Agenda item - Sexual Health and Teenage Pregnancy

Agenda item

Sexual Health and Teenage Pregnancy

Report of the Director of Public Health

Minutes:

Helene Denness, Consultant in Public Health, introduced the topic of Sexual Health (including RSE and Teenage Pregnancy) to the Board. She summarised the complex commissioning model meaning that local authorities, CCGs and NHS England are each responsible for different services within sexual and reproductive health landscape. She went on to introduce Uzmah Bhatti, Public Health Insight Manager who presented a number of slides around sexually transmitted infections highlighting the following points:

 

(a)  Some STI rates in Nottingham were higher than comparators.  Whilst acknowledging the gravity of this, it was highlighted that Nottingham had significantly high testing rates and positivity rates.  There is a suggestion that higher testing leads to higher detection rates and the fact that Nottingham had high positivity rates meant that the right people were being tested and testing resources were being used efficiently;  

 

(b)  There has been an increase in rates of Gonorrhoea, with a small but steady increase in diagnoses in older age groups. This trend in the diversification of age groups is also seen across other STIs;

 

(c)  There has not been a significant reduction in the instances of genital warts since2016, further work is underway to understand this and inform any action.

 

Catherine Kirk, SRE Consultant presented slides to the committee focusing on Relation and Sex Education highlighting the following information:

 

(d)  There was a positive response to the day, not only in city schools but also across the wider country as RSE Day became a national celebration for the first time after being pioneered in Nottingham;

 

(e)  Nottingham City Council recognises the concerns raised by some families and is leading discussion and supporting schools to enable all young people to access age appropriate RSE;

 

(f)  The RSE Charter is currently being refreshed and updated guidance issued in light of new legislation being issued recently;

 

(g)  Nottingham City Council recognises that it is important to work with parents around any concerns and share best practise with schools to encourage an open and frank dialogue between parents, schools and the wider community;

 

Helene Denness went on to present information around teenage pregnancy.

 

(h)  To date the work to reduce teenage pregnancy rates has been effective and the rate of teenage pregnancy has been reduced by almost 65% in Nottingham since the baseline year of 1998;

 

(i)  However, teenage pregnancy rates in Nottingham are still higher than the national average, higher than our statistical neighbours and there are still wards within Nottingham where the rate is significantly higher than the Nottingham average;

 

(j)  Since 2012 there has not been a statistically significant reduction in the Nottingham teenage pregnancy rate;

 

(k)  Nationally and locally, 80% of teenage conceptions are to 16 and 17 year olds with the remaining 20% to under-16 year olds.

 

Ruth Taylor, NHS Consultant in Sexual Health gave the Board an overview of some cases seen in the City Centre Clinic on a daily basis and the day-to-day work her colleagues performed. She emphasises the range of ages of patients as well as the range of issues they presented with.

 

Following questions and comments the following information was highlighted:

 

(l)  Although there is no specific mention of work with BAME communities, a Health Equity Audit with a specific focus on access by BME service users is being conducted.  The results of this audit will be shared with Board members when they are available;

 

(m)Demographics of patients accessing clinics are recorded but rely on self-identification of patients and not all patients wish to declare their ethnicity, therefore, there are a high number of incomplete records in terms of ethnicity;  

 

(n)  There are a number of services available where there are multi-language clinicians, most notably at the Mary Potter Centre.  If committee members are aware of links that can be made into BAME and emerging communities they are asked to make officers aware so that further connections into the community can be made;

 

(o)  There were a number of well publicised protests around RSE in schools recently. Head Teachers, the Leader of the Council, and the Deputy Leader of the Council met with religious and non-religious groups, to discuss concerns. Parents had access to the teaching materials and the community was reassured. In addition to this Councillors have signed up to the RSE charter;

 

(p)  Commissioning pathways need to be improved to ensure that services are not duplicated and that no one falls into gaps between services.  Once the PCN’s and the ICP is in place, it is envisaged that better collaboration will be facilitated and will lead to more efficient commissioning of sexual health services;

 

(q)  A targeted focus on digital education should be considered  for 12-25yr olds as an effective way of further progressing access to information and education around sexual health;

 

RESOLVED to:

 

(1)  Conduct a sexual health commissioning review to ascertain if and where there are any gaps

 

(2)  Aim to protect the sexual health budget from further cuts.

 

(3)  To consider guidance  in the House of Commons Health and Social Care Committee report on Sexual Health and identity long term opportunities  around integrating commissioning of services

 

(4)  Support the RSE agenda mandatory roll-out and continue to work together to overcome challenges and resistance by addressing local people’s concerns

 

(5)  Support recommendations from the Teenage Pregnancy JSNA upon completion later this year.

 

 

Supporting documents: