Brook Outreach in Bristol Schools

With high teenage pregnancy rates in Bristol, improving access to services is a high priority for Bristol PCT. In 2004-6 the teenage pregnancy partnership worked with the PCT to commission a pilot outreach service targeting vulnerable young people. Brook managed the service, which was delivered by an outreach nurse visiting selected schools, youth clubs hostels and a college.

The success of the pilot led the teenage pregnancy partnership board to develop a successful bid for Neighbourhood Renewal Funding (NRF) to extend the service to other schools in the NRF area. Brook was chosen as a delivery agent because they had staff skilled in working with young people and the flexibility and capacity to extend the pilot rapidly.

The Director of Children's Services wrote to all schools in the NRF area in support of the planned service extension. This was followed up by visits from the Teenage Pregnancy Coordinator to meet the head of each interested school.  Brook was able to offer flexibility in terms of the day and time that service would be delivered depending on the schools need. Although it was different to anything the schools had done before, trusting relationships were built up and the schools accepted the need for the service.

The service was set up rapidly in sixteen schools. Money had been allocated for evaluation and the University of the West of England (UWE) was commissioned to provide this. UWE set up robust monitoring of service usage, which included analysis of characteristics of young people accessing the service, for example if they had ever been excluded from school. Monitoring was also designed to track young people through their service use over the one year pilot period.

The quality and independence of the evaluation helped to secure future funding. The PCT had looked at the programme as an investment and are now mainstreaming the service. The service has now extended to 21 sites including an FE and a Sixth Form College. A sexual health worker has also been recruited to work one-to-one with young people that need extra support.

Brook adds value as a delivery agent because they have skilled staff and a good name with young people. Brook nurses often work in NHS community clinics as well so this helps build relationships between services. One of the findings from the UWE evaluation was that some young people were put off using the service in school because it was clearly a sexual health service and did not want to be seen visiting it. As the service enters the next phase a new specification with school health is being developed which focuses on building capacity. The aim is to train school nurses to be able to deliver EHC and work alongside Brook outreach nurses.

The pilot period indicated that involvement of the youth services was essential in ensuring that young people at risk were supported to attend the service. A partnership was established with the youth service so that all the school based services are supported by a local youth worker. Alongside this, 4 youth workers have been appointed as part of the outreach team to support the drop-ins by offering the condom distribution scheme and doing small group work. They also support the delivery of sex and relationships education in schools to ensure links are made between SRE and local service provision.
 
The publication of the UWE report in 2008 prompted a flurry of press interest. The Teenage Pregnancy Coordinator and Brook briefed schools about handling press queries - and the Director of Public Health added weight by contributing a quote. Media coverage was generally positive. The robust evaluation of the service clearly shows that it is valued by young people, since it was reported that 61% of young people using the service would not have used any other service.

Further information and contacts:
Anne Colquhoun, Teenage Pregnancy Coordinator, Bristol
Email: Anne.Colquhoun@bristolpct.nhs.uk

Jackie Haskins, Brook Outreach Nurse Manager, Brook, Bristol
Email: jhaskins@brookbristol.co.uk

UWE research report and press release.

Brook 4YP Outreach Bristol [PDF 115KB]
Presentation delivered at a Sex Education Forum Conference on schools and sexual health services, April 2009.