Reducing teenage pregnancy and support for young parents action plan 2012 - 2015 www.cornwall.gov.uk Dear Friend I have great pleasure in recommending the “Reducing teenage pregnancy and support for young parents” action plan to you. It is essential that if we are to maintain and improve on the great strides made in this service over the last 3 years and further improve outcomes for our children and young people, we must maintain the momentum by further working together within our communities and with our young people – this action plan details just some of the ways in which we intend to do this. Working together in this arena is not a new concept – in fact, here in Cornwall, we have been working in a joined up way for many years, and I am glad to say we have seen many successful initiatives which have become nationally recognised best practise developments. I am convinced that together we can and will further improve our commissioning and provision of services to young people as they enter adulthood. I would like to thank and applaud the dedication and ownership of everyone that is involved in providing services to young people within the public, voluntary and community sectors who continue to play their part and have the greatest pleasure in endorsing this document to you. Most Truly Neil Neil Burden CC Cabinet Member for Children’s Services and Deputy Leader Cornwall Council We intend for this Action Plan to be a live document that will be amended and updated as work develops and partnerships are made. The actions detailed have been agreed by Cornwall Council, NHS Cornwall and the Isles of Scilly and the partners referred to. This version is accurate only at point of publication. For development around particular action points, or if you would like to work in partnership with the Action Plan, please contact teenagepregnancy@cornwall.gov.uk Contents Page Priority 1 To provide early intervention for young people who are deemed to be at increased risk of teenage pregnancy and poorer sexual health. Key objective 1.1 Key objective 1.2 Key objective 1.3 4 9 10 Key objective 2.1 11 Key objective 3.1 Key objective 3.2 Key objective 3.3 Key objective 3.4 Key objective 3.5 14 15 16 18 19 Key objective 4.1 Key objective 4.2 Key objective 4.3 Key objective 4.4 21 25 27 28 Key objective 5.1 Key objective 5.2 Key objective 5.3 29 32 33 Key objective 6.1 35 Priority 2 The needs of young people who come under the remit of the Teenage Pregnancy Action Plan is understood and addressed through eff ective use of local data. Priority 3 Increase access to Contraception and Sexual Health Services so that young people have easier access to contraceptive and sexual health services and a greater choice of contraceptive methods across Cornwall9. Priority 4 Children, young people and their parents will benefit from high quality relationships and sex education provision, advice and guidance on a formal and informal basis, in a variety of settings. Priority 5 Protecting the future health and wellbeing of teenage parents and their children. Priority 6 Workforce development that takes a sustainable approach to ensuring that children, young people and families have access to professionals who can effectively support them. Teenage pregnancy action plan 3 Priority 1 To provide early intervention for young people who are deemed to be at increased risk of teenage pregnancy and poorer sexual health. Key objective: pathways for identifying children and young people ‘at 1.1 Develop risk’ of early sexual activity and teenage pregnancy and offer early intervention and support. Evidence suggests that early intervention to promote social and emotional development can significantly improve mental and physical health, educational attainment and employment opportunities as well as prevent teenage pregnancies, drug and alcohol misuse and criminal behaviour1. pregnancy and sexual health in their work with schools. School nurses are commissioned to be highly visible and accessible to pupils in school and at a minimum provide a weekly drop in clinic, plus targeted interventions for any young people who may need additional support, advice, or guidance, including vulnerable young people at risk from risk taking behaviours and poor sexual Effective early intervention with children and health. The new school nurse service specification families is a key component in Cornwall’s is currently being developed and as part of Children’s and Young People’s Plan2 and programme to safeguard children, and promoting this we are exploring the historical agreements surrounding the provision of contraception in positive outcomes for vulnerable children school and the role of the school nurse within is incorporated in the 2012/13 Safeguarding this. Improvement Plan3. In Cornwall the “CAF4” process routinely considers and addresses the needs of young people who are at risk due to both risk taking behaviour and difficult family situations. This is integrated into CAF training and guidance for completion of CAFs. School nurses in Cornwall are commissioned under the Healthy Child Programme5 which promotes prevention and early intervention with a specific emphasis on addressing teenage Our currently commissioned young parent service WILD continues to contribute to prevention work in Cornwall via a peer education programme; WILD trains young mothers to lead workshops with vulnerable groups in schools speaking about the realities of young parenthood. Young people who have participated in these workshops have commented on the benefit of learning from ‘real life’ people and felt it increased their understanding of teenage pregnancy, the realities of young parenthood, the benefits of safer sex and delaying parenthood. 1 Allen, G (2011) Early Intervention: The next steps, HM Government 2CYP3 Cornwall Children’s Trust: Children and young people’s plan 2012/13. 3 For more information on safeguarding procedures and requirements go to www.swcpp.org.uk 4 Common Assessment Framework 5 For more details about the Healthy Child Programme please visit www.dh.gov.uk 4 Recognising that young people in and leaving care are a particularly vulnerable group. WILD work in close partnership with Carefree, supporting young people in or leaving care through the joint delivery of the Developing Enterprise and Entrepreneurial Flare Course which aims to build confidence, aspirations and enterprise skills. WILD also fosters a strong working relationship with social care and youth work teams via joint workshops, cross-referrals, advocacy and training ensuring positive communications links are maintained with children’s workforce teams across the Authority. Poor sexual health can also be a risk indicator of potential abuse and child exploitation. The Local Authority has recently appointed a Lead for Child Sexual Exploitation Officer whose role involves implementation of the South West Child Exploitation Strategy in Cornwall. Lead for Child Sexual Exploitation Officer The Lead for Child Sexual Exploitation Officer’s duties include: • Working with other areas across the South West peninsula on a joint protocol and strategy for Child Sexual Exploitation (CSE) • Facilitating monthly area Missing and CSE operational forums to ensure multi-agency working and sharing of information to protect children and young people • Supporting workforce development via training, multi agency workshops and raising awareness sessions • Data collection and developing information sharing protocols and pathways in order to protect children and young people For more information about the post and CSE please contact jlwoods@cornwall.gov.uk or the Safeguarding Unit on 01872 254549. The Teenage Pregnancy Coordinator and Lead for Child Sexual Exploitation Officer work closely together to ensure an integrated approach around vulnerabilities and risk taking behaviour. The Teenage Pregnancy Coordinator sits on the Missing and CSE operational forums and the two posts are considering the potential for joint workforce training opportunities (please see priority six). Multi agency CSE awareness sessions will be taking place throughout Cornwall and the Isles of Scilly in January, February and March 2013. Brook also offer targeted work to those identified as at risk of poor sexual health, in particular through their boys and young men worker. Brook Boys and Young Men Worker The Brook Boys and Young Men Worker offers both one to one and group work support to boys and young men identified as exhibiting risky behaviour and poor sexual health in order to help them: • Acquire knowledge and understanding of sexual health • Increase uptake of Chlamydia screening and sexual health services • Form positive attitudes to relationships • Develop skills to enable them to participate in safer sexual relationships • Understand parenting issues, particularly among young fathers • Providing one-to-one education sessions for young men at risk of a poor understanding of healthy relationships, poor sexual health or displaying inappropriate sexual behaviour • Supporting youth organisations to develop ways of working with boys and young men We are currently evaluating the impact of this post and looking at options for the future. Teenage pregnancy action plan 5 Recognising how important positive aspirations and self esteem are to supporting positive outcomes for young women, Cornwall College in partnership with Leading Women UK, are developing ‘young women inspiration days’. These sessions, which are currently being piloted with young women in years 9, 10 and 11, aim to raise aspirations, confidence and self-belief alongside providing young people with an