Learning from practice

Liverpool’s teenage pregnancy rate has fallen by 24.7% between1998 to 2004.

Liverpool provides strong services through two discrete, highly visible, and young people friendly sexual health/contraceptive advice services in the city centre – Brook and Abacus. These services are highly accessible and trusted by young people. The services are supported by strong outreach work provided by So To Speak, a project which is supported by funding from the Liverpool and Sefton Teenage Pregnancy Partnerships.

So to Speak train professionals to improve their ability to engage with young people on sexual health issues as well as equip young people with information to make informed choices about their sexual health. Liverpool Brook has been providing contraceptive services for young people for over 30 years. It has been located in the city centre for the last 20 years and, following relocation to larger more visible premises in 2002, has been offering a ‘drop in’ service, which is open every weekday from 10am to 6pm and on Saturdays from 10am till 2pm.

The service is commissioned by Liverpool PCTs, and provides all the main methods of contraception, emergency contraception, pregnancy testing, referral for abortion, chlamydia screening and sexual health advice. The centre also provides a twice weekly full STI testing service run in partnership with the Royal Liverpool University Hospital GUM department and 2 Chlamydia Treatment Sessions. Appointments can be made to see the Brook Counsellor who is available one day a week and there is a Male Information Worker at the centre 5 days a week to provide sexual health and contraceptive advice to male clients.

Although Liverpool Brook does not have an Outreach Team, it is one of the partners in a Healthy Living Centre “Healthy Arts Project” which aims to address health issues and problems which affect young people, through the use of arts and media. As part of this project, for the last 3 years, “Brook Advisors” have taken part in a Theatre in Education Project touring local schools with plays highlighting a different sexual health theme each year, and has contributed to various other Healthy Arts activities including magazines and videos.

Abacus clinics for Contraception and Reproductive Healthcare are a mainstream NHS service which provides open access to all methods of reversible contraception, including Long Acting Reversible Contraception (LARC), emergency contraception, pregnancy testing, referral for abortion, Chlamydia screening, and sexual health advice. The service provides 60 sessions per week, over 6 days per week, across Liverpool and South Sefton. There are 9 dedicated young-persons sessions across the area, although all sessions are attended by clients of all ages. The service also includes a base in Liverpool city-centre which is open 6 days per week, in an easily accessible, non-NHS building.

Provision of contraception following an abortion is also a high priority. Women attending for a termination at the Bedford Clinic, Liverpool Women’s Hospital, have immediate access to post-abortion contraception via an Abacus contraceptive nurse or doctor, who attends the clinic on a daily basis. All clients are actively encouraged to access contraception prior to leaving the service.

LARC is also actively promoted within the clinic. Women who attend for a termination at Merseyside BPAS also have the opportunity to obtain contraception on-site. For those who want to discuss contraception at a later date, information is provided about the Merseyside and Wirral Brook Advisory Centres.    

Liverpool adopts a strong targeted approach to working with at risk groups of young people, and to providing workforce training on sex and relationship issues within mainstream partner agencies through So To Speak – a sexual health education outreach team, funded through the Liverpool and Sefton Teenage Pregnancy strategies. The aim of the project is to equip young people with the information required to make informed choices about their sexual health; to promote a greater understanding of the broader issues that impact upon sexual health; and to support agencies that work with young people to appreciate their role in tackling those issues and thereby enabling good sexual health.

The team employs a number of different methods of delivery including face-to-face work with small groups of young people and parents; outreach; and promotional campaigns. In order to ensure sustainability of this work the team also delivers staff training and support to agencies that work with vulnerable young people and help to tackle inequalities in health through community development in targeted wards.