Targeted youth support: redesigning services - rolling out good practice around teenage pregnancy through the targeted youth support change process

Issue
Conceptions among young women of 18 and below have reduced by 23.8 percent in Leicester since 1998, compared to 11.1 percent nationally. However, Leicester's under-18 conception rate of 49.2 per 1000 conceptions is higher than the East Midlands (41.0) and the country as a whole (41.5). At the current rate of improvement the authority's 2010 target of a reduction to 29.1 may not be met.

Leicester teenage pregnancy strategy needs to address longstanding issues around sex and relationship education (SRE), increase the availability of contraceptive services across the city, reach resistant professional groups and find ways to make the best use of scarce resources.

Background
Initiatives delivered across Leicester City by the teenage pregnancy and parenthood partnership include:

Turning Point: this voluntary agency has developed an effective SRE programme that uses trained peer educators to deliver SRE in schools and youth settings across the city. It is currently being delivered in eight secondary schools in the hotspot areas

The Community health development worker for New Parks (the TYS pathfinder area) is employed by the Primary Care Trust (PCT) and has established an effective practice model with the youth service and Choices contraceptive service for young people. This group has set up two contraceptive and sexual health drop-in services in youth clubs in the area and is in the process of setting up a C-Card (condom distribution) scheme

The Parenting Information and Pregnancy Support (PIPS) team provides intensive support to pregnant young women and parents under 19 years of age. The team includes specialists from midwifery, Connexions and early years, and provides holistic support to young people from the moment they suspect they are pregnant through to parenthood. The Connexions team includes two peer advisers who are young parents themselves

The Teenage Pregnancy and Parenthood Partnership Board has commissioned De Montfort University to evaluate all prevention aspects of the teenage pregnancy prevention strategy, including:

Sex and Relationship Education (SRE) Provision
Contraception (sexual health) services/provision
Engagement of appropriate agencies
Promotion and media publicity
Involvement of young people

These areas will be investigated and assessed on: the experience and opinion of young people, parents and professionals; factors that have enhanced and hindered developments since the strategy was implemented; what is working - good practice, and what is not working; where improvements need to be made; how young people and service users are involved; gaps in local knowledge and provision; and how the teenage pregnancy strategy is perceived.

Actions prompted by TYS
Despite the challenges of special measures, New Park's secondary school, New College, has recognised the links between poor school attainment and a wide range of social issues including teenage pregnancy.

A member of the school's senior leadership team has been appointed to lead on pastoral support, including sexual health, crime, smoking and substance misuse advice and is actively involved in the TYS process and is part of a TYS change team.

Benefits/results
Involvement in the change team has brought the school in regular contact with leads on a number of initiatives, including the local Teenage Pregnancy Coordinator and the Turning Point Peer Educators lead who is now delivering a series of sessions on sexual health and relationships in the school.

Young people in New Parks are being recruited as peer researchers to investigate and assess the quality of sex and relationship education and services in the area, not only the school. This evaluation, combined with routine monitoring, will assess the effectiveness of the interventions.

In addition, links are being strengthened with the specialist PIPS team to improve how it incorporates its services into local universal services to provide early support for professionals and young people.

Agencies have been more than willing to pull the work together and look at the needs of the local community in New Parks. Teenage pregnancy projects and initiatives are now operating in the area to enhance and strengthen the TYS learning and local practice.

TYS has helped us replicate the successes we've had in other parts of the city into New Parks, says Kirsty Reid, Teenage Pregnancy Coordinator in Leicester City. It has been the catalyst that has enabled us to do this quickly and has given us the opportunity to invest and integrate local resources, expertise and initiatives into the community with the intention to improve health and social outcomes for children, young people and their families.

The local authority
Leicester City is an urban unitary authority with high levels of black and minority ethnic (BME) individuals. However, this case study relates to a largely white working class ward with high need, but fewer deprivation indices than other areas in the authority, and has, as a result, received fewer funded initiatives. Other authorities with similar characteristics to Leicester (DfES statistical neighbour measure) include Wolverhampton, Sandwell, Coventry, Blackburn with Darwen, Derby, Walsall, Luton, Birmingham, Nottingham and Southampton.