opportunity to meet and talk with positive role models. We know from research that both low aspirations and educational disengagement are significant risk factors in relation to teenage pregnancy and so look forward to hearing the outcomes from this pilot and the potential impact these sessions can have in addressing these factors. The SAFE Project 6 The SAFE Project, which sits within the Cornish charity Skoodhya, has delivered lessons around safe relationships and preventing domestic abuse to all year groups at two schools, Richard Lander and Pool Academy and to many of the County’s schools at Year 9, including on the Isles of Scilly, for the last four years. This has enabled young people to recognise warning signs that a relationship might be becoming abusive. either school’s anti-bullying policies but is now specified in both, supporting a position that bullying will not be tolerated, the sanctions that will be used to deal with it and the commitment on staff’s part to challenge it whenever it arises. The SAFE project have also been able to offer individual support on particular elements of domestic abuse on request from the schools they work with. The project has strong links with colleagues at the Willow Centre, Cornwall’s Sexual Abuse Referral Centre, as a result of students they are working with speaking to workers about their experience of rape and the ongoing Police investigations. Sexual bullying was not previously covered in In the academic year 2012/13 the SAFE project are working with secondary schools in Wadebridge, Truro, Saltash, Launceston, Helston and Falmouth and are always interested in taking the project to other schools who might be interested. For more information please contact Sarah Leigh on Sarah.Leigh@victimsupport.org.uk What we need to do: Action Evidence we have done so Who should make sure this happens We want young people to understand the difference between positive and negative relationships and be able to make positive choices about the relationships they embark on. To support this CLEAR (Children Linked to and Experiencing Abusive relationships) have been commissioned to develop an educational intervention to be delivered across schools. This interactive programme will promote positive aspirations and self esteem alongside understanding of healthy and risky relationships. The programme will also signpost young people identified to be experiencing, or linked to abusive relationships, into the organisations’ therapeutic service. The CLEAR Healthy relationships programme delivered to Year 9 pupils in the Safer Town schools6 by July 2013. Community Safety and Protection, Cornwall Council We will establish a consistent and effective form of two way communication with front line practitioners in order to disseminate up to date information across the workforce as well as gain feedback from frontline staff about their experience and perception of needs. The Healthy Relationship Programme will be measured by the impact of the programme on the attendees including being able to evidence that as a result of attending the programme 90% of attendees can as a minimum; • Differentiate between positive and negative relationships • Understand the importance of own self-esteem and respect and have achieved a higher level of self-esteem and respect for self and others through the programme • Understand and be able to identify pressures and expectations within relationships and to make informed decisions that prioritise their needs and are respectful to themselves and others • Understand the impact on their own health and wellbeing if engaging in risky behaviour • Be able to identify warning signs within their own relationships • Understand the range of services for support and be able to access support Either the establishment of a Teenage pregnancy practitioner network, or The inclusion of the teenage pregnancy agenda onto an existing network, or Supporting Families, Cornwall Council Ensure updated information about services, strategies and resources are available via an existing information channels. 6http://safercornwall.co.uk/make-a-difference/priority-areaspriority-actions/ Teenage pregnancy action plan 7 What we need to do: Action Evidence we have done so Who should make sure this happens We recognise that many young people who are engaged with our Children’s Social Work and Psychology Service care may be vulnerable to poor sexual health. This includes children and young people who are in care as well as those who have a child protection or child in need plan. We also recognise that children and young people with additional needs may need additional support. Membership of taskforce agreed and group established. Supporting Families The development of practice guidelines that align with current child protection procedural manual. Children’s Social Work and Psychology Service, Cornwall Council We will put together a task force of frontline practitioners and policy leads to develop practice guidelines for workers which assists them to identify and work with children and young people at risk of poor sexual health and teenage pregnancy. Potential indicators: The taskforce will consider the differing remits and relationships of the various roles across the workforce including, but not limited to, assessment worker, family support worker, residential worker and foster carer. We also recognise that Locality based Integrated Youth services, and those providers externally commissioned to provide these, as key partners delivering direct work with young people. These services both universally promote positive relationships and sexual health as well as identifying young people at risk of poor sexual health to whom they can deliver direct interventions. To ensure the work of the services continue to be positive and current we will undertake a review of the service’s Relationship and Sex policy and practices including a review of the multi-agency sexual health training for practitioners. 8 Practice guidelines agreed by Senior Management team and Children’s Leadership Group. Implementation of practice guidelines across the Children’s Social Work and Psychology Service. Evidence that risk factors have been considered and appropriate action taken within case notes Young people and children’s workforce reporting an increase in advice provided by professionals. Updated Relationship and Sex policy implemented across Integrated Youth Services. Refreshed sexual health training for frontline workers. Supporting Families, Cornwall Council Key objective: 1.2 Increase our understanding of the needs of teenage parents and the reasons why they have become teenage parents. In 2012 we interviewed the education group: Young Mums Will Achieve to try and better understand the reasons why these young people became young mothers and to see if there were common factors within their lives with which they would have benefited from more support. We are currently in the process of analysing the results. Role of the Teenage Pregnancy and Sexual Health Coordinator Cornwall and the Isles of Scilly PCT currently fund the teenage pregnancy and sexual health coordinator role which is hosted by Cornwall Council. It is the Coordinator’s duty to be an advocate for the reducing teenage pregnancy and supporting teenage parent strategy. The Teenage Pregnancy Coordinator forges links with relevant areas of work addressing the risk indicators related to early sexual activity and teenage pregnancy in order to identify areas for joint work. This includes, but is not limited to: • • • • • • • • Social Care Early intervention Domestic violence Resilience and aspirations Sexual exploitation Youth homelessness Child poverty Troubled Families What we need to do: Action Evidence we have done so Who is responsible Use the information shared with us by the YMWA group and from WILD outcomes data to better understand the needs and experiences of young people who do become pregnant and use this to shape services for teenage parents in the future. We also plan to conduct further research with a wider, larger group of young people – including young fathers and those working with the Family Nurse Partnership - to further increase our understanding of our local needs and experiences. A literature review will also be undertaken to see if there are specific differences which impact on choices made locally. A direct link between research outcomes and service development. Supporting Families, Cornwall Council Cornwall College The outcomes of this research project will be published and used internally to highlight areas of need and potential trends in those vulnerable to early parenthood. Supporting Families, Cornwall Council Family Nurse Partnership, Cornwall Foundation Trust Teenage pregnancy action plan 9 Key objective: 1.3 Ensure that the Teenage Pregnancy Strategy is linked to other relevant strategies relating to vulnerable children, young people and families. A reduction of teenage pregnancy rates can only be achieved if action is taken to address the underlying factors that increase the risk of teenage pregnancy, such as poverty, educational underachievement, low aspirations and lack of engagement in post-16 education and training. The Teenage Pregnancy and Sexual Health Coordinator role has a responsibility to forge links with relevant areas of work addressing the risk indicators related to early sexual activity and teenage pregnancy in order to identify joint agendas and opportunities as well as represent the strategy and the needs of the co-hort of young people identified by the strategy. What we need to do: Action Evidence we have done so