FAQs - Sexual Health Services in Further Education

Q1. How can we fund sexual health services in further education settings?

Q2. Can we include 14-16 year olds in college services?

Q3. Can we offer a confidential sexual health service in further education settings?

Q4. Will we get adverse media publicity?

Q5. What is the role of tutors in promoting young people's sexual health?

Q6. How can we support young LGBT people?



Q1. How can we fund sexual health services in further education settings?

There is no single model for funding on-site services, but successful strategies include:

1. Effective networking which helps to build relationships and facilitate 'finding out fast' about funding possibilities.

2. Multi-agency working and joint commissioning which enables the pooling of expertise and resources. All partners involved should contribute resources, as this generates joint ownership and commitment from all parties.

3. Exploring the possibility of accessing local grants, for example through the Neighbourhood Renewal Fund and European Social Fund.

4. Starting small with an achievable and relatively inexpensive goal, such as setting up a condom distribution scheme, then evaluating progress and using evidence of success to attract further funding.

PCT and Local Authorities are jointly responsible for the Public Service Agreement to reduce teenage pregnancies. The PCT should provide sexual health services in colleges because it will help them to achieve their targets.

In some colleges health professionals employed by the PCT visit the college to staff a drop-in clinic, for example three lunch-times per week.

The involvement of specialist contraception and sexual health nurses extends the range of services that can be offered in a non-medical setting. It also extends the PCTs access to a key target group.

Provided adequate training is given, non-medical professionals such as student services staff and counsellors can offer condom distribution and pregnancy testing. Combining PCT funded medical professionals with trained non-medical staff in this way is an extremely efficient use of resources. This creates joint ownership so helps to ensure sustainability.

PCTs also provide non-staff resources such as local health promotion campaign materials and access to free condom schemes. Many PCTs are actively engaging with further education settings in their Chlamydia Screening Programme, at no extra cost.

Connexions Partnerships provide Information, Advice and Guidance (IAG) services to young people aged 13-19, and allocate a proportion of their Personal Adviser resource to support students in further education.

Some Personal Advisors have been trained as sexual health specialists so can contribute to an on-site sexual health service. Similarly the local youth service may be able to allocate some youth worker time to spend supporting young people in further education settings.

Local voluntary sector agencies may also have the capacity to contribute.

Further education institutions are funded by the Learning and Skills Council (LSC). The LSC determines funding mainly on the basis of the number of students enrolled and the qualifications they achieve.

As there is currently no dedicated budget for student services decisions as to how much money to spend on student services are for individual institutions.

The LSC currently allocate just over £800 per student per year specifically for use in providing enrichment, tutorial and key skills. Colleges are advised to dedicate approximately 5 hours a week per full time student to meet this 'Learner Entitlement'.

Learner Entitlement funding can provide a resource for colleges to develop SRE delivered through tutorial, enrichment and key skills.


Q2. Can we include14-16 year olds in college services?

Yes. 14-16 year olds can and should be fully included in college services.

The number of 14-16 year olds getting some of their education in college is increasing. In 2005, over 100,000 14-16 year olds took courses at college as part of the '14-16 Increased Flexibility Programme'.

These programmes have been well evaluated and provide a platform of experience from which to develop effective systems for the first wave of specialised diplomas in 2007, which will involve an increasing cohort of 14-16 year olds spending time in college. To respond to the new cohort of younger learners some colleges have employed a 14-16 manager, who is responsible for both curriculum and welfare.

The AoC & LEACAN recommend that this younger cohort be enrolled as full college members. Schools should note that they retain the prime duty of care for their pupils.

Legally, FE Colleges must provide schools with adequate details of provision to enable the school to obtain parental consent for their child to participate. These details should include information about the range of student support services available in the college.

In obtaining parental consent schools need to provide information that includes details of on-site health and welfare services.

Parents have a right of withdrawal from non-statutory SRE delivered in school. The college should communicate details of any SRE to be delivered to 14-16s.

Equipped with these details of provision, the school should inform parents of any non-statutory SRE that is included in the college programme.

Evidence suggests that parents are very supportive of SRE programmes delivered in school and college settings. Indeed if young learners are attending college while SRE and PSHE are being delivered at school it is important for colleges to ensure that they do not miss out.

Where a college has a number of school partners it is sensible to agree a common procedure for all schools. In some cases communications between the further education provider and schools are brokered through the Local authority or the LSC. However the same responsibilities outlined above apply.

In accordance with DfES and AoC guidance a variety of measures will support effective inclusion of 14-16s in college welfare services:

1. The college should provide a thorough induction for young learners at the start of their programme including a tour showing them where student services can be found. It is essential that the confidential nature of services is explained. 

2. As well as the learner contract, a young learner's handbook should contain information about the college services including details of the tutorial and pastoral support system.

3. Celebrating young learners achievements will help build their motivation and self-esteem. For example celebrating the signing of the learner's contract and involving successful role models from previous programmes.

4. All staff should be informed about arrangements relating to young learners including their right to access to the full range of student services including confidential sexual health services.

5. Staff unfamiliar with working with young learners will need to access further training on continuing professional development (CPD) programmes that address the pastoral and behavioural support needs of younger learners.

