Sexual Health and Wellbeing Work Programme
This section gives an update on the progress of Health Scotland’s programme of action on sexual health and wellbeing.
Health Scotland’s pan-organisation sexual health and wellbeing programme is founded on a collaborative partnership with key stakeholders with the aim of improving knowledge and awareness of effective practice, policy and research.
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Providing timely and evidence-based inputs to health improvement policy and planning
Advancing understanding of Scotland’s sexual health and how to improve it
Increasing competence and capacity in the delivery of health improvement programmes
Improving the quality of strategies to disseminate evidence, learning and good practice
Enhancing the Sexual Health and Relationships Education (SHARE) resource
Reducing barriers encountered by harder to reach groups
Outlined below is a summary of activities undertaken to date together with an indication of our current work. For further information email - shwln@health.scot.nhs.uk.
Providing timely and evidence-based inputs to health improvement policy and planning
Respect and Responsibility: Strategy and Action Plan for Improving Sexual Health
The programme provides ongoing support to the implementation of the national sexual health strategy through participation in the National Sexual Health Advisory Committee (NSHAC) and to a range of NSHAC subgroups, namely around Education and Training, Needs of Rural Areas, Research, Data Collection, Clinical Indicators, HIV Health Promotion and Equality and Diversity.
This includes providing evidence-based reviews of effective interventions (as in rural needs), obtaining and collating information from non clinical educational service providers (as in education sub group) and quality assurance checking in relation to key clinical indicators development.
Through ongoing liaison with and involvement of key stakeholders, work has also begun on:
- addressing issues around confidentiality for those aged 13, 14 and 15 years in accessing sexual health services through a Scotland-wide practice review of commissioners and practitioners in NHS boards, local authorities, voluntary sector, police and other key stakeholders. This will feed into the work on the Scottish implementation of the Bichard recommendations and potentially lead to guidance based on the series of confidentiality leaflets produced by Healthy Respect
- a commissioned review of existing sex and relationships education programmes which will be measured against the recommendations of the McCabe report and SHARE with a view to making recommendations to HMIE around those issues that require continuous auditing and to schools (and local authorities) around effective practice
- developing a sexual health communications framework, the first part of which is reviewing the evidence of effective practice, taking account of previous work including that undertaken by Healthy Respect.
Advancing understanding of Scotland’s sexual health and how to improve it
Facilitating networks and partnerships
Collaborative working with key agencies provided the opportunity to raise awareness of a range of sexual "ill health" issues as well as those health promotion initiatives that address 'harder to reach groups'.
This has included joint seminar sponsorship around effective condom schemes (with fpa Scotland), female genital mutilation (in conjunction with NHS Greater Glasgow), sex and relationships education in denominational schools (with Scottish Catholic Education Service), sexual health needs of looked after and accommodated young people (with Scottish Healthy Care Network) and HIV and BME communities (with HIV Scotland).
The audiences of these events have been a mix of commissioners and practitioners from NHS boards, local authorities (particularly education and community and learning development) and voluntary sector.
Support for the development of a sexual abuse prevention programme for school aged children, Think, Feel Do (with NHS Forth Valley and Clackmannanshire Council) will result in a video resource for use in classroom and other settings; the evaluation of a SRE parenting programme (with NHS Greater Glasgow and Glasgow City Council) will improve the knowledge of how to provide interventions to young people in more deprived areas.
Meanwhile, financially supporting the continued provision of the fpa sexual health helpline helps improve access to information and advice for those people not accessing services. All of this demonstrates the organisation’s commitment to partnership working and in turn helping to reduce the inequalities gap.
Commissioning of research/evaluation
Health improvement policy comprises a number of national level initiatives that are delivered locally. Health Scotland’s role is to maximise the potential effectiveness of these programmes by maximising the evidence-basis of the planned actions through the work of the Evidence for Action division. Health Scotland also generates learning about the effectiveness of implementation through appropriate monitoring and evaluation and ensures that cross-programme/policy learning is captured and drawn together in order to develop more effective practice for the future through the Policy Evaluation and Appraisal division. A key element of this is designing, commissioning and managing research and evaluation by the Public Health Sciences Directorate. Management of the Phase 2 evaluation of Healthy Respect demonstrates the organisation’s leadership role in this area.
Filling some of the gaps in the sexual health evidence base will be met through the research commissioned around the needs of young people with learning disabilities and young people from BME communities. Both include feedback from young people, systematic evidence review and identification of case studies and will provide key pointers for policy makers and local commissioners on effective practice. It is intended that the results will be fed back to NSHAC and its subgroups as well as holding a specific dissemination seminar in autumn '06 for NHS boards and their stakeholder partners.