Who is responsible Teenage pregnancy and sexual health coordinator to strengthen links with: The teenage pregnancy agenda is represented in appropriate working and strategic groups. Supporting Families, Cornwall Council • • • • Evidence of joint working with identified areas. Child Sexual Exploitation Officer Social Care and Psychology Service Family Intervention Project Domestic Abuse and Sexual Violence Strategic Coordinator • Troubled Families Officer 10 The teenage conception rate remain a key performance indicator for the Supporting Families Service Plan and Cornwall remains comitted to a 50% reduction from the 1998 baseline as set out in the Governments 1999 national reducing teenage pregnancy strategy. Priority 2 The needs of young people who come under the remit of the Teenage Pregnancy Action Plan is understood and addressed through effective use of local data. 2.1 Key objective: Data is effectively collected and used to identify: • Vulnerable young people, risks and needs • The needs of teenage parents • Geographical areas of high need (‘hotspot areas’) • The impact that current projects and services are having on young people’s lives (conception rates/sexual behaviour) • Progress in meeting agreed targets What we are doing Detailed, accurate and up‐to‐date data and information are essential for determining need, planning, commissioning and performance managing appropriately targeted programmes. Additional local information is required to identify young people most at risk to allow effective targeting. Information on issues such as school attendance, deprivation, ethnicity at ward level is critical7. We also collect local data. Whilst this is unverified and usually made up of numbers so small we cannot share for confidentiality reasons, this information is very useful internally as it gives us an earlier indication of conception rates across Cornwall. Information is used to report on progress internally and to identify areas with consistently high rates of conceptions so resources can be better targeted. We use the national data provided by the Office of National Statistics (ONS) to track our quarterly progress in reducing teenage conceptions and to measure our progress against other Local Authorities. This information is published on our website (www.cornwall.gov.uk/jsna) and it is the Teenage Pregnancy Coordinator’s responsibility to maintain, update and disseminate this information. It is important that we recognise that this information is always historic and relates to a period eighteen months prior to publication. Because we know that young parents are less likely to be in education, employment or training, Careers South West report specifically on the number of teenage mothers, and fathers (where known) in education, employment and training on a monthly basis. We use this information to measure our progress against a target of 40% of mothers engaged in education, employment and training by April 2013. 7 DCSF (2009) Teenage pregnancy prevention and support: A self-assessment toolkit for local performance management Teenage pregnancy action plan 11 To ensure that this target is aspirational we also measure our performance against other Local Authorities (see Care to Learn8).Currently we are ranked third in the country and aim to stay amongst the leading Local Authorities in relation to this target. Careers South West www.careerssw.org Careers South West (CSW) advisers are currently commissioned by Cornwall Council to deliver impartial information, advice and guidance to vulnerable 13 to 19 year olds who are at risk of not engaging in education or training, and to track the participation rates of all young people aged 16 to 19. Advisers are based in various young people settings and proactively follow young people’s education and employment activity, supporting those needing most help. Advisers link with key support staff and organisations to co-work and share information to safeguard young people and their families, and to help them access opportunities in employment and learning and fulfil their aspirations. 8 Care to Learn https://www.gov.uk/care-to-learn/overview 12 What we need to do: Action Evidence we have done Who should so make sure this happens We need to make sure we are consistently and effectively evaluating our programmes of support to make sure we are meeting the needs of our children, young people and families as well as we possibly can. Introduction of the Outcomes Star as an evaluation tool capturing ‘soft outcomes’ in the Young Mums Will Achieve Group and young parents support service (currently WILD). As resources are very tight we also need to ensure the Council is getting value for money. Anecdotally we know that young people who are in care, or have a history of care or social care involvement are at increased risk of poor sexual health and teenage pregnancy. We also know that children of teenage parents often have social care involvement. Locally, however, we do not have the data to support our understanding of the needs in this area. To address this we will establish a method of data sharing in order to identify the number (percentage): Supporting Families, Cornwall Council Service Providers Evidence of robust contract reviews with performance measured against agreed targets for all services commissioned by the Teenage Pregnancy and Sexual Health Coordinator and the appropriate commissioning manager (children’s). Internal data reports between the Social Care and Psychology Service and the Teenage Pregnancy Coordinator. Cornwall Council • of children of teenage parents currently open to social care services • of teenage parents who have had previous social care involvement including those in care and care leavers • of children of teenage parents currently open to locality teams • teenage parents who have been identified as being in a high risk relationship, or linked to a high risk household. Teenage pregnancy action plan 13 Priority 3 Increase access to Contraception and Sexual Health Services so that young people have easier access to contraceptive and sexual health services and a greater choice of contraceptive methods across Cornwall9. 3.1 Key objective: Develop and commission sexual health services that ensure service follows need. Over recent years the number of dedicated young people’s sexual health services have increased, both in clinical and non clinical settings. Services now available for specifically for young people are available at www.EEFO.net Cornwall offers an integrated model of service delivery Genito-Urinary and contraception services co located at many locations across Cornwall. This ensures that young people visiting the GU clinic for screening and treatment can also use this opportunity to access a range of contraceptive services, as well as giving staff the opportunity to further promote positive sexual health and choice of contraceptive use. Over the past three years the GU team has increased its number of community clinics and is aspiring towards complete coverage across Cornwall. All Cornwall Council contracts are robustly evaluated, to ensure that service follows need, and we aim to offer equitable service provision to all. We are currently in the process of evaluating the School Based Integrated Health Centres model to consider the benefits for students and the possibility of future provision within schools. 9 In supplying contraceptive and advice services to young people under the age of 18 professionals follow their agency’s safeguarding procedures. The Fraser guidelines are uniformly used to assess competency and confidentiality and provide clear guidance that a young person under the age of thirteen cannot consent to sex. If a professional or agency suspects that a young person under the age of 13, or a young person over the age of 13 but not Fraser competent, was engaging in sexual activity, or any young person was at risk of harm, then the agency’s safeguarding procedures are followed. 14 What we need to do: Evidence we have done so Action Who is responsible The upcoming Health and Social The Teenage Pregnancy Action Plan Care Bill will place a duty on our is included within Cornwall’s wider commissioning activity to have Health and Wellbeing Strategy. due regard for Cornwall’s Joint Strategic Needs Assessment. Teenage conception data will feed into the assessment and both promoting sexual health and reducing teenage conceptions will remain a key area of the Cornwall’s Health and Wellbeing Strategy. Supporting Families, Cornwall Council The GU team is looking to develop its outreach services, specifically targeting vulnerable and hard to reach groups via new GU drop ins. Additional clinics established in areas of high need and hard to reach groups proactively targeted. Patient data used to evaluate impact. GU, Royal Cornwall Hospitals Trust Cornwall Healthy Schools, on behalf of a range of partners, will conduct an Authority wide Health Related Behaviour Questionnaire in years 8 and 10, covering a range of health issues. This will be used as a vehicle to better understand the experiences, views, needs and perceptions of young people in regard to their sexual health and wellbeing as well as their views and experience of service provision. Questions regarding sexual health and contraception provision included in schools questionnaire. Evidence that this information has been considered in service provision. Supporting Families, Cornwall Council Health Promotion Service 3.2 Key objective: Modernise and improve the choice in termination of pregnancy. Cornwall and the Isles of Scilly is a large rural area with deprivation, transport