The Practicalities of Running Time4U in a Worcestershire School

The brand
The Time4U brand has been designed to offer a consistent young-person centred service in a range of settings including schools, colleges and youth centres across Worcestershire.  The Time4U service is staffed by a team of family-planning trained nurses who offer confidential one-to-one advice about any health-related issues the young person wants to discuss including smoking, diet and stress. As well as providing advice, information and referral Time4U nurses can provide contraception, pregnancy testing and Chlamydia testing  where needed.

Youth work bridge to service
The Time4U service at Dyson Perrins is staffed by a Time4U nurse, a School nurse and a Time 4U outreach worker. This makes it possible to have informal health promotion sessions that young people can attend in small groups with the option to see the nurses on a one-to-one basis. The outreach worker focuses on building trust with young people - and has noticed that young people may not access the nurse the first time they come - it may be after several visits. This 'health service promotion' role is invaluable and relies on youth work skills. A local youth worker was previously placed in this role on a trial basis - and found she was ideally placed to build on her relationship with local young people to make successful links to Time4U. 

A different health promotion theme is chosen every month for example being safe in the sun and healthy eating.  The nurses and outreach workers set up leaflets, games and activities to engage young people in discussion. At the same time young people approach the nurse about a wide range of health issues including mental health, sexual health, smoking and diet.

Opening hours
Time4U at Dyson Perrins is open every Friday lunch-time and is always busy. In other schools the service has been piloted after school hours but attendance was very low. Because the lunch-time session is busy young people can get a slip from the nurse excusing them from lessons and they can then access the service before or after the lunch-time.  A Time4U outreach team that operates throughout Worcestershire is on call to visit the school for out-of-hours requests.

Service promotion and use
Students first learn about Time4U in assembly. Every September information is presented about what the service offers so all students hear about it. There are also posters in the school and a metal swing-sign is put out every week near the entry to the drop-in during opening hours.
The service is mostly used by Year 10 and 11 - and there is a fifty-fifty split between boys and girls. The nurse explained that sometimes boys ask for condoms not because they are having sex but because they want to learn about them and practice using them. Time4U staff are comfortable with this as it supports boys to be more confident in using condoms in the future, accessing services and talking to health staff.

One Year 10 boy using the service said that the first time he came to visit Time4U he came in a group. Finding the atmosphere relaxed he felt OK about coming back on his own or in a pair. He explained: "you feel you can talk - its really informal rather than you shouldn't do this, shouldn't do that". He also said that if other students ask him about Time4U he tells them where it is and that it is a good place to go to.

Getting educated
Young people attending Time4U said the drop-in backs up their learning in Personal Social and Health Education - for example doing a condom demonstration in class and also at the drop-in. Being able to ask questions one to one was seen as an advantage of the drop-in: "It's more one to one - If you ask something you're not sure about in lessons it's like ha ha".

One student was very clear that teaching about sexual relationships needs to happen before it happens to you: "It's a bit worrying because you are not taught and then when things happen you don't know what to do". He advised other schools not to try and shelter young people too much - complaining that if you type 'sex education' into the internet you get either pornography or teachers TV - but nothing that actually helps young people get the facts.
 
Support for Time4U at Dyson Perrins
The senior management team were aware that learning in PSHE can only go so far - children at the school also needed one-to-one health advice. Time4U was already set up in another local school so this provided a model to understand how it would work in practice. The next step was to consult with the school council, parents and governors.

Information went out in the school newsletter and parents were invited to a meeting. Some parents were concerned about the service providing contraception so it was agreed that the service be promoted as a general health advice service. Staff had initial concerns about young people coming out of lessons and how it would affect their role. However far more problems were anticipated than actually materialised.

Approval from the governing body was key to moving forward - with governors recognising that the service complemented the schools Church of England ethos of prioritising young people's welfare.
Since the service opened adults and young people alike see it as a success. Teaching staff say it helps them to be able to tell students there is Time4U - and avoid awkward situations where they feel out of their depth to advice. Staff learn about the service routinely as part of their induction programme and in ongoing staff training.

On-going management and review
The service at Dyson Perrins has been very successful and Liz Swann, the Time 4U nurse puts this down to the pragmatic and professional approach of the school management. Each venue that hosts Time4U manages the service by holding regular meetings. At Dyson Perrins school a meeting is held every half-term and includes the Assistant Head, Time4U nurse School nurse and outreach worker.  This is an opportunity to discuss any issues arising and flag up seasonal health promotion themes that are planned for the next few weeks.

Adjustments have been made along the way - for example the drop-in was sited in a thoroughfare area to start with - but this did not work so it has now been moved to a more quiet area. 
In terms of school performance - the Time4U service is linked into internal auditing of Every Child Matters. The service has also been praised externally through inspection. Assistant Head Teacher Wendy Bevan sums up the contribution of Time4U to Dyson Perrins school: "it has given us an additional string to our bow".

Contact:
Assistant Head Teacher, Dyson Perrins School: Wendy Bevan: wb@dysonperrins.worcestershire.uk Time 4U Nurse, Worcestershire PCT: Liz Swann: eswann@nhs.net
Time4U Service Manager, Worcestershire PCT: Kim Tanner, kim.tanner@nhs.net