Useful documents:

Legal Requirements for FE Colleges providing for young learners, DfES, 2006

Best Practice Guidance for Doctors and other Health Professionals on the Provision of Advice and Treatment to Young People under 16 on Contraception, Sexual and Reproductive Health, (DoH 2004).


Q3. Can we offer a confidential sexual health service in further education settings?

Yes. FE and sixth form colleges and work-based learning providers can offer a confidential sexual health service.

All young people, including those aged under-16 have a right to access confidential sexual health advice and treatment. This right is supported in law in the Sexual Offences Act 2003.

Assurance of confidentiality is of paramount importance to young people.

Colleges already offering one-to-one advice with counsellors and student advisors are likely to have a confidentiality policy in place. It is good practice to review this document, asking for input from a range of people affected.

The college child-protection policy should be read in tandem with the confidentiality policy. Child protection procedures explain what to do if a serious threat is identified to the safety of a young person which might lead to the need to disclose sensitive information.

It is vitally important that both the confidentiality policy and the child-protection policy are understood by all staff, not just those staff who have a welfare role. One breach of a young person's confidentiality can permanently jeopardise trust.

Health professionals have their own code of professional conduct that covers confidentiality, child-protection and duty of care. As college sexual health services are likely to be delivered through a multi-agency partnership it is important to check that policies are consistent and mutually understood and supported.

Health professionals will be familiar with using the Fraser guidelines with young people under 16 years as a procedure for checking the young person's understanding and competence to consent to treatment.

Fraser guidelines are regularly used with young people.  They help service providers to check if young people understand the emotional and physical implications of sexual activity, are not being pressurised into sexual activity, and are aware of the benefits of communicating with a responsible adult about their relationship.

Reference to the use of Fraser guidelines can be made in the college confidentiality policy, thus ensuring that the policy caters for all learners.

Professionals delivering sexual health services in any setting have a responsibility to explain the confidentiality and child-protection policy to young people.

This may need to be explained through a conversation as well as having a written version. Literacy and fluency in the English language cannot be taken for granted. But full understanding of the confidentiality available is vitally important and will encourage take-up of services.

Sheffield college were successful in developing joint ownership of their confidentiality policy through engaging partners in a steering group. See case study.


Q4. Will we get adverse media publicity?

When colleges are new to providing sexual health services senior managers often fear negative press coverage. The worry is often that providing free condoms in college will be seen be misrepresented by the media as 'encouraging young people to have sex'.

Since the launch of the teenage pregnancy strategy in 1999 access to free condoms for young people has increased and the rate of teenage conceptions has dropped and there has been no change in the age at which young people become sexually active. 

Young people see the provision of condoms in college as a practical and helpful approach. 

Both at the local and national level there are examples of responsible media coverage of teenage sexual health issues. Identifying a supportive journalist can really help. By taking a pro-active approach to the media when launching a new service, clear messages can be promoted.

Preparing a joint press release together with partners in the local health authority and PCT can make the process easier.

Young people are very critical of the media for the mixed messages portrayed about sex:
"Especially in the music videos - sex sells - they just make it sordid and dirty - they are not promoting it in the right way"  College student, aged 17

But they can also have a constructive role in creating positive media messages. Following discussions with the local public health manager, art and design students at South Thames College were invited to design submissions for a local sexual health campaign.

Not only did the results communicate powerfully to young people, but the competition made a platform for positive publicity, and a means to raise the self-esteem of the young people involved.


Q5. What is the role of tutors in promoting young people's sexual health?

Sexual health can be a challenging topic for both adults and young people. Not all tutors feel comfortable, confident or competent in leading discussions about sexual health with their tutor group.

The extent to which tutors engage with sexual health topics should be a matter of choice. However a minimum expectation is that all tutors signpost young people to the services available.

Training and support will develop the confidence and competence of tutors to facilitate discussions and learning about sexual health.  

In some cases tutors are leading innovative sexual health work with young people at a very high standard. The energy and commitment that tutors give to developing sexual health projects needs to be recognised and rewarded. Tutors can play an important championing role helping other tutors to get involved across the college. 

Tutors are often the first port of call when young people experience personal difficulties that impact on their ability to attend college and concentrate on their studies. They are well-placed to build a young person's confidence to approach health professionals.

Tutors can help increase the take-up of both on and off-site services by informing the group as a whole about how, where and when they can be accessed.

Tutors may worry that raising issues relating to sexual health will prompt questions and disclosures that are difficult to handle. Tutors need to be clear about boundaries and to refer young people for specialist help.


Q6. How can we support young LGBT people

Although the use of services is often monitored by gender, less is known about the sexual orientation of young service users. Lesbian, gay, bisexual and transgender (LGBT) young people say that they often feel excluded from services and may conceal their sexual orientation because they are afraid of negative judgements.

Many further education colleges have an active Student Union. This provides an ideal forum to audit SRE and service provision from the perspective of equality and diversity.

Many colleges have set up LGBT groups. In some cases a student chairs the club and is supported by the Equal Opportunities Officer. Information about local services providing services for young LGBT people can be displayed on a notice-board, and outside agencies may support the group by attending meetings.

By creating links with local services and making information visible some of the inequality which young LGBT people experience can be addressed.