and financial difficulties affecting the young, most vulnerable and at risk. Therefore easy access to termination services is paramount. It is also known that young people’s circumstances can lead to them accessing services later. have been made to develop a centralised selfreferral booking system, passing the choice of termination of pregnancy provision from a referring clinician to the service user. This will empower young women seeking termination of pregnancy by enabling them to make choices about where they access this service. Cornwall is committed to providing early access to services and a termination service that promotes choice. In support of this proposals Teenage pregnancy action plan 15 3.3 Key objective: Ensure Services are provided within settings that suit the lifestyles, needs and ‘travel realities’ for young people in Cornwall, especially those living in rural isolation. The C Card Scheme ensures young people have access to contraception across a wide range of settings. The scheme is now accessed by over 12,000 young people with over 180 C Card outlets across Cornwall. The target number of new registrations for 2012/13 is 3000. In addition to facilitating of the C-Card service, the Young People’s Sexual Health Worker works in partnership with other agencies including the Youth Service, Brook, The Hub and the Royal Cornwall Hospital Trust and the Chlamydia Screening service, to provide a co-ordinated approach to sexual health and contraception choices for young people. This is achieved through campaigns, events, group work and one to one sessions where necessary for those with specific needs. C card is also represented at ‘youth events’ such as Boardmasters, Cornwall College Fresher Events, Truro College Healthy Fortnight and Cornwall University Health & Wellness Events ensuring it reaches the greatest number of young people. C Card The C Card scheme is a free and confidential condom distribution scheme for young people aged 13-21 in Cornwall and the Isles of Scilly. Young people under the age of 16 wishing to register for the scheme are assessed using the Fraser Guidelines10. The aim of the scheme is to provide easy access to free condoms and sexual health information, advice and guidance at young people friendly outlets. Once a young person has registered for a C-card they are able to use any C Card distribution point. The card can be used up to ten times before re-registration is required. Professionals working with young people and organisations can be registered as registration sites, distribution sites or both. Workers that operate the scheme must attend a training course. Registration sites complete two way condom demonstrations with young people wishing to register for the scheme to ensure young people know how to use condoms effectively. Cornwall currently has over 12 000 registrants to the scheme and 196 organisations involved with C-card. Since 2009, 363 individuals have been trained to offer C-card registration, distribution or both. 10 Criteria outlined by Lord Fraser in 1985 in the House of Lords’ ruling in the case of Victoria Gillick v West Norfolk and Wisbech Health Authority and Department of Health and Social Security. This criteria is commonly known as the Fraser Guidelines: · The young person understands the health professional’s advice · The health professional cannot persuade the young person to inform his or her parent or allow the doctor to inform the parents that he or she is seeking contraceptive advice 16 · The young person is very likely to begin or continue having intercourse with or without contraceptive treatment · Unless he or she receives contraceptive advice or treatment, the young person’s physical or mental health or both are likely to suffer · The young person’s best interests require the health professional to give contraceptive advice, treatment or both without parental consent The mobile young people’s sexual health service which services St. Austell, The Clays, Bodmin Wadebridge and Camelford continues to provide a needed service in more isolated areas where young people may face geographical barriers to accessing services. The service provides young people with confidential information, advice and guidance alongside contraceptive services, Chlamydia screening pregnancy testing services. Our target number of visitors to the bus per year is: 720 What we need to do: Action Evidence we have done so Who is responsible We know school nurses are a key point of access for our young people who are concerned about travel and confidentiality within the rural landscape of Cornwall. Cornwall’s C Card Coordinator will deliver training to all the school nurses across the localities in Cornwall and will attend and deliver a workshop for school nurses at Cornwall’s Annual School Nurse conference. C CARD Scheme is currently recruiting GP practices in the County to offer free condoms and C CARD registration to young people. Increased number of school nurses trained to register and distribute condoms under the C Card scheme. Health Promotion Service Target of 20 new GP sites for 2013/14. Health Promotion Service Number of attendants attending refresher training courses. Health Promotion Service To ensure that staff in all the registered sites are trained to an appropriate standard so that they can implement the C Card scheme effectively in light of the latest good practice research, the C Card Coordinator will run C Card refresher courses for all staff trained prior to 2009, throughout 2013. Teenage pregnancy action plan 17 3.4 Key objective: Ensure universal and specialised services are accessible and meet the needs of all individuals, including those with learning disabilities and from minority groups. Equality and diversity is at the centre of all the services we provide and commission. Special Schools receive support in order to deliver meaningful personal, social and health education (PSHE) and relationship and sex education (RSE) that meets the needs of their students via Cornwall Healthy Schools Programme. Training and support is given to staff in clinical settings to understand the needs and expectations of working with people with a learning disability. Patients with additional and complex needs, including those with learning difficulties also have access to GU services at an additional drop in session on Wednesday evenings. Equalities issues and needs have been considered in our Equalities impact assessment which is available on our website. (www.cornwall.gov.uk/ equality) What we need to do: Action Evidence we have done so Who is responsible Currently there is no C Card provision C Card implemented on the Isles of Health Promotion on the Isles of Scilly. However, due Scilly so young people can access Service to a recent Ofsted report it has been confidential advice and contraception identified that this Scheme needs to be offered to young people. With the support of the local GP on the Isles of Scilly, C Card is looking to be implemented at the GP Surgery on St Marys, available for all the young people. We need to ensure that all service providers carry out Equality Impact Assessments of services to ensure they are as equitable and accessible as possible. 18 Equality Impact Assessments completed for: • • • • WILD contract YMWA Service Brook Contract Teenage Pregnancy Strategy Cornwall Council 3.5 Key objective: Young people understand and have access to a wide range of contraceptive methods and are equipped to make informed choices about what best meets their needs. All clinical and contraceptive provision is widely publicised via leaflets, posters and representations at key events. Young people are also signposted to specialist contraceptive advice via Brook’s educational outreach and one of Brook’s key performance indicators is percentage of young people accessing clinical provision following signposting. EEFO eefo.net EEFO has developed a set of quality standards that address the barriers that can stop young people from accessing the services they need. There are a wide range of services across Cornwall that have met the EEFO quality standards and have been EEFO Approved for providing a young person friendly service. The EEFO level 3 Quality Standard meets the ‘You’re Welcome’ national criteria for young person friendly services. The eefo website is for young people aged 13 – 19 and aims to provide: • Signposting to all services in Cornwall that have met the EEFO Quality Standard • Advice and information about issues young people face in everyday life Website: www.eefo.net Telephone: 01209 313419 Emal: info@eefo.cornwall.nhs.uk EEFO.net provides a ‘go to point’ for young people and provides information on health services, including sexual health services, in the young person’s area including those services awarded the EEFO quality standard. The website also provides more general information and advice regarding all aspects of physical and emotional health and wellbeing. Our education outreach aims to support young people’s knowledge of different forms of contraception so that young people can make choices appropriate to their needs and lifestyle. This work runs alongside supporting young people to understand and aspire to healthy relationships as well as identify risk in relationships. EEFO also offers services the opportunity to be recognised as being ‘Young Person Friendly’ via the EEFO quality standard. Services that have been assessed as ‘young person friendly’ can display the EEFO logo. The Quality Standard is renewed annually and services can be assessed anonymously by young people through the ‘Mystery Shopper’ evaluation. Cornwall’s