Sexual Health Outreach Services in Croydon Colleges

The aim of the project
The aim of the project in Croydon is to improve sexual health service provision and SRE to young people of post-compulsory school age. There was a recognition that conception rates in Croydon amongst post-school aged young women (16-18 year olds) were high and the project also aimed to reduce these rates.

Strategic development
The initiative was led by the Public Health Lead -Young People for Croydon. Following a teenage pregnancy needs analysis, the Public Health Lead -Young People put in a bid as part of the NHS Croydon Commissioning Strategy and local Operating Plan for funding for a variety of young people's sexual health promotion and contraceptive initiatives. Service development in FE colleges was one element of this bid and an additional £15,000 was made available by the Department of Health to assist with the development of the sexual health clinics during 2009/2010.

Partners involved
This initiative included all three FE colleges in Croydon, and involved working closely with Senior Managers in the colleges as well as Welfare and Enrichment Leads. Additional support has been provided to help promote general SRE and sexual health information events within the colleges by the NHS Teenage Pregnancy and Sexual Health Outreach Team, other health colleagues and local voluntary sector partners and to ensure that all young people in Croydon attending college are able to access a holistic package of sexual health care.

Service development
Sexual health outreach services have been set up in all three Croydon colleges. These clinics are run by the Young People's Sexual Health Outreach Nurse. These took place initially once a week for two to three hours, but have been subsequently increased. Young people tend to access this service on a drop-in basis; however, appointments are also available.

As part of this initiative all the colleges have developed comprehensive SRE policies. They also work with the local Teenage Pregnancy and Sexual Health Outreach Team to deliver teenage pregnancy prevention programmes (TP3) and sexual health peer mentoring opportunities. They have also been involved in delivering regular DASH (drug, alcohol and sexual health) education and information events in each college, along with other sexual health information and chlamydia screening events.

The Public Health Lead -Young People and other members of the Teenage Pregnancy and Sexual Health Outreach Teams deliver specialist SRE and sexual health services within the colleges. The following sexual health services are available in all colleges as part of the sexual health drop-ins:

  • sexual health information, advice and support
  • free condoms, femidoms and lubricant
  • pregnancy testing
  • referral for termination
  • chlamydia testing and treatment
  • emergency contraception
  • hormonal contraception, including contraceptive pills and Depo-Provera injections
  • advice on and referral to family planning services for implant/IUD
  • advice on STI screening at the genito-urinary medicine (GUM) clinic.

Working with specific groups of young people
In addition to the sexual health clinics set up in each of the colleges, sexual health drop-in services have also been developed in a range of other targeted settings and in other areas of the borough where there are high teenage pregnancy rates. These services are open to all young people but particularly those identified as being particularly vulnerable, such as NEET young people, young, asylum seekers, looked after children and care leavers, and young people under the youth offending team etc.

The needs of LGBT (lesbian, gay, bisexual and transgender) young people are included in the colleges' SRE policies, developed with advice from the Teenage Pregnancy and Sexual Health Outreach Team. Sexual health services are also mindful of the needs of LGBT young people and those exploring or questioning their sexuality. In addition to these generic services, Croydon also has specific LGBT support services for young people.

Learning and future development
It was recognised that it was necessary to have a local champion who can ensure that the vision is implemented. Benefits to the college were clearly explained and the strategy promoted as a joint enterprise. Monitoring and evaluation of uptake is happening in each clinic setting as well as user evaluation. The outcome of this is fed into ongoing service development and improvement.

As a consequence activity has been increasing by about 10% year on year with approximately 1400 young people who accessed these sexual health drop-in clinics in 2011-12. Gender breakdown remains consistent at approximately 2:1 female to males.

It is believed that this intervention has had a significant part to play in Croydon's success in reducing its teenage conception rates over recent years.

Croydon is keen to maintain and improve this successful service and considerations for future development include:

  • provision of a LARC clinic in one of the larger colleges in partnership with the local contraceptive health service
  • provision of screening for other STIs.

Material for this case study contributed by Kate Naish, Public Health Lead -Young People, and Katie Greenaway, Sexual Health Outreach Nurse for Young People and updated October 2012.