By: Joanna Wainwright, Director of Commissioning and Partnerships

To: Local Children’s Trust Boards

Date: February 2011

|Subject: |Teenage Pregnancy |

Classification: Confidential Unrestricted ______________________________________________________________

| |
|Summary: Local Children’s Trust Boards are important players in vitalizing the strategy to reduce teenage pregnancy in Kent. This paper |
|outlines the local place infrastructure and actions required of local partners to ensure a cohesive approach to reduce teenage pregnancies |
|in their areas. |
| |
| |
|Local Children’s Trust Boards are asked to: |
| |
|1. Incorporate the district teenage pregnancy action group as a sub group to the Local Children’s Trust Board (LCTB). |
| |
|2. Establish local reporting mechanisms to mesh with the outcomes based County wide structure with the district teenage pregnancy action |
|group, also link this reporting to the Kent Children’s Trust Board (KCTB) |
| |
|3. Share successful practice with each other. |
| |

1. Introduction & Background

1. Teenage pregnancy is too high in Kent. The overall reduction is 14% against a national 50% 2010 target (2009). Progress within districts is too slow and variable across Kent. While Canterbury has achieved a 19% reduction, the under 18 conception rate in Maidstone has increased by 11%. More detail on local progress in detailed in Appendix 1.

Figure 1 Table demonstrating percentage change in conception rates between 1998/00 and 2007/09

[pic]

2. The Kent Teenage Pregnancy Strategy and Joint Commissioning Plan were refreshed in January 2010 and are monitored by Directors (including Public Health, Children’s Health, Commissioning and Partnerships and Communities) on the Teenage Pregnancy Executive Board.

3. Many of the essential support mechanisms and services identified in the strategy are now in place but there continue to be actions to progress. Local leadership is essential to ensure further reductions.

2. The Kent Vision for Reducing Teenage Pregnancy

1. “Through the successful implementation of the Teenage Pregnancy Strategy we will contribute to improving the aspirations and life chances of children and young people so that they are able to make informed choices about their lives, their wellbeing and their health. In particular, we will focus on those children and young people who are most at risk. Through this work we will support the reduction of conception rates and ensure that the right help is provided for young parents”. (Kent Teenage Pregnancy Strategy March 2010).

2. The Kent strategy has four themes:

• To offer timely prevention, early intervention and support when needed • To support the development of young people’s aspirations and life skills • To develop the children’s workforce so that they are competent and confident to offer appropriate advice and support to children and young people • To seek and respond to the information and advice we receive from children and young people and their families and enable them to shape our services

3. Future direction

1. It was expected that the Teenage Pregnancy Grant would cease at April 2011. However this grant is now within the Area Based Grant. This will allow the post of Senior Commissioning Officer - Teenage Pregnancy and programmes that secure good outcomes to continue for at least a further year.

2. As yet there has been no directive from the government regarding how the teenage pregnancy focus will continue when the Strategy comes to an end in March 2011. However, ministers have urged local authorities to continue with their strategies to reduce teenage conceptions.

3. Reducing teenage pregnancy is an impact indicator in the Department for Education’s Business Plan and an outcome in the proposed Public Health Outcomes Framework. Further detail is expected shortly. In the meantime, Kent will continue to implement the strategy through joint commissioning arrangements.

4. Local Teenage Pregnancy Action Groups

1. All Districts now have teenage pregnancy action groups. The groups are chaired by a strategic lead from the NHS, KCC or District Council. Each group is tasked with providing a local focus to the broader actions put in place at a county level. Each of the groups has two identified priorities, although most have a broader district action plan reflecting the breath of the work required to reduce teenage conceptions.

2. Reporting mechanisms between the action groups and the Local Children’s Trust Boards will be clarified as the LCTB’s develop since their inception late last year. We recognise that local boards know their business and local issues well and are identifying their priorities for the CYPP.

3. It is important for Boards to reflect strategically the social and economic impact of teenage pregnancy, on young women and their children. Even when teenage pregnancy numbers are low there will be a negative impact on the achievement of a range of priorities.

4. The vast majority of young parents and their children will have poorer health and economic outcomes and will need significant health and social support for many years. It is estimated that for every £1 invested in preventing teenage conception there is an £11 saving for the public purse, this cost is exclusive of welfare benefits.[1].

5. Young people can avoid becoming vulnerable if they have sufficient access to information and confidential services to make an informed choice about becoming a teenage parent.[2]

6. In December 2010 the Senior Commissioning Officer for Teenage Pregnancy presented an update to the Kent Children’s Trust Board and identified actions for partners to further progress the success of the strategy. These are detailed for information in Appendix 2 and need to be discussed and endorsed locally.

Kent Children’s Trust Board has agreed the district based priorities and requested that the Local Children’s Trust Boards report back to the KCTB. The Senior Commissioning Officer for Teenage Pregnancy will provide an update to Kent Children’s Trust in March 2011.

