sandwell teenage pregnancy strategy
TRANSCRIPT
SANDWELL TEENAGE PREGNANCY STRATEGY
Presentation to Scrutiny Panel 7 January 2009Sarah New
Senior Joint Commissioning Manager Partnership and Joint Commissioning
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WHY THE NEED FOR A STRATEGY?
• 75% of teenage pregnancies are unplanned
• 47% under 18 conceptions end in abortion
• Inconsistent contraceptive use compared with European peers
• STI’s highest in 16-19 year old women
• High levels of regret
• Young parents - ‘wish they had waited’
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TEENAGE PREGNANCY IS A KEY INEQUALITY & SOCIAL EXCLUSION ISSUETeenage mothers are less likely to finish their education, and morelikely to bring up their children alone and in poverty. They face:
• 60% higher rates of infant mortality• 50% lower breastfeeding rates• 3 x rate of smoking in pregnancy• 3 x rate of postnatal depression• Low educational attainment & high drop-out rates• Low income, poor quality housing• Relationship breakdown • Poor Outcomes for their Children:
• Children of teenage mothers are generally at increased risk of poverty, low educational attainment, poor housing and poor health, and have lower rates of economic activity in adult life.
INEQUALITYRates are highest amongst deprived communities, so the negative consequences of teenage pregnancy are disproportionally concentratedamong those who are already disadvantaged.
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WHY THE NEED FOR A STRATEGY
Annual costs to NHS - £63 millionBenefit Payments to teenage mother unemployed 3 years after birth £19,000 and £25,000Every pound £1 spent on the strategy saves £4 to public purse
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Key risk factors for teenage pregnancy
Risky behavioursEarly onset of sexual activityPoor contraceptive use Mental health / conduct disorder/ involvement in crime Alcohol and substance misuse Teenage motherhood Repeat abortions
Education-relatedLow educational attainment Disengagement from school Leaving school at 16 with no qualifications
Family / backgroundLiving in careDaughter of a teenage motherEthnicityParental aspirations
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National background1999 Social Exclusion Unit Report & StrategyPrevention & Support
better SRE better services better support all met through joined up action
All local areas appoint a TPC & establish a TPPBRegional TPC and national TPUNational targets
To reduce the under 18 conception rate by 50% by 2010 – a joint DfES and DH PSATo increase to 60% the proportion of 16-19 mothers in education, training or employment by 2010To reduce by at least 10% the gap in infant mortality between the routine and manual group and the population as a whole by 2010 (DH)
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Policy DriversDH: National Service Framework for children, young people and maternity services (2004)
Department for Education and Skills: Every Child Matters: Change for Children (2004)
DH: Choosing Health: Making Healthy Choices Easier (2004) / Delivering Choosing Health: Making Healthy Choices Easier (2005)NHS Operating Framework for 2007-08Sexual health priority under Health Inequalities
DH: The National Strategy for Sexual Health and HIV (2001)
DH: Our Health, Our Care, Our Say(2005)
Extended Services (2006)
DH/DfES: Healthy Schools Programme
DfES: Every Parent Matters (2007)
Reaching Out: An Action Plan on Social Exclusion (Sept 2006)
DfES: Care Matters: Transforming the lives of Children & Young People in care (Oct 2006)
DfES: Youth Matters (2005)
HM Treasury. DfES. DTI. DWP. Choice for parents, the best start for children: a ten year strategy for childcare (2004) / Sure Start Children’s Centres
Department for Communities and Local Government, PSA performance target 1 education & worklessness
Department for Communities and Local Government. Supporting People
Anti-Poverty Strategies
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Supporting parentsTo discuss sex &
relationships
Building aspirationsand self esteem
Strong use of local data
Targeted SRE work with young people
at risk
Strong youth servicethings to do, places to go
Workforce training on SRE
Strong messagesto young people
and partner agencies
Young people friendlyContraceptive services
SRE in schoolsand out of school
settings
TP ChampionStrategic leadership
What works? Key factors for success (Next Steps Guidance)
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WHAT WORKS? KEY FACTORS FOR SUCCESS (Next steps guidance)
Supporting pregnant teenagers and teenage parents
Ensuring midwifery & health visiting services provide tailored support to teenage mothers and fathers Children’s centres have vital role in reaching most vulnerable teenagers & providing access to broad range of support servicesTargeted Youth Support services can help teenagers to cope with challenges of early parenthood by providing co-ordinated support from a lead professional who can also act as an advocate and broker servicesEnsure offer high quality support to all mothers under 18 who cannot live with own parentsMake services more attractive to fathers & help them to overcomebarriers to EET.Help teenage mothers back into EET
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SANDWELL STRATEGYAIM:
To reduce Sandwell teenage conceptions by 55% by the year 2010 to a target rate of 31.1 from 1998 baseline rate of 69.1However the Local Area Agreement (LAA) has negotiated a reduced local target. The LAA target for 2008 is to reduce rate of conceptions to 53.6 and to 49.3 in 2009. (Rates are per 1000 female population aged 15-17.)