young people’s sexual health promotion worker also undertakes promotional work with young women at College campuses in the Authority, offering workshops about all forms of contraception including Long Acting Reversible Contraception. Young women are also signposted to access Brook Clinics and Contraceptive Clinics for full range of contraception available to them. EEFO provide young people with up to date information regarding sexual health and a range of other issues. This includes factual information around contraception and Sexually Transmitted Infections STI’s as well as support and advice for dealing with issues and scenarios that may face young people in respect of their sexual health. Teenage pregnancy action plan 19 Share SHARE is a service currently commissioned by the Integrated Youth Service. Share provides a confidential information and advice service for young people aged 13 – 25. The SHARE service is based in Young People’s centres across the county in Penzance, Camborne, St Austell, Truro, Newquay, Bodmin and Liskeard. They also run an outreach service in schools, youth and community settings. SHARE provides: • The C Card service • Facilitates access to emergency contraception (morning after pill) • On site pregnancy testing • Access to Chlamydia screening • Information, advice and guidance on a wealth of areas including sexual health, welfare and benefits (including maternity benefits), employment and housing • Personal support around the needs of young people including relationships, peer pressure and bullying • Referrals to specialist services as required, including mentoring and counselling All centres are open generally from 10 – 4.30 on weekdays and young people can access the service on ‘drop in ‘basis. The service is run by volunteers (supported by paid workers) and is always keen to increase the proportion of young volunteers (aged 18 – 25). Volunteers have the opportunity to gain qualifications in Advice and Guidance and Youth Work. What we need to do: 20 Action Evidence we have done so Who is responsible To develop a centralised web-based information point for all clinical and support regarding sexual health across the county for all ages. Sexual Health central website running. Health Promotion Service 6000 unique site visits for 2013/14. Priority 4 Children, young people and their parents will benefit from high quality relationships and sex education provision, advice and guidance on a formal and informal basis, in a variety of settings. 4.1 Key objective: Children and young people are supported within their educational settings to develop their understanding and skills in order to make positive life choices around healthy relationships, deciding when to have sex and contraceptive use. Identified as an important age group in the Sexual Health Strategy for Cornwall11, good Relationships and Sex Education is an essential link in improving health and wellbeing outcomes for children and young people both in the shorter and longer term. It ensures that children and young people have reliable and factual information and a supportive environment in which to learn about relationships and sexual health. Children and young people are supported in their educational settings via the work undertaken by Brook (external provision) Health Promotion Service’s Healthy Schools & the Sexual Health & Alcohol teams (supporting internal provision). The Health Promotion service has introduced primary and secondary educational resources and training via the Christopher Winter project. Schools are also signposted to the South West RSEHub and the Healthy Schools’ website in order to access evidenced based resources to support their in-house provision of RSE education. 11 Sexual Health Strategy for Cornwall and the Isles of Scilly 2010-13. Available at http:// www.cornwallandislesofscilly.nhs.uk/DocumentsLibrary/CornwallAndIslesOfScillyPCT/Policies/ PublicHealth/SexualHealthStrategy.pdf Teenage pregnancy action plan 21 Relationships and Sex Education Advisor The Relationships and Sex Education (RSE) Advisor’s role is to enable and support secondary schools to deliver consistent, evidence based effective relationships and sex education (RSE)’ in years 7 and 8 (11-13years). This is undertaken in conjunction with Cornwall Healthy School’s programme. The RSE Advisor offers schools a range of training and advice in order to support schools to deliver factual, coherent, comprehensive and effective RSE which meets the educational needs of children and young people and is sensitive, responsive and reflective of the realities of society. The RSE Advisor can provide: • Curriculum Consultation • Resourcing and Materials • Policy Development • Student Consultation • Teaching & Learning Methodology • Schemes of work (SOW) Construction • Teacher Training (Christopher Winter Project) The work is pro-actively focussed towards where the needs are most significant – i.e. Schools that are in areas identified as “teenage pregnancy hot-spot” areas. 22 Cornwall Healthy Schools Cornwall Healthy Schools’ aim is simple: to support schools throughout Cornwall and the Isles of Scilly to improve health and wellbeing for pupils, staff, parents and carers in the wider school community. Cornwall Health Schools consists of two elements: Schools can work to gain ‘Healthy School’ status by using the on-line annual audit which is a school-specific self-evaluation tool to help schools demonstrate how they bring added value to school life through their health and wellbeing work. Healthy Schools Plus encourages and supports schools to identify specific health needs in the school community and deliver an effective, evidence-based piece of work delivering real outcomes. Cornwall Healthy Schools work in partnership to ensure the best possible support for schools and we bring an innovative and energetic approach to all that we do. Website: www.cornwallhealthyschools.org/ Twitter: @CornwallHSTeam Facebook: www.facebook.com/CornwallHS Speakeasy Speakeasy is a national programme, supported by FPA with facilitator accreditation through the Open College Network (OCN), that enables parents and carers to acquire the necessary skills, confidence and knowledge to: • Be able to talk positively about relationships and sex to children according to their age and level of understanding • Feel comfortable taking on the role of ‘relationships and sex educator’ at home • Understand the changes children go through during puberty • Understand how to help children deal with pressure from media and advertising • Have up-to-date information on contraception and sexually transmitted infections • Know more about the relationships and sex education that is taught in schools With this knowledge, Children and young people are less likely to engage in risk taking behaviour that may lead to unplanned teenage pregnancy, acquisition of sexually transmitted infections, they will also be aware of contraception methods and where to access them. Speakeasy’s objectives are to; • Prioritize Teenage Hot-Spot areas for development of Speakeasy provision • Recruit parents/carers and professionals from diverse backgrounds to train as facilitators • Develop and deliver Speakeasy facilitator training (with OCN accreditation for participants) • Co-ordinate the delivery of Speakeasy course for parents and carers, ensuring evaluation and monitoring is fed back to relevant parties • Work strategically with the Healthy Schools programme and Primary Schools to share information and to meet mutual objectives The Speakeasy course for parents and carers offers a non-threatening group based opportunity for parents to learn together and acquire the confidence and skills they need to talk to their children about sex and relationships. It is designed to be fun and relaxed, and provide an atmosphere where parents can learn together from their own experiences. Backed up by the FPA’s extensive training resources and expertise, the course offers a flexible and relaxed way to gain greater confidence in an area that can cause embarrassment and awkwardness for parents and carers with children of all ages. Creative group work methods including collage and artwork, role play and games are utilised, as well as more traditional written work. The emphasis is on making the courses as accessible as possible. Speakeasy in Cornwall provides opportunities for schools and community settings to receive free taster sessions (and initial courses for parents and carers in areas of high teenage pregnancy). We then train members of the school staff and/or parents/carers as Speakeasy Facilitators to deliver the Speakeasy course in their own community. The course for parents and carers is accredited at level 1 and 2 by the OCN and the Facilitator training at level 3. We welcome parents and carers, all primary schools and community organisations that work with children and families to participate in Speakeasy. Teenage pregnancy action plan 23 Brook Schools Outreach Brook is currently commissioned by Cornwall Council to provide universal Relationship and Sex Education (RSE) programmes for secondary schools in Cornwall. A programme of ageappropriate RSE sessions ensures young people gain a wide range of relevant information and skills as they need it. Recommended sessions, delivered to individual tutor groups are: • Year 9 (age 13/14): Confidential Questions; providing a confidential space for young people to ask questions about relationships and sex. This session covers sex and the law, consent, peer pressure, confidentiality and access to services. It also explores strategies for young people to delay first sex as well