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ITEM EX8

OXFORDSHIRE TEENAGE PREGNANCY PLAN

Report by Director for Social & Health Care

1. The work of the local Teenage Pregnancy Strategy is subject to external scrutiny on an annual basis, by the Regional Teenage Pregnancy Assessment Panel (based at the Government Office of the South East) and the Teenage Pregnancy Unit (a cross-governmental unit, based in the Department of Health). The purpose of this report is to present the outcome of the last assessment, received in June 2002. The categories for assessment were: Local Co-ordination Arrangements; Better Prevention: Sex and Relationship Education (SRE); Better Prevention: Services; and Better Support for Teenage Parents. The overall feedback was extremely positive. A copy of the full assessment/report and the officers’ response is available in the Members’ Resource Centre.
2. An Action Plan which responds to the recommendations made in the report is being implemented. This was compiled by the Teenage Pregnancy Partnership Board, the multi-agency group who have responsibility for the development and implementation of local teenage pregnancy plans.
3. This report provides an overview on the work of the Oxfordshire Teenage Pregnancy Strategy, and is also being presented to the Executive Committee of Oxford City Primary Care Trust (PCT)

Background

4. Following the publication of the Social Exclusion Unit Report on Teenage Pregnancy (1999), the Teenage Pregnancy Unit (TPU) was established and charged with delivering a 30-point national Action Plan. The TPU has two main aims:

• to reduce by 50% the number of conceptions to young women aged under 18 (over the next 10 years);
• to reduce the social exclusion experienced by young parents (by getting 60% of young parents into education, training or employment by 2010).

5. In order to meet this national target, regional and local structures were developed to support the work occurring nationally. All local authority areas had to nominate a Local Teenage Pregnancy Co-ordinator and establish a multi-agency Partnership Board to oversee the development and implementation of a local Teenage Pregnancy Strategy. This work was funded initially through a Local Implementation Fund, given to the Health Authority, and since April 2002 given to the local authority. The local Co-ordinator is jointly managed by the Social & Health Care Directorate and Oxford City PCT. Every March it must send an Annual Report to the Regional Teenage Pregnancy Assessment Panel, which assess the progress made locally and identify areas for development.

Targets

6. The Teenage Pregnancy Partnership Board has the following targets to meet:

• Reduction of under-18 teenage conception rates in Oxfordshire by 45% by 2010 (with an interim target of 15% reduction by March 2004).
• Increase the proportion of teenage parents in education, training and employment to 60% by 2010, in order to reduce long-term risk of social exclusion.
• All lone parents aged under 18, who cannot live with their parents or partner, should be provided with suitable accommodation with support by March 2003.

7. These Targets have also been incorporated into the following agencies:

• Primary Care Trusts - reduction of the under 18 teenage conception rate is a PCT Performance Indicator. Furthermore, the recently issued document ‘Improvement, Expansion & Reform: The Next Three Years– Priorities & Planning Framework for 2003-2006’ (Department of Health, September 2002) incorporates this target into the Reducing Health Inequalities section.
• Connexions – must reduce teenage conceptions rates by the locally agreed target and increase the proportion of teenage parents in education, training and employment to 60% by 2010.
• Local Authority (Housing Departments) – must ensure that Target 3 is met by 2003; all lone parents under 18 must be provided with suitable accommodation with support.

8. While Oxfordshire as a whole has a lower average teenage conception rate than England, this conceals areas where our rates are well above the average. The rates in at least two local wards fall within the 20% highest rate wards in the country (Blackbird Leys & Neithrop). See Annex 1 for more details.

Geographical area	Conception Rate for 15-17 year olds (per 1,000) for 1998-2000
England	44.9
South East Region	36.4
Oxfordshire	30.9
Oxford City DC	40
Cherwell DC	31.8
West Oxfordshire DC	31.8
Vale of White Horse DC	27.3
South Oxfordshire DC	22.2

Source: ONS (2002) & Public Health Information Team (2001).