To improve support available to all pregnant teenagers and teenage parents
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Main objectives of the strategy•
To improve sex & relationships education
•
To improve access to advice & contraception
•
To target vulnerable young people
•
To improve services for pregnant teenagers &
teenage parents including health, housing &
engagement in education, training & employment
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How we deliver the strategy•
Teenage Pregnancy Partnership Board & strategy
•
SMBC & PCT commissioned services
•
Teenage Pregnancy virtual team
•
Borough-wide approach to improving services and education
•
Targeted work to address inequalities
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Governance arrangementsGovernance arrangements
Children & Young
Peoples Partnership
Healthy Start to Life
(Report on Teenage Parents Support)
Successful Young People
(Report on prevention of teenage conceptions
Teenage Pregnancy Partnership Board
TP VirtualTeam YP TP
Board
SRE Group
TP & Housing
TP NEET MTG
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Re-integration Officer
Head of Batmans’s
PRESWNF Post
Children Centre TP Project Worker
TP Welfare Rights Officer
African Caribbean RC
Post
Barnardo’sSouth Asian
PostBrook Lac &Young Men’s
Outreach workers
Primary SRE Healthy Schools
Worker
2 Youth workers2 Peer
Educators
TP Health VisitorSRE co-ordinator
Contraception Outreach Nurse
Cx’s Raising Asp’sCo-ordinator &
Young Men’s Post
TP Midwife
TP SocialWorker & WNF
post
TP CommissionerTP Com. Officer
Procurement & Performance Officer
The Teenage Pregnancy Virtual Team
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Sandwell Teenage ConceptionsYEAR RATE NUMBER1998 69.1 379
1999 65.6 355
2000 63. 346
2001 64.0 359
2002 62.1 359
2003 65.6 376
2004 56.6 327
2005 61.9 356
2006 62.7 (-9.2%) 364
2010 Target 31.1 (-55%)
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Current progress towards 2010
0
10
20
30
40
50
60
70
80
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Con
cept
ion
rate
per
100
0 15
-17
yr o
ld
Target Actual
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Town Level Analysis of Under 18 Conceptions
Rates of under 18 conceptions by Town, 3 year rolling average
0102030405060708090
100
1998
-2000
1999
-2001
2000
-2002
2001
-2003
2002
-2004
2003
-2005
Years
Rat
e pe
r 100
0
Oldbury
Row ley Regis
Smethw ick
Tipton
Wednesbury
West Bromw ich
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Number of town conceptionsTOWN 1998 1999 2000 2001 2002 2003 2004 2005Oldbury 64 44 43 35 48 54 47 52
Rowley Regis
51 49 66 71 72 70 72 68
Smeth-wick 40 46 57 65 55 62 59 57
Tipton 66 56 55 54 44 67 52 52
Wednes- bury
60 53 50 31 53 49 43 50
WestBromwich
79 64 79 84 78 68 50 62
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Teenage conceptions by ward 2003 to 2005
WardConceptions per 1,000
Abbey 39.0
Blackheath 55.4
Bristnall 45.2
Charlemont and Grove 45.2
Cradley Heath and Old Hill 61.9
Friar Park 65.1
Great Barr with Yew Tree 35.9
Great Bridge 70.6
Greets Green and Lyng 40.3
Hately Heath 55.2
Langley 88.5
Newton 38.8
Old Warley 30.4
Oldbury 48.1
Princes End 108.5
Rowley 47.3
Smethwick 59.6
Soho and Victoria 62.0
St Pauls 40.4
Tipton Green 52.6
Tividale 92.0
Wednesbury North 58.1
Wednesbury South 45.1
West Bromwich Central 36.6
Wards with highest rates
Source: Sandwell PCT Public Health.