as exploring healthy relationships. • Year 10 (age 14/15): Healthy Behaviour; delivered over two sessions with a focus on staying safe and healthy. The first session provides an introduction to contraception whilst the second session provides an introduction to sexually transmitted infections and aims to raise awareness of the risks of unprotected sex and to develop negotiating skills for negotiating condom use. The Health Promotion team and Healthy Schools team work with primary school educationalists providing support and advice as well as offering Speakeasy facilitator training to staff alongside parents. Sexual health and quality Relationships and Sex Education is a key part of the Health Schools Programme and the Healthy Schools Plus accreditation. As part of their package of support to schools, Healthy Schools deliver training for teachers, governors and parents and help schools evaluate the effectiveness of their work. Cornwall Learning12 has developed Walk Tall, a home- school partnership resource aimed at helping children understand and talk about relationships and sex. The resource, which was developed following local research into the 12 For more information about Cornwall Learning please visit http://www.cornwall.gov.uk/default.aspx?page=18118 24 • Year 11 (age 15/16): Healthy Relationships; focussing on sexual health with a broader context of relationships, attitudes, stereotypes and media. It includes discussion about the qualities that make a healthy relationship and the importance of healthy behaviour. In addition, Brook offer schools additional support through • Bitesize Brook; an interactive full or half day event with a focus on sexual health and risk taking behaviour. Bitesize Brook can deliver to up to 100 young people at a time. Young people rotate in teams of 12-15 around a number of themed learning zones, facilitated by Brook and specialists from other agencies such as the Health Promotion Service. • Assemblies; generally focused on a specific issue to address need identified by the school. • One-off sessions; addressing specific identified need in the school or locality. • Targeted Work; for groups of young people who may be at risk of poor sexual health. These sessions can be based around specific topics identified as an issue for a particular group of young people. Brook’s targeted work also offers sessions which look at self esteem and confidence building. support needs of parents around relationships and sex education for their children, provides primary schools with 32 hours of curriculum content across key stage two, including lesson plans, worksheets and take home interactive discussion sheets for parents to complete with their children. The ethos of the Walk Tall programme is to support schools to develop a partnership with parents around relationship and sex education. Parents whose children attend schools that have delivered the programme consistently report increased emotional literacy and increased understanding of the school’s RSE curriculum. The resource has recently been updated and rebranded and is in the process of being re-launched to schools who buy in the resource. What we need to do: Action Evidence we have done so Who is responsible The RSE advisory role has recently developed from a focus on primary support to secondary in order to better meet the RSE needs of years seven and eight. The impact of this shift of focus will need to be evaluated to ensure provision is best meeting the needs of our children and young people. • Needs Assessment completed • Identify and engage with 6 secondary schools in high priority areas • Provide support and training to teachers in delivering RSE Health Promotion Service 4.2 Key objective: Young people are provided with consistent information, advice and guidance to support them in recognising and managing the risks of drugs and alcohol to sexual health. All WILD staff working with young parents are SUST (Substance Use Screening Tool) trained enabling them to carry out brief interventions around drugs and alcohol with their service users. Brook also incorporate the potential impact of substances on sexual health into their education. Teenage pregnancy action plan 25 What we need to do: Action Evidence we have done so Links will be established between • Screening tool developed for GU and YZUP – the current tier three GU clinics by YZUP to support provisions for young people around self identification of problematic substance misuse- so that young substance use people with potential problematic • Substance use training provided to substance use can be signposted GU staff towards services whilst also providing • GU staff provided with referral reflective tools for both GU staff and pathway for young people and young people to better understand adults who report, or they are the impact substance misuse may concerned have, problematic be having on their sexual health and substance use, or whose use is behaviour. impacting on their sexual health • GU to provide information leaflets in clinics The project will be evaluated by the We are currently undertaking an following indicators: Alcohol & Substance Use Early Intervention Project • Web-based hub developed and This project will form the Early Intervention element of a multiagency Risk Taking Behaviour Strategy for the county, beginning with Drugs and Alcohol, by pulling together a quality assured package of policies, educational and information sources, screening and brief intervention tools, lesson and session plans for groups in schools and the community, information on how to access specialist services and links to other web resources. It will also provide training and support to schools, colleges, training providers, short stay schools and voluntary and statutory youth work providers to facilitate the consistent use of evidence based materials in providing a coherent approach to early intervention and education around drugs and alcohol aimed at 13-19 year olds. A range of leaflet based resources for young people around reducing risk related to alcohol and sexual health/unplanned pregnancy called “A Guide To Sexual Health” & “A Survival Guide To A Night Out” will be produced. 26 • • • • used by a minimum of 50% of Secondary Schools and 10 partner agencies / locality teams within 6 months of the site going live High quality, effective, sustainable and tested E-learning package for drugs and alcohol for practitioners, young people and parents developed A consistent, quality assured approach to educational delivery of drugs and alcohol work in schools and youth settings across the county Final evaluation report written – ‘what’s changed for young people as a result’, key stakeholder feedback and recommendations for the future 2000 leaflets distributed at key events – Freshers, Cornwall College Alcohol awareness, Xmas campaign, Newquay Safe, Boardmasters, Youth Centres etc Who is responsible YZUP, Cornwall Council GU, Royal Cornwall Hospital Trust Health Promotion Service Supporting Families, Cornwall Council 4.3 Key objective: Parents and Carers are able and encouraged to support and develop their children’s understanding of healthy relationships and the ability to make positive choices around relationships, sex and sexual health. The parents and carers of primary school aged children in Cornwall are supported to develop skills in speaking to their children about relationships and sex through the Speakeasy Programme and the Health Schools support package. (please see page 23) Universal literature is also published and distributed offering tips, support and signposting regarding speaking to your child about relationships and sex. What we need to do: Action Evidence we have done so Who is responsible Ensure Information, Advice and Guidance literature for parents and Carers in Cornwall is available online and parents are signposted towards it. Literature is available online. Health Promotion Service Consideration be given to including the messages learned through the Speakeasy programme to alternative parenting support such as parenting classes. Inclusion of Speakeasy Principles in parenting class syllabus Page hits are recorded in order to evaluate reach of this information. Supporting Families, Cornwall Council Health Promotion Service Supporting Families, Cornwall Council Teenage pregnancy action plan 27 4.4 Key objective: There is a consistent approach across corporate parenting that acknowledges children in care as a vulnerable group of children and young people who may require additional support and guidance Cornwall Council has corporate parenting responsibilities to the children in its care that include helping children to overcome experiences of neglect and abuse, supporting children to achieve better outcomes in health and education and assisting young people to make a successful transition to adulthood and independence. What we need to do: 28 Action Evidence we have done so Who is responsible Foster carers and residential workers will be included as key strands in the development of practice guidelines for the Children’s Social Work and Psychology Service. The practice guidelines will provide clear guidance around the expectations of those exercising the role of corporate parent in terms of understanding the law, risk and the needs of children and young people in terms of positive sexual health. The role, remit and relationship that corporate parents have with children and young people is included and explicitly explored in the development of sexual health/risk sexual behaviours practice guidelines developed for the Social Work and Psychology Service. Supporting Families, Cornwall Council Children’s Social Work and Psychology Service, Cornwall Council Priority 5 Protecting the future health and wellbeing of teenage parents and their children. 