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Sexual Health and Relationships

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Introduction

The Government's Framework for Sexual Health Improvement in England (2013) reports that most people become sexually active and start forming relationships between the ages of 16-24 years.

Regrettably, sexual health can be surrounded by stigma, prejudice and discrimination which makes it difficult to access information and openly discuss issues which affect both individuals and communities.

Young people in this age group have significantly higher rates of poor sexual health, including sexually transmitted infections (STIs) and abortions, than older people. However, sexual health is more than sexually transmitted infections such as HIV or Chlamydia.  Sexual health also refers to the emotional and physical aspects of sex, sexuality, sexual activity and relationships:

Sexual Health and Relationships forms part of the wider Blackpool Sexual Health Needs Assessment 2016 and further information is found in the Sexual Health section

Personal, Social and Health Education (PSHE)

The Schools White Paper 'The Importance of Teaching', published in November 2010, states that children need high quality sex and relationships education (SRE) so that they can make wise and informed choices. Whilst it is compulsory for all maintained schools to teach some parts of sex education, i.e. the biological aspects of puberty, reproduction and the spread of viruses, the broader topic of sex and relationships education is currently not compulsory but is contained within non-statutory PSHE in the National Curriculum and is strongly recommended within SRE Guidance1. School governors are by law expected to give 'due regard' to this guidance. Academies and free schools do not have to follow the National Curriculum and so are not under this obligation but if they do decide to teach SRE, they also must have regard to the guidance.

Academies have greater freedoms than maintained schools, including not having to follow the National Curriculum.

Figure 1: The difference between the current legal status of SRE in maintained schools and academies
Maintained schools Academies 
 Required to have a broad and balanced curriculum   Required to have a broad and balanced curriculum
 Must have regard to SRE Guidance 2000  Must have regard to SRE Guidance 2000
 Sex education is compulsory as part of the statutory Science Curriculum  Sex education is not compulsory
 Requirement to have up-to-date policy on SRE  There is no requirement

In view of the above, and that two of Blackpool wards have consistently higher referrals for child sexual exploitation, SRE should be given high priority in all secondary schools in Blackpool, including academies. This may also go some way to address the high teenage pregnancy rates seen in some areas of the town.

Connect

Attendances at the young people's sexual health service 'Connect' have declined from around 8,500 in 2011/12 to 5,200 in 2015/16. Reasons for the fall in attendances include rectification of data quality issues and Connect ceasing to run the C-Card (condom distribution) scheme in 2012/13. A higher number of young people (under 25) have attended the 'all age' service at Whitegate Drive rather than the Connect Young People's centre on Talbot Road in the last 3 years (figure 2). However, despite a reduction in the number of attendances year on year at both services, the greater reduction (22%) has been at Whitegate Drive compared to 11% at Connect in the same period. From April 2016, the 'all age' and 'young people' services have been re-commissioned as two separate contracts. It is expected that innovative developments and marketing of the dedicated young people service will reverse this trend, with an expectation that more young people will access sexual health services through Connect.

Figure 2: Young people (<25) total attendances at Blackpool sexual health clinics.

AttendancesatSHS
Source: Blackpool Teaching Hospitals Sexual Health Service

Figure 3 demonstrates that a greater proportion of young people aged under 25 attend sexual health services in Blackpool compared to older age groups. However, whereas the number of attendances in people aged 25-35 has not changed in the last 3 years, a gradual reduction has been seen in the number of attendances in the under 25 age group. In 2013/14, young people under 25 in Blackpool made up 60% of all attendances at SRH, decreasing to 55% in 2015/16. Nationally, young people make up approximately 40% of all attendances and this proportion has not changed significantly over the last three years.

Figure 3: All clinic attendances (by age) - Blackpool residents

Clinicattendancesbyage
Source: Blackpool Teaching Hospitals Sexual Health Service

Health Related Behaviour Survey (School Health Education Unit)

The SHEU survey provides valuable insight into the health behaviours children of young people and this insight is expected to be used in very practical ways to shape services based on need. Results from the 2015 SHEU Survey show 47% of Year 10 boys and 63% of Year 10 girls say they know how to access contraceptive and sexual health advice locally. Thirty six per cent of pupils said that school lessons were their main source of information about sex. PHSE within Blackpool schools aims to improve on this by raising greater awareness, knowledge and understanding.

    • 8% of Year 10 pupils said that they were currently in a sexual relationship.
    • 15% said that they had a sexual relationship in the past and 4% said they were currently in a relationship and thinking about having sex.
    • 47% of pupils said they have used an Internet chat room.
    • 10% of pupils said they have received a chat message that scared them or made them upset.
    • 45% of pupils said they have seen images aimed at adults
    • 30% (63% Year 10 boys) of pupils said they had looked online for pornographic or violent images, games or films.

Wellbeing in Sexual Health (WISH): Young People's Harm Reduction Service

The WISH team offer 1-1 and group support to young people under 18 regarding sexual health and relationship issues. The team support schools with their delivery of sexual health and relationships education and training to professionals on how to support young people who engage in risk taking behaviours.

The service is available to young people aged under 18, but extends to under 25 for young people with a learning disability. The team's primary focus is on young women to reduce the risk of under 18 conception. The team offer 1-1 and group sessions for vulnerable young women and group sessions for young men. The team work predominantly with schools and colleges but also receive referrals from other services, such as clinical sexual health services. As the service is offered throughout Blackpool schools and colleges, it is also accessed by some out of area residents.

Group and 1-1 work focuses on sexual health issues, contraception, healthy relationships, challenging gender stereotypes and raising aspiration. Sexually active young people are encouraged to access STI testing, particularly Chlamydia testing. The work with young women focuses on improving access to long acting reversible contraception (LARC) and WISH workers will often accompany young women to appointments for contraception. More recently, the team have been working closely with young people's clinical sexual health services to implement domiciliary visits for LARC, particularly for high risk young people.

A mobile provision called 'The Bus' also operates for young people aged 13-19 years. The bus allows the WISH team and other professionals to listen and give advice and information on sexual health, relationships, drugs, alcohol, smoking and other issues. The team also coordinate the C-Card scheme - a condom distribution scheme for young people.

C-Card Scheme

The WISH team took over the running of the C-Card (condom distribution) Scheme in April 2013. This is a free condom distribution scheme providing quick, easy and confidential access to condoms for 13-18 year olds. Young people are registered onto the scheme by a nurse or other trained professional. Under-16's have to re-register after getting six lots of condoms and over-16's after ten lots of condoms. This allows the nurse/trained professional to monitor the sexual activity and safeguard the young people where issues are identified. There was on average 750 clients registered with the C-card scheme at any one time in 2015/16.

 


[1] Dept for Educationa and Employment, Sex and Relationship Education Guidance, DfEE 0116/2000, July 2000