(Only one ward meets the 2010target rate of 31.1)
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Improving sex & relationships education
“APAUSE” High School delivery
by teachers & school nurses
“Living & growing” rolling out across Primary Schools & Co-
ordinator
SRE policy development,
schools, Youth clubs, LAC
“Raising Aspirations”
Project targets year 11
Barnardo’s South
Asian Project
Regional SRE review
Brook
Outreach
education
Target young men &
young fathers
African Caribbean Resource Centre
Project
Youth Service &
Peer education
“Raising Aspirations Plus”
WNF Peer Ed Project
Target
LAC Healthy Schools
SRE Co- ordinator
Sandwell College
School Nurse Drop-in
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Improving access to advice & contraception
Birmingham Brook
service
Sandwell & Dudley Brook clinics in Blackheath, Tipton &
Oldbury (& Dudley)Family Planning (FPS)
clinics in West Bromwich & Wednesbury
Enhance school
nurse drop- in’s
Brook Outreach &
Education (LAC, young men)
Condom
Projects – Youth Service, Connexions, Vol sector, Children Centre’s,
Primary Care etc
Barnardo’s Mystery
Shopper Project
New SHA £ for Further Education
Brook & FPS
Contraception Outreach Nurses
(DECCA, YOT)
MAP
Pharmacy
Scheme
Care Leavers Drop in
Sexual
Health
strategy
FPS Domiciliary service
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Targeting vulnerable young peopleBarnardo's South
Asian Project
Africa Caribbean
Resource Centre Project
Family Planning Service – targets young mothers
Task Group to
reduce second conceptions
Connexions Raising Aspirations
Project target year 11
TP Social worker
targets LAC
Brook Outreach worker for LAC
Youth Service – target high
conception rate wards
WNF Raising Aspirations Plus
Project
Brook Outreach worker for young men
Sandwell & Dudley Brook resource for
non English speakers
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Improving services for pregnant teenagers & teenage parents
Specialist TP
Midwife
Specialist TP
Health Visitor
Anti Poverty Unit – Welfare Rights Officer for TP
Connexions PA, Young
Fathers post, WNF Academic coaches
and peer ed.
Plan’s for TP Children
Centre
Batman's Hill PRES &
WNF Project
Children Centre’sWNF NACRO
Mum’s to be and Parents with Prospects
Joint work Housing & Supporting People -
Child Poverty Supported Housing
Pilot Bid
Re-integration Officer
Y.S. weekly young
Parents groups
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Other work
Young Peoples Teenage
Pregnancy Board
Developing town TP Action Plans:
Wednesbury Extended services & Core offer
partnership
Media & Communication
work:
Campaigns
www.ourguideto.com
Workforce training &
development
Young Parents Forum
Targeted
Youth
Support
Joint commissioning of services from PCT and Council budgets
with clear service level agreements and
performance management
framework in place.
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Funding the strategy
The Senior Joint Commissioning Manager is supported by a Procurement and Performance Officer. A range of services are commissioned and performance managed on behalf of the Council and the Primary Care Trust.
£630k PCT Sexual health & Choosing Health budgets£328k Council grant from DCFS for Teenage Pregnancy – now through LAA route (not confirmed for 2009/10).Many services mainstreamed in 2007 – estimated ££260k (of which £220k is council funded)
New 2008/09£150K Working Neighbourhood Fund – Committed 2008/09 only.Strategic Health Authority £20k 2008/09 then £50k next two years only. Awaiting outcome of child poverty bid – could be £200k over next two years.Children's centre grant to support development of Teenage Parents Centre.Social care contribute half-time post to support WNF Project
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Challenges for the FutureFuture LAA and WNF fundingReporting on mainstream staff activity Centralised & accessible dataLack of provision for post 16 parents (limited funding for provision at Batman’s PRES)Targeted/integrated youth supportBuild on Wednesbury Core Offer Partnership work and develop TP action plans across all towns.
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Challenges for the FutureReview CASH services, ensuring better integration SNS, CASH, General Practice & implement “your welcome”Need to strengthen and co-ordinate peer educationExpand work with yp in residential units & care leavers to foster care & children in need.Work with ParentsMore work young menContinue to raise aspirations of young people and their families
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IF TO MEET 2010 TARGET…
Teenage pregnancy is everybody’sbusiness!
Mainstream, mainstream, mainstream!!!!!!!!!
Ambition is key to prevention!Every interaction with a young person counts!