5.1 Key objective: Support and interventions aimed at supporting parents to achieve positive outcomes for Parents and their child(ren). Young parents in Cornwall are supported by the WILD and YMWA13 projects (see case studies) that provide opportunities and support to develop both their education and skills including self confidence, aspirations and parenting skills alongside intensive support to young parents aimed at improving healthy outcomes for parent and child. Both projects also focus on positive sexual health for their participants and work with their young people to support a reduction in second unplanned pregnancies. First time mothers aged nineteen and under also benefit from the Family Nurse Partnership which provides an intensive health visiting programme until the child’s second birthday (see case study) In 2011/12 WILD supported the wider public health agenda continuing to support www.wildproject.org.uk breastfeeding through group workshop and individual support sessions, enlisting WILD work with around 450 young families (up to the age of 23) a year. WILD young mums 4 breastfeeding peer mentors, providing 62 young mums and 45 young dads with group is commissioned to support healthy lifestyles and improved mental health in young individual outreach breastfeeding support mums. All of the target groups are mothers or and developing its WILD breastfeeding face mothers to be, commonly disadvantaged from book forum which now has 243 members. In addition specific work has been done to training and employment opportunities, and support smoking cessation or reduction, experience the wider manifestations of social increased uptake of smoke free homes, exclusion. exercise and positive photo shoots of young WILD aims to provide young mothers and parents with their children for the annual their children and families with opportunities calendar. to develop their skills, improve self-esteem, make positive and healthy choices, protect themselves, participate as equal members of their communities and achieve their potential. WILD 13 YMWA is provision for mothers only. Teenage pregnancy action plan 29 Young Mums Will Achieve (YMWA) YMWA was established in 2009 with the primary objectives to support mums back into mainstream education, employment and training whilst supporting the development of positive parenting and life skills. YMWA aims remove to some of the barriers that young parents can face. On site childcare is provided via the Care to Learn fund whilst tutors from Cornwall College provide two days of education and life skills support. The programme offers a level 1 ‘step up’ Family Nurse Partnership The Family Nurse Partnership (FNP) is evidence based, preventative programme offered to young mothers (aged 19 and below) having their first baby. It begins in early pregnancy and is orientated to the future wellbeing of the child. It is a nurse-led intensive home visiting programme – intensive enough to make a difference and filling the gap in the continuum of the progressive universal Healthy Child Programme (HCP). Evidence shows that FNP intervention has the following outcomes: • Improvements in women’s antenatal health • Reductions in children’s injuries • Fewer subsequent pregnancies Recognising that child care provides vital opportunities for children to interact, Cornwall offers 15 hours of free childcare for two year olds to parents who are under 18. Young parents who are on employment or income support or extra tax credit due to disability are eligible for this provision. In April 2013 Cornwall plans to drop additional local criteria and extend the scheme to all benefit dependent families. This means that more families, including young parents over 18, will be able to benefit from the scheme. Teenage parents also represent a priority group for Careers South West who actively monitor and support young parents in accessing education, employment and training opportunities. Careers 30 qualification alongside functioning skills in maths and English, employability skills and parenting support. The group, available to all mothers and expectant mothers aged 19 and under, has been designed to encourage peer support and new participants can join the group at any time of the academic year. Participants are able to remain in the group for up to two years. YMWA currently has 7 groups across Cornwall with another new group starting in January 2013, supporting around 65 young mothers. • • • • • Greater intervals between births Increases in fathers’ involvement Increases in employment Reductions in welfare dependency Reduced substance use initiation and later problems • Improvements in school readiness FNP is a licensed programme with well-tested theories and methodologies. Cornwall has been involved in a Randomised Controlled Trial which is due for completion at the end of 2012. FNP in Cornwall is delivered by a team of 8 trained Family Nurses, based throughout Cornwall and led by the FNP Supervisor. FNP is commissioned to provide the programme to 203 eligible teenagers. South West is represented at the Teenage Pregnancy Board providing opportunity for their experience of what is needed on the ground to be fed in at a strategic level. Across Cornwall we are working to an target of 40% of young mothers engaged in education, employment or training by April 2013. This reflects some of the long term challenges which we know are faced by those vulnerable to young motherhood, such as poor aspirations, risk taking behaviour, an increased likelihood of a care background and previous disengagement from education and support. Our projects aim to help remove the barriers these young people experience in accessing education, employment and training whilst building their confidence, self efficacy and aspirations to support a continued education and/or employment journey. Cornwall’s Care to Learn take up rates show that Cornwall is now the third best performing Local Authority from has raised from 138th in 2009. Recognising the complexities of many young parents’ lives WILD offer a variety of projects and support aimed at addressing young parents’ potential wider needs. This includes: • WILD positive relationships – a peer led programme providing education advice and support on positive relationships, understanding cycles of abuse, understanding the impact this has on children, attachment, resilience and protective behaviours • WILD mental health project – supporting young parents to access mental health support alongside Cornwall’s Peri-natal strategy; and • WILD First Steps – supporting and advising young parents around housing, benefits, debt and independent We aim to offer all young parents in Cornwall a CAF and will be working towards this target in 2012/13. What we need to do: Action Evidence we have done so Who is responsible The young parents support service (currently provided by WILD) will be re-tendered in Spring 2013 when the current contract ends. Contract awarded for 2012/13. Cornwall Council Research outcomes available. Cornwall recently participated in a randomised trial of the FNP programme to measure outcomes for FNP ‘graduates’ compared to a control cohort who received universal services. The trial is due to end in November 2012 and Cornwall looks forward to the research outcomes in 2013. This year we will review the Young Mums Will Achieve programme so as to look at ways the Council can continue to expand and improve the programme for young parents and their children. Family Nurse Partnership, Cornwall Foundation Trust Review completed and use to shape service design. Supporting Families, Cornwall Council Cornwall College The review will look at: • • • • Sustainability of the programme Referral Pathways to YMWA Progression routes on from YMWA Participants’ experiences of YMWA Increase the number of children of teenage parents who have a CAF. That CAFs are initiated in at least 50% Supporting Families, of new young families in 2013 with a Cornwall Council view to 75% in 2014. Teenage pregnancy action plan 31 5.2 Key objective: Ensure that young parents can access timely support and are aware of both specialist and universal support/resource that is available to them. Cornwall’s Family Information Service (FIS, (cornwall.childrensservicedirectory.org.uk) provides a centralised hub of information for all families across Cornwall. FNP nurses, YMWA, WILD and the young father’s group all also signpost young parents to further advice, support and resource. From speaking to young parents we have learnt that they are not always aware of the resources available. We need to make sure that as far as possible, teenage parents have easy access to information about what is available for them and their children. We have already taken steps to address this; YMWA now provide all participants with packs containing information about services to meet a range of needs, and FIS are undertaking outreach with pre existing services for young people to sign post young parents to their telephone service and website as a point of information. We also plan to: What we need to do: 32 Action Evidence we have done so Who is responsible Develop a single point of referral for all midwives. By merging a number of referral routes we hope to support an increase of referrals to all projects aimed at supporting young parents in Cornwall. Review current maternity pathway for young parents who are pregnant in line with the introduction of maternity payment