership has undertaken a best practice audit of all the housing authorities in respect to housing issues for young parents. In liaison with Supporting People who contract organisations to provide tenancy-related support, research was commissioned to look at the quality of this support from the young parents' perspective.

9.2 Using a self-assessment process, the majority of housing authorities in Hampshire reported that they were following most of the best practice guidance suggested by the Partnership, and there are some good examples of supportive schemes around the county. Housing authorities are continuing to improve their approaches, but some challenging issues remain:

9.2.1 In some areas, parents living in supported housing schemes are waiting long periods for a permanent home which can lead to these schemes being blocked to other young parents/pregnant young women. The general shortage of affordable housing in the south east is a key factor in this issue.

9.2.2 Some young parents and pregnant young women have experienced difficulties in accessing accommodation via their housing authorities, mainly due to meeting the legal tests required to prove homelessness. The Partnership has endeavoured to help housing authorities improve their understanding of best practice as cases come to light.

9.2.3 Some supported accommodation provided for young mothers will not allow fathers to visit, or to live with them, whilst others permit a maximum stay of three nights per week. Eligibility for benefits can also impact upon this issue as it is often substantially reduced if she is cohabiting -sometimes to the point where the couple's accommodation costs cannot be met.

9.2.4 In some cases, young mothers are temporarily housed with other groups of vulnerable young people which can be stressful to them in their new parental role.

9.3 The above points have been raised with the appropriate housing authorities and Supporting People for them to consider how improvements can be made.

10 Sexual health

10.1 The former Children's Services Board agreed the Partnership's wish to formally extend its remit to cover the sexual health of young people in Hampshire for 2006/7. The Havant Teenage Pregnancy Project Worker, which was fully funded by the Partnership has now been appointed to the post of Young People's Sexual Health Project Worker for South East Hants, jointly funded with the local PCTs.

10.2 The Chlamydia Screening Programmes are continuing to extend their reach into the 15-24 sexually active population and indicate a 10% positivity rate. Unfortunately the PCTs in South West Hampshire have diverted the funding provided to extend the Programme into the New Forest and the rest of Eastleigh Borough towards their financial recovery plan, so this will remain the only part of the county without the screening programme in operation.

11 Participation by young people

11.1 Young people have been regularly consulted on their thoughts to improve sexual health and to reduce teenage pregnancy - the Partnership's Action Plan has been developed in response to their comments. A young mother is a member of the Partnership and the Strategic Manager regularly visits groups of young people to discuss current work and to give/receive feedback on actions taken.

11.2 Young people are involved in delivering several training courses and young parents are helping to prepare a new training course which they will co-deliver, for practitioners to learn more about the barriers faced by young parents.

11.3 The County Youth Service was commissioned to develop a peer education programme involving young parents from Andover and it is intended that they will be involved with local SRE lessons in 2006/7.

11.4 Publicity materials and information leaflets are designed with young people, and often by young people.

11.5 Young parents from Basingstoke and Andover were involved in a consultation event on the Children & Young People's Plan.

11.6 Several groups of young people around the county have undertaken Snapshots visits to local sexual health services. These involve them working with a youth worker, teacher or health practitioner and visiting a service to find out how young-people friendly it is. Photographs and questionnaires are used so that the young people can prepare a report for their class/youth club when they return and so that they can feed back comments to the service.

12 Future of the Teenage Pregnancy Partnership

12.1 Whilst the national grant to Hampshire County Council for work on reducing teenage pregnancy will continue until 2007/8, the Children's Services Partnership Management Board has yet to decide how the teenage pregnancy and sexual health agenda will be managed and funded beyond 2006/7. This discussion will be part of the process in deciding future Outcome Partnerships and the way forward for joint commissioning.

13 Legal implications

13.1 None

14 Financial implications

6.1 None

15 Personnel implications

15.1 None

16 Impact assessment

16.1 Teenage parents significantly experience social exclusion and prejudice with British society and young people are disproportionately affected by sexually transmitted infections, compared to other age groups which is why the Partnership has developed an action plan specifically for this age group.

16.2 Research evidence suggests that young people from some ethnic groups are more prone to teenage pregnancy than other groups but the lack of ethnicity recording by local health services, currently prevents a local factual analysis.

16.3 There are different views on sex and relationships issues held by religious and cultural groups. The Partnership works with faith-based groups on different aspects of its Action Plan, though when there is disagreement, the Partnership has adhered to the current legal position which is sometimes being actively challenged by certain faith-based groups.

16.4 Research evidence suggests gay, lesbian and bisexual young people suffer badly from bullying and prejudice, often resulting in isolation and associated problems.

17 Crime prevention issues

17.1 The decision requested will not impact on crime prevention issues.

18 Views of the Local County Councillor

18.1 Not applicable.

Recommendations

1 The Committee is asked to note the report and the progress achieved.

2 The Committee is also asked to commend the achievements of the Hampshire Teenage Pregnancy Partnership as a positive example of partnership working in the county.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB: the list excludes

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

Hampshire Teenage Pregnancy Partnership Action Plan 2005/6

Hampshire Teenage Pregnancy Partnership Action Plan 2006/7