Increasing competence and capacity in the delivery of health improvement programmes
Learning, development and resources
Two practitioner events around SHARE led by the Children and Young People’s Team were supported through presentations and eliciting feedback on the development of the SHARE resources.
A SHARE Training for Trainers course has resulted in an additional cadre of 12 SHARE trainers within health, education and the voluntary sector to support the ongoing implementation of Respect and Responsibility. The enhanced materials were 'road tested' with these trainers prior to final publication. The feasibility of course accreditation will be explored in 2006/07. Further training for trainers events are planned for 2006/07 to ensure a continuous flow of trained practitioners.
Completion of the enhanced SHARE resources
This has been an example of cross organisational collaboration across the Sexual Health and Wellbeing programme, the Children and Young People's Team, and Publishing which will be continued in the future.
This collaborative approach was also reflected in the work undertaken on the Review of Sexual Health Resources to support young people with learning disabilities between Health Scotland, statutory and voluntary sector agencies as well as practitioners.
Feedback has indicated that practitioners as well as parents and carers have found the review valuable in highlighting the range of resources available on a range of sensitive issues for this user group.
Development of booklets for parents and carers to support communication around relationships and sexual health, support the overall thrust of national policy and the strategic approach to sex and relationships education for primary and secondary school age children (one new booklet for parents of children aged 4-9 and an updated booklet for parents of young people aged 10-13).
Both build on the learning from Healthy Respect and health promotion specialists and educators across Scotland. The views of parents were actively sought on the text and design as part of their development. These will be actively disseminated in 2006/07 through health promotion, schools, specific parents' organisations and other agencies who work with parents and carers.
Improving the quality of strategies to disseminate evidence, learning and good practice
Evidence Dissemination
The Sexual Health and Wellbeing Network, as established through Towards a Healthier Scotland and Our National Health continues to act as a bridge between policy, research and practice with a steady stream of new 'joiners' to the existing database of just over 2000 members. Increasingly members are contributing to bulletins and newsletters as well as using the Network to exchange practice and research both within Scotland and beyond. In addition, Health Scotland staff are often the first point of call for staff from NHS boards, local authorities and others around policy and resource development on a range of sexual health issues.
Sharing the learning from Healthy Respect
To support the ongoing dissemination of learning from Healthy Respect and to widen knowledge of the sexual health evidence base, the joint Health Scotland/Healthy Respect Learning Exchange events continued with policy makers, commissioners and practitioners in health, local authority and voluntary sectors in nine NHS board areas. Over 700 staff have participated in these events (two undertaken in 04/05 and one more in 06/07). These events provided a springboard for local NHS boards and their local authority partners in producing their interagency sexual health strategies as well as proving useful to Health Scotland and Healthy Respect in the ongoing development of their work.
In response to demand from these events, evidence briefing papers have been produced on: the place of abstinence within sex and relationships education; and the effectiveness of condoms in STI prevention, together with a range of outputs to promote research and practice dissemination.
To access these reports and presentations from past seminars and events organised in support of the Sexual Health and Wellbeing work programme, please see our Sexual Health and Wellbeing Network pages on seminar reports and presentations.
Detailed Information on Work Programme:
Enhancing the Sexual Health and Relationships for Education (SHARE) Resource
SHARE (external link) is a sexual health and relationships education programme for secondary school pupils aged 13 to 15 years. External evaluation of the current materials and feedback from those delivering the programme has highlighted a number of areas that require refinement. In particular, it does not address same sex relationships nor is it easily applicable for teaching young people with learning disabilities.
Under the guidance of Health Scotland, a multi-disciplinary multi-agency SHARE development group has developed an enhanced resource which now includes references to the links between sexual risk taking and substance misuse as well as pointers to additional resources for pupils with learning disabilities.
Publication of the enhanced resource is now complete and copies of the new resource are now available to those staff who have undergone the appropriate level of SHARE training. For further information on SHARE email share@health.scot.nhs.uk.
Reducing barriers encountered by harder to reach groups
Young people with learning disabilities
Little is known about the views and needs of individuals with a learning disability in terms of sexual health and wellbeing. We have completed focus group work with young people who are learning disabled to find out their views on sex and relationships education and accessibility to and relevance of services.
Parallel to this, a multi-agency evidence review group is looking at what works (and what doesn’t) in sex and relationships education, how young people access sexual health services and what supports would be useful for parents and professionals.
It is anticipated that this work will be completed by early summer and the results will be disseminated at a seminar in early autumn. For further information, please contact shwln@health.scot.nhs.uk.
Young people from black and minority ethnic communities
Finding out how to improve access to services and providing young people with the skills to negotiate mutually respectful relationships is important for all young people, but particularly so for those from black and minority ethnic communities given their risk of sexual ill health. This work is almost complete. For further information, please contact shwln@health.scot.nhs.uk.