Consultation on the Pregnancy and Parenthood in Young People Strategy: Analysis of Responses

4. Parenthood in Young People

Although parenthood may be a positive experience for some young people, it is often associated with an increased risk of poor social, economic and health outcomes. The Scottish Government considers that good quality, integrated support for young parents and their families will contribute to better engagement with support services and, in the longer term, greater engagement in education, training and employment which will contribute to improved health and social outcomes for young parents and their children.

Question 9: What ways of working, within and between agencies, will help ensure that there is a co-ordinated approach to take forward the actions in section three in your area?

Thirty-eight respondents addressed this question, however six of these just referred to their responses to previous questions.

Existing integrated frameworks

A common theme across several respondent sectors was that existing integrated frameworks provide the structure for ways of working within and between agencies which will help to ensure that there is a co-ordinated approach to taking forward the actions in section three. Four respondents made specific mention of CPPs, one remarking:

“As a CPP we... have the opportunity to work across the partnership around inequalities and strengthen links with staff working in money advice and income maximisation, early education and childcare, housing and employment” (East Renfrewshire Community Planning Partnership).

Whilst some respondents referred broadly to the need for “multi-agency” and “joined up working”, others were more specific in their reference to the FNP (9 mentions); the Named Person initiative (3 mentions); GIRFEC (2 mentions); Children and Young People (Scotland) Act 2014, ICSPs, Link midwife approach (each one mention respectively).

Examples were provided of area plans and groups which worked in a cross-cutting manner: Sexual Health and HIV plan (LA); Young People’s Sexual Health Steering Group (NHS); Health and BBV Steering Group (NHS).

Links between schools and the NHS were cited as examples of effective inter-agency work with Menzieshill High School and the Young Person’s Support Base at Smithycroft Secondary School highlighted in this regard.

Recommendations for strengthening links and new initiatives

One respondent (NHS) called for more explicit links between maternity services and health visiting and suggested that although no mention is made of this in the Strategy, the national review of health visiting may inform the links. Another respondent (Third) advocated strengthening the links between childcare funding and young parents’ choices to remain in education and/or training.

Five respondents shared the view that more could be made of the potential contribution of Third Sector organisations in realising the Strategy. One stated that in their area:

“....there still needs to be open dialogue and joint planning with services and third sector organisations specifically delivering services local for young parents and families” (Third).

Once again, the acknowledgement of Community Pharmacy as playing an integral part in NHS support for young people was recommended (Prof Rep).

Calls were made for more explicit inclusion of consideration of young fathers in the parenthood section of the Strategy (two Third Sector and one individual respondent).

Two respondents mentioned the potential of area hubs to underpin integrated service provision. One (Joint) referred to the importance of drop-in, informal health and well being hubs which could be delivered at youth projects; the other (Prof Rep) recommended the introduction of post-natal hubs, located strategically to take joined-up services to young people, rather than requiring them to access individual services separately.

Broader context

A few respondents referenced the wider context, one suggesting a need to involve the Department for Work and Pensions and Her Majesty’s Revenue and Customs at a strategic level to ensure, for example, that young people are not disadvantaged financially by participating in any new initiative (Third). Another view (Joint) was that a national steer would be helpful for more engagement from wider services such as housing. One respondent (Third) recommended that the Scottish Government take a coherent rights-based approach to positive parenting across all legislation and policies.

Three respondents (Prof Rep, Joint, Ind) highlighted the need for adequate resourcing to support the joined-up working and iniatives of this section. Two respondents (Prof Rep, NHS) called for high quality, multi-agency training to support a co-ordinated approach.

Question 10: Are there local systems in place to take forward these actions?

Thirty-one respondents addressed this question. Five stated simply that local systems are in place; and four (three Professional Representative Bodies and one Third Sector respondent) considered that the existence of relevant local systems varied between areas.

A few respondents referred to local delivery of national systems such as ICSPs, Named Person and the FNP as systems to take forward the actions in this section. Others repeated responses to previous questions in which they highlighted strategic and delivery groups within their jurisdictions which link at different levels to provide an integrated approach.

Examples of local systems and services

Examples of local systems and services which respondents considered would facilitate implementation of these actions included:

• Youth Alliance consultation processes (Joint).
• Young/teen parenting groups (NHS, Third).
• Volunteer breastfeeding coaches in NHS GGC (NHS).
• Named midwife service (Joint).
• Childminding services to enable girls to remain at their local school (LA).
• Signposting to local Home-Start (Third).
• Drop-in initative in a shopping centre for ante and post natal advice (Prof Rep).
• Mother and baby unit within an affordable housing complex (NHS).
• Websites and Facebook pages (NHS).
• East Lothian’s “Support from the Start” initiative – a network of local practitioners and volunteers who give access to information and opportunities for parents of early years’ children (LA).
• Health services working together to ensure a holistic support to contraception for young parents (LA).
• In North Lanarkshire: First Steps 1:1 supporting first time mothers under 21 years; One Parent Families Scotland Young Parents’ Progression Pathway; Barnardo’s Family Support Services; and Family Information Service providing a hub for relevant community information (Third).

