Securing Senior Support for School-Based Health Services

Developing school-based health services has been on the agenda in this local authority for 6 years. Funding difficulties for the PCT meant that a pilot in one school in 2005 could not be mainstreamed.

The Youth Service has been at the forefront of service provision with the condom-card scheme in youth points, supported by the PCTs Health Promotion Service. This scheme is advertised through school sex and relationships education and by school nurses - but to-date condoms and other contraception have not been available in schools.

Sexual health service development for young people had been static in this local authority for some years. But with the 2010 targets for the teenage pregnancy strategy looming - and recent conception rates showing a slight increase - attention has become sharply focused on improving young people's access to contraception and services.

The Teenage Pregnancy Coordinator (TPC) has led the local authority in developing a strong consensus voice on the need for services informed by evidence gathered locally and nationally; from a resident questionnaire, evaluation of the pilot school service in 2005, consultation with school councils and the Sex Education Forum national mapping survey.

The Director of Children's Services (DCS), has played a crucial role in securing support from senior PCT officials. The DCS explains that the TPC cannot be expected to be effective unless they have direct access to the DCS - even if via another officer. In this locality, the conversation with the PCT was led by the DCS following consultation with the TPC. The DCS went to the PCT Chief Executive - articulating that support from the PCT was essential if the necessary services were to be developed to tackle teenage conception rates.

As each area is different the DCS advises that in some cases it may be more effective for the DCS to approach the Director of Commissioning. In this local authority, the DCS has a monthly meeting with the PCT Chief Executive - enabling services to go on the agenda and remain on it for follow up.  Support and funding from the PCT has now been secured for the development of 4 school-based and 1 college-based health service to open in December 2008.

Besides the need for funding another blockage to service development had been the assumption that heads and governors would not be supportive - but meetings with individual schools showed that this was not the case. Four influential heads are now signed up to service development in their schools. The Local Authority has played a role in supporting communications with schools around this agenda. The Head of Learning Services was able to act as a broker - by helping to find the right language to approach schools - and the right forums: the monthly heads meeting - and through representatives from schools attending Children's Trust meetings.

Eagerly awaiting the launch of four school-based health services the TPC says that it has been important to link teenage pregnancy issues to the bigger picture of young people's health and well-being. The DCS encourages her peers in other local authorities to take advantage of a new environment, which facilitates the PCT and Local Authority to take shared responsibility for the sexual health of young people, pointing to: 

- The advent of Local Area Agreements with teenage conception rates included as a priority in most local authorities

- Increased profile for children's health through creation of DCSF, the Children's Plan and the forthcoming Child Health Strategy

- The duty on Local Authorities to form Children's Trusts - which include the PCT as statutory partners.