9. Approximately 240 children are born to young mothers (aged 19 or under) every year in Oxfordshire.

Age of Mother at birth of Child	Proportion of all Births to Teenage Mothers
19 years	40%
18 years	30%
17 years	19%
16 years	8%
15 years	3%
13 & 14 years	0.3%

Source: Child Health Database

Primary Care Trust	Proportion of Births to Teenage Mothers (aged 19 and under) by PCT
Oxford City	35%
South West	28%
Cherwell Vale	19%
North East	12%
South East	6%

Source: Child Health Database

10. No reliable data on the ethnicity of teenage mothers was available at time of writing.

Areas of Commendation made by the Regional Assessment Panel

11. There were a significant number of strengths highlighted in the report, notably:

• Joint management of TP Co-ordinator
• Excellent range of Working Groups supporting the Partnership Board (including the Planning, Monitoring & Evaluation Working Group)
• Action Plan is evidence-based, practical and achievable

• Good ethos of reviewing effectiveness of resources and advertising.

• Existence of Bodyzones in schools & community settings.
• Work of Space Young People’s Project (based at Terence Higgins Trust Oxfordshire)
• Supporting schools to deliver better SRE: through production of county SRE Guidelines; training of Governors; SRE Advisory Teacher post; survey research project on SRE.

• GP Audit on Accessibility of Primary Care for Young People
• GP Confidentiality Training in all PCTs
• Links to the Sexual Health Strategy Group
• Space Young People’s Project work in Huntercombe Young Offenders Institute (YOI)

• Health Liaison Worker post – jointly managed by Youth Service and Teenage Pregnancy (TP) Co-ordinator; working with young parents and leading strategically on initiatives to provide better support for young parents and training to professionals around sexual health promotion.
• Small Projects Fund – for Young Parent Support Groups to run initiatives to improve the health or educational outcomes of young parents.

12. The following particular areas were highlighted.

• Clear accountability for TP Plans to be established, ensuring senior support from OCC and the PCTs.
• Ensure Learning Skills Council & Early Years Partnership involved with the local Teenage Pregnancy work plans.
• Ensure Action Plans & funding are aimed at high rate teenage pregnancy areas outside of Oxford and in improving access to services for young people in rural areas.

• Develop Media Strategy (including how to handle press enquiries).

• Unclear progress made in SRE development in mainstream schools and how schools in high rate teenage pregnancy areas are being targeted.

• Involvement of PCTs from rural areas
• Ensure access to contraception for young people in rural areas
• Ensure young people have access to emergency contraception 7 days a week

• No work with LEA and schools to ensure young (expectant) mothers of compulsory school-age have appropriate educational provision.
• No Action Plan in place for meeting the childcare needs of young parents.
• No assessment of whether Oxfordshire will meet its Housing Target

13. An Action Plan has been developed and is being implemented – see Annex 2. The plan identifies the key tasks and organisations responsible. Where specific tasks/resources are requested from organisations, detailed reports will be presented.

Financial and Staff Implications

14. The Authority has an annual grant of £60,000 to implement this strategy. In addition, Health contributes funding for the SRE Advisory Teacher, part-funding for the TP Co-ordinator (as well as administration time and premises), the time of other Health professionals. The purpose of the grant is to create the services that will be necessary to sustain a reduced level of teenage pregnancy over a period of time, together with appropriate support services for those that become parents.
15. There are no staff implications arising directly from this report.

Implications for People Living in Poverty

16. Most teenage parents rely on benefits and therefore reducing the rate of teenage pregnancy and increasing support for those that become pregnant means that life chances for both them and their children are significantly improved.

Implications for Ethnic Minorities

17. Hitherto the collation of this information has been poor and work is planned with the PCTs to identify ethnic origins of those who become pregnant and those who become parents, so that a Work Plan can be drawn up and implemented.

RECOMMENDATIONS

18. The Executive is RECOMMENDED to:

1. note the areas of strength and weakness of the Oxfordshire Teenage Pregnancy Plan;
2. endorse the Action Plan in Annex 2. to the report, developed in response to the Regional Assessment Panel’s Report;
3. authorise the Director of Social & Health Care to ratify the 2002/03 Oxfordshire Teenage Pregnancy Annual Report and the 2003-4 Action Plan in consultation with the Executive Members for Children & Young People and Community Care & Health.

CHARLES WADDICOR
Director for Social & Health Care

Background Papers: Nil

Contact Officers: Phil Hodgson 815833, Fran Fonseca -815005

November 2002

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