Actions or Decisions Required

|The Local Children’s Trust Board is asked to:- |
| |
|1. Incorporate the district teenage pregnancy action group as a sub group to the Local Children’s Trust Board (LCTB). |
| |
|2. Establish local reporting mechanisms to mesh with the outcomes based County wide structure with the district teenage |
|pregnancy action group, also link this reporting to the Kent Children’s Trust Board (KCTB) |
| |
|3. Share successful practice with each other. |

For further information:
Key contact: Ruth Herron
Job Title: Senior Commissioning Officer – Teenage Pregnancy
Telephone Number: 01622 694623
Email: ruth.herron@kent.gov.uk
Appendix 1

Office of National Statistics data: Change by district in conception rates

Figure 1. Under 18 Conceptions, 1998/00 – 2006/08 Progress detail in rates and numbers

[pic]
(Source: Kent and Medway Public Health Observatory)

Real time data: Teenage conceptions estimates by quarter – using maternities (births) and termination data

Real time data using maternity bookings and terminations suggests that the rate of teenage pregnancy is continuing to decrease over the first six months of 2010. It should be noted that this data generally appears to overestimate figures.

Figure 3. Under 18 Conception rates and numbers, January 2008 – June 2010
[pic]

(Source: Kent and Medway Public Health Observatory)

Conceptions in under 16’s

The Office of National Statistics data is used for monitoring and tracking conceptions in young people 15-17 years as local data is not yet available.

Figure 4 Under 16 conception rates 2006/08

[pic]

(Source: Kent and Medway Public Health Observatory)

The data demonstrates that Kent and the majority of districts have seen reductions in conceptions in females 13-15 years and the best progress has been made by Shepway and Dartford.
Priorities by District

Each district has been encouraged to take a local focus for teenage pregnancy and most have developed specific action plans. There are common actions for many areas.

Dartford

Priorities include: • Increase number of pharmacies offering Emergency Hormonal Contraception • Increase number of young people subsequently using C Card

Gravesend

Priorities include: • Increase number of schools offering a health clinic with a sexual health element • Increase number of young people subsequently using C Card

Maidstone

Priorities include:

• Increase locations offering Long Acting Reversible Contraception • Increase access to C Card

Sevenoaks

Priorities include:

• Increase C Card access points • Increase C Card registration points

Tonbridge and Malling

Priorities include:

• Increase locations offering Long Acting Reversible Contraception • Increase the number of schools with health clinics offering a sexual health element

Tunbridge Wells

Priorities include:

• Increase the number of schools with health clinics offering a sexual health element • Increase the number of pharmacies engaged in the C Card scheme • Improve access to Long Acting Reversible Contraception

Ashford

Priorities include:

• Increase the number of schools delivering high quality sex and relationship education • Increase the number of pharmacies engaged in the C Card scheme

Canterbury

Priorities include:

• Increase number of young people registering for a C Card • Increase number young people subsequently using a C Card

Thanet

Priorities include:

• Increase the number of schools delivering high quality sex and relationship education • Increase use of C Card

Shepway

Priorities include:

• Increase the number of schools delivering high quality sex and relationship education • Increase the number of pharmacies engaged in the C Card scheme

Swale

Priorities include:

• Increase the number of pharmacies engaged in the C Card scheme • Increase the number of young people registering for C Card

Dover

Priorities include:

• Increase the number of schools delivering high quality sex and relationship education • Increase the number of schools in Deal area offering a health clinic with a sexual health element

Appendix 2

Actions required by partners to further progress the strategy

Health

• Embed service costs for C Card, pharmacy scheme, outreach nurses, sexual health training, and media materials into core PCT commissioning processes • Increase access to Long Acting Reversible Contraception • Review sexual health services to ensure they target high rate • Commission school nurses to support secondary school teachers in delivering SRE • Develop and embed the You’re Welcome standard in all young people’s health services • Develop General Practitioner services to increase the offer of young person friendly services • Increase the number of school health clinics with a sexual health element • Review termination provision and seek to establish equitable access for young people

o CFE Specialist Children’s Services

• Collect information regarding teenage pregnancy or teenage parent for young people known to Children’s Social Services • Embed SRE training for foster parents • Develop the skills of the workforce to be able to offer basic interventions related to sexual health and teenage pregnancy • Ensure Children’s Centres are the local leads for work with young parents by offering Young Parent Support Groups and working with education providers to offer targeted training for young parents.

o Youth Offending Service

• Collect information regarding teenage pregnancy or teenage parent for young people known to YOS • Develop the skills of the workforce to offer basic interventions related to sexual health and teenage pregnancy

o CFE Learning

• Support and encourage schools to offer high quality SRE • Support schools to develop clear signposting to confidential support regarding sexual health advice and services.

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[1] Teenage Pregnancy Independent Advisory Group Final Report (December 2010) Teenage pregnancy Past Success-future challenges.