by results. We also hope to develop a progression and referral pathway for young parents in Cornwall to be agreed and shared with all specialist young parent specific services. The aim would be to encourage professionals to refer, support young parents to access specialist support and, when ready, progress onto universal services to ensure long term sustainable support. We will use the pathway to encourage young parents to make use of universal community resources alongside specialist provision and ensure are young parent programmes work in partnership with wider early years provision. Single referral form developed and rolled out across midwifery service. Supporting Families, Cornwall Council Public Health Pathway developed agreed and implemented. Supporting Families, Cornwall Council 5.3 Key objective: Support young fathers to play a positive and active role in their child’s life Both FNP and WILD work on a whole family model which values fathers alongside mothers Brook Young Fathers Brook young fathers (under 25) aims to: • Support young fathers to value and understand the importance of their role as a father • Develop their skills and knowledge to effectively fulfil their responsibilities as parents • Increase young fathers’ voluntary access and engagement with universal services Brook Young Fathers runs a rolling programme of education work every Tuesday evening in St Austell aimed specifically at young fathers to help them to access the vital information they need to perform their role as parents. The project works with fathers who cohabit with their partners and children, step fathers, and fathers who are estranged from their families. They deliver work that is factual and carefully researched in line with current advice such as nappy changing, bathing, infant feeding, However Fathers are often totally reliant on the relationship with the mother of their child in order to receive close targeted support that improves their ability to play an active role in the child’s life. Even in cases where the father and mother are involved with a service such as WILD or FNP, the father will only be able to access the service through the mother. In the case of statutory services, although fathers can establish a separate relationship with them they often perceive that because they don’t have full time care of the child they don’t realise they can access these services just like the mother. If there is a break down in relationships then there are few services offering support from the father’s side to help negotiate getting back to a position where they can play and the role they play in raising their children. Fathers represent one third of WILD service users. preparing for birth and child development as well as soft skills sessions relating to relationships, sexual health, supporting mother and baby, making life changes and managing money. The project aims to be responsive to the needs of the group and individuals and the young fathers worker spends much of their time following up the individual needs of the group throughout the week in between sessions. The workers provide information, advice and guidance according to the needs of the individual alongside advocacy and support in navigating services for them and their child. In 2011/12 The young fathers group ran play days and cooking workshops on the weekends that have been well attended by fathers and their families. This year the group has also been involved in the production of films to accompany a resource pack aimed at young fathers. Brook young fathers group piloted the activities in the pack and provided vital feedback to help create an effective resource. an active role again. Brook young fathers service seeks to advocate on behalf of fathers and to support young fathers to work with services and to make positive life changes to enable them to demonstrate that they can provide a positive role in their child’s life. Following feedback from the Young Mums will Achieve group, where the participants told us they felt a similar provision should be available for fathers, Cornwall College has employed a part time designated worker until July 2013. A young father himself, his remit is to work with fathers to develop a programme which young fathers would want to engage in. We look forward to hearing the outcome of this work. Teenage pregnancy action plan 33 The Young Fathers Resource Pack An introductory parenting programme designed for young fathers and young fathersto-be. Brook Young Fathers, in partnership with Inspire Cornwall and Cornwall Council, has designed a parenting programme, through a resource book and DVDs, specifically for young fathers. This resource helps young fathers to understand the importance of their role for the mother and for the child, and includes key messages on how to look after their baby, playing with their baby, healthy eating, and the importance of healthy relationships and good communication. The roll-out and delivery of this resource is currently under discussion within the NHS. What we need to do: Action Target for 2012/13 Expand the remit of the Brook young Continued, extended service. fathers project to offer one to one support and groups in a number of locations across Cornwall. To pursue a bid to the Big Lottery funding to fund two full time countywide workers to deliver an extended one to one service and further groups. This would enable the service to work more closely with individuals to encourage their participation with universal services as well as increase access to the service across the county. 34 Who is responsible Brook Supporting Families, Cornwall Council Priority 6 Workforce development that takes a sustainable approach to ensuring that children, young people and families have access to professionals who can effectively support them. 6.1 Key objective: To continue to develop a trained and informed children’s workforce that are able to identify and support children and young people who are at increased risk of teenage pregnancy and poorer sexual health. To provide universal and specialist support and interventions and signpost and refer on to further services as meets the needs of the individual. Sexual Health Training Team The training team is a multi agency partnership that deliver the Council run free sexual health training courses for professionals and volunteers working with young people. The training aims to provide knowledge and skills to support and signpost young people in relation to sexual health and relationships. The local children’s workforce are offered support in understanding the sexual health needs of young people as well as communicating with young people about sexual behaviour and sexual health via the two day Multi Agency Sexual Health Training course; delivered in partnership by sexual health and youth professionals. The children’s workforce all also have access to the C Card training day which aims to develop professionals sexual health knowledge alongside skills in working with young people to encourage contraception use and develop positive choice skills. We also want to make sure that all frontline staff have up to date policy advice and guidance in their front line work with young people in relation to risk taking behaviours, sex and sexual health. To ensure this we plan to: Teenage pregnancy action plan 35 What we need to do: Action Target for 2012/13 Who is responsible Use the teenage pregnancy network (or alternative communication tool) to ensure professionals are routinely updated on current research, policy and resource. Develop and signpost the children’s workforce towards information around: Routine provision of information via the network. Supporting Families, Cornwall Council Information and resources are available on centralised hub on the web. Children’s workforce is directed towards these resources. Supporting Families, Cornwall Council Links established between clinical providers and specialist services. Supporting Families, Cornwall Council Review carried out and used to further develop training based on workforce need. Supporting Families, Cornwall Council • Risk factors for early sexual activity and parenthood • Protective factors for young people at risk of early sexual activity and parenthood • What works in supporting young people to delay parenthood • Appropriate RSE resources • Identifying and assessing risk in young people’s relationships, including domestic abuse, and knowing when to refer to specialist services The Teenage Pregnancy and Sexual Health Coordinator will work with sexual health clinical provision to identify potential training needs of staff around identifying risk for young people and appropriate referring including, drug and alcohol, sexual exploitation and domestic abuse and sexual violence. Review of current training packages for the children’s workforce, including, but not limited to, the Children’s Social Work and Psychology Service and the Multi Agency Sexual Health Training with the view to develop focused training around risky behaviour and sexual health. Work with the Sexual Exploitation officer to develop a specialist training programme for professionals working with vulnerable young people. 36 Training leads, Cornwall council Cornwall Safeguarding Children’s Board Notes Teenage pregnancy action plan 37 Notes 38 If you would like this information in another format or language please contact: Cornwall Council, County Hall, Treyew Road, Truro TR1 3AY Telephone: 0300 1234 100 Email: enquiries@cornwall.gov.uk www.cornwall.gov.uk Jn32008 January 2013 Printed on recycled paper.
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