Issue - meetings

To consider feedback from NHS Haringey and the Children and Young People’s Service on issues that have been identified by the Panel from evidence received to date (attached).

To receive the views of the following:

·            Claire O’Connor, Head of Sexual Health, 4YP

·            Adrian Kelly, Regional Teenage Pregnancy Co-ordinator, Government Office for London

The Panel received evidence from the following:

·              Mesfin Ali from the Pan African and Caribbean Sexual Health Project (PACSH)

·              Adrian Kelly, the Regional Teenage Pregnancy Coordinator from the Government Office for London

·               Claire O’Connor, the Head of Sexual Health, Contraception and Reproductive Services, NHS Haringey.

Mr Ali stated that his service was not directly aimed at reducing teenage conceptions.  Its main focus was on addressing the issues of HIV and Aids within the African and African Caribbean communities and this was what the project was funded to provide.  It provided a range of services including information, distribution of condoms and awareness raising across the community.  It also provided support for those who had been recently diagnosed with HIV.  Testing was actively encouraged.  The main focus of the service was on outreach work and it did this by working closely with local businesses and services that were used by people from the range of communities in question. 

They had approximately 50 fully trained volunteers working for them, whose role was to go out into the community and talk to people who were potentially at risk and build relationships and awareness.  70% of the volunteers were women.  They had a card which they gave to people which could be taken to the GUM clinic to arrange a test. Their aim in promoting HIV testing was to reduce the number of people who were undiagnosed.

Their Love Safely programme included specific reference to sexual health and infections and the provision of free condoms.  If they came into contact with under 16s., they referred them onto either 4YP or the Teenage Pregnancy team.  There was roughly an equal split between male and female clients on this programme.  As part of it, they had so far handed out 50,000 condoms.  They normally talked to clients before handing out condoms in order to ensure that they were aware of the correct way of using them, how to spot counterfeit ones and the need to observe expiry dates.  They also handed out female condoms and lubricants. 

The stigma attached to STIs and, in particular, HIV was the biggest barrier that they faced in their work.  In a number of countries where clients came from, homosexuality was illegal and this could provide an additional barrier in encouraging people to access services.  There were also issues with some faith communities.  In addition, there was denial of the problem in some communities. 

The age range of the clients that they worked with was 16 – 50.  They currently supported a number of teenagers in Haringey but most of their clients were in the 25-44 age range.  The overall number of clients that they dealt had increased by 25%.  There were currently more female then male clients.  They had undertaken pieces of work with 6^th. forms and CoNEL including presentations and workshops.  Some work relating to sexual health and teenage pregnancy had also been undertaken with schools.  They had also brought HIV positive speakers into schools to speak to  ...  view the full minutes text for item 16

To receive the views of representatives of the following:

·        Haringey Secondary Heads Association

·        Haringey Primary Heads Association

·        The College of North East London

·        The Youth Service.

To receive a presentation from the Health, Well Being and Sustainability Manager, Children and Young People’s Service and the Associate Director of Public Health, NHS Haringey on the following:

·        How the Council and its partners currently aim to reduce the prevalence of sexually transmitted diseases and teenage conceptions within the Borough

·        The outcome of the sexual health needs assessment

·        Progress made and any issues arising that relate to the prevention of conception from the previous teenage pregnancy scrutiny review

Background papers and supporting information are attached.

Susan Otiti, Associate Director of Public Health at NHS Haringey, gave a presentation to the Panel on:

·        How the Council and its partners currently aimed to reduce the prevalence of sexually transmitted infections (STIs) and teenage conceptions within the Borough

·        The emerging findings of the current sexual health needs assessment

·        Progress made and any issues arising relating to the prevention of conception arising from the previous teenage pregnancy scrutiny review.

The World Health Organisation definition of sexual health was as follows:

“A state of physical, emotional, mental and social well-being, related to sexuality; it is not merely the absence of disease, dysfunction or infirmity.  Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.”

Sexual health outcomes were relatively poor in Haringey and there were higher levels of need in the east of the borough.  Sexual health was also not distributed equally amongst the population. Poorer outcomes were experienced by women, gay men, teenagers, young adults and black and minority ethnic groups. A range of social, economic and cultural influences determined the sexual well-being of individuals

Sexual health services were commissioned to achieve the following outcomes:

·        Prevention of unwanted pregnancy

·        Detection and treatment/management of cases of sexually transmitted infections, including HIV as a long term condition

·        Prevention of onward transmission of STI/HIV through primary and secondary prevention interventions

·        Improvements in psycho-sexual well-being

Young people (16-24 year old) were most at risk of being diagnosed with a sexually transmitted infection.  Whilst young people represented 12% of the population, they accounted for half of all sexually transmitted infections (STIs) diagnosed in the UK (2007):

·        65% of all Chlamydia

·        50% of genital warts

·        50% of gonorrhoea infections

Chlamydia, gonorrhoea, genital warts and genital herpes are most common STIs amongst young people.

In terms of teenage conceptions, Haringey had:

·        The 8^th. highest teenage pregnancy rate in England (70 per 1000 women under 18); and

·        The 4^th. highest rate in London

65% of conceptions led to abortion (2007 & 2008) and 28% were repeat abortions, including under 19s (highest regional level (2008)).  Of boroughs classified as inner London, Haringey was the only borough showing an increase in teenage conceptions when compared to the 1998 baseline.   However, provisional data for the first two quarters of 2008 showed an improvement in the rates of teenage pregnancy and could indicate that progress was being made.  The rates were 52.1 per 1000 for the 1^st quarter and 57.2 for the second. 

Genital Chlamydia infection was currently the most commonly diagnosed STI in the UK. Women aged 16-19 years and men aged 20-24 years had the highest rates of positive diagnoses.  Untreated Chlamydia could cause pelvic inflammatory disease (PID) which could lead to infertility and ectopic pregnancies.   In terms of Chlamydia screening, the borough had not hit its target for 2007/8 but had been successful in meeting all its targets  ...  view the full minutes text for item 5