Gaps in local systems

The need for champions and clear leads at local level was identified (NHS). One local authority described a pathway in their area to fast-track vulnerable young women for contraception, but perceived this to be an informal arrangement which requires to be formalised (LA).

One respondent (Joint) recommended more opportunities for the workforce to understand the different needs of young parents in wider contexts, not just focusing on their pregnancy. Another (Joint) called for increased provision of appropriate housing for young parents in their local area. Lack of adequate local counselling provision including helplines was identified as a problem by one respondent (Third).

Question 11: Do you think the actions meet the outcomes in the logic model?

Thirty-one respondents addressed this question. Of these, 14 across seven different categories considered that the actions broadly meet the outcomes in the logic model. Two respondents (both Professional Representative bodies) remarked that this depended on whether the actions would be supported with adequate leadership and resources; one (Joint) suggested that this depended on whether the actions would be universally implemented. The view of one respondent (Third) was that the actions did not meet the outcomes in the logic model; a further respondent (Joint) reported difficulty linking them.

One respondent suggested that the actions for implementers were “lightweight” in places. As an example, on page 24 the action relating to professionals working with young parents was perceived to be rather passive in tone. Another respondent (Joint) considered that the action plan could be more reaching in aspiration.

Whilst one respondent (Third) called for more actions involving fathers, another (LA) explicitly welcomed the inclusion of young fathers amongst the actions.

One respondent (Third) cautioned that even with well meaning actions (e.g. those relating to providing information and resources) some young parents will still need more one-to-one support for these these to be useful to them.

The view of one respondent (NHS) was that in the section on Education and Positive Destinations, more could be said about what opportunities are available to help young parents and what strategies are in place to encourage young mums back to school and/or training. In addition, this respondent considered that more emphasis should be made to reflect that delivery needs to encompass the breadth of cross-sector working, especially in terms of approaches and interventions to achieve positive destinations and impact on social determinants.

Question 12: Is there anything missing in this section?

This question was addressed by 37 respondents. Of these, three (Acad, Third, Ind) considered nothing was missing from the section, one stating that it was comprehensive (Third). Two topics were identified most frequently as omitted from this section. These are detailed below.

Inclusion of young fathers

Nine respondents across four categories (Third, NHS, Joint and LA) identified mention of inclusion and engagement with fathers as missing in this section. Views were that more detail is required on the opportunities available to young fathers and what is expected regarding their involvement in parenthood. Actions relating to supporting young fathers to remain in education were called for.

A few respondents commented that the Strategy should show through its actions what should be done to pro-actively engage young fathers. One respondent remarked:

“….this Strategy, in places, seems to unintentionally reinforce the current situation of low engagement with young fathers. We would welcome explicit recognition of the role, contribution and support needs of young fathers; it is only with such actions that we will begin to see change and greater engagement of young fathers. We believe this Strategy should be the opportunity to be proactive and to increase the level of engagement of young fathers in their parenting role and life outcomes. We would urge a review of the language of this document to ensure inclusion of young fathers when appropriate or to make an inclusive reference to young parents” (Youthlink Scotland).

Parenting

More detail and actions on different aspects of parenting was called for by a variety of respondents. Six respondents (three of them NHS) considered that the role of the young person’s parents and/or grandparents were underplayed in this section. Common views were that they had much to contribute in terms of educating, supporting, advising and indeed potentially providing housing for the young parents and their baby.

Stronger links were recommended between parenting and the early years and parenting policy agenda with national resources such as “Talking to Your Child/Young Person” and Speakeasy courses. One respondent (Third) emphasised the need to make explicit the connection to the Curriculum for Excellence as, they argued, parenthood education is contained within this.

One respondent (Joint) identified the role of corporate parenting as missing from this section.

Identification of other missing topics

A few respondents identified aspects of behavioural change which they considered merited more attention in the Strategy. Breastfeeding was identified by two respondents (LA, Third) in this regard. They felt that actions which targeted support for informed choices over breastfeeding should be included, with explicit links made to the Scottish Government document “Improving Maternal and Infant Nutrition: A Framework for Action”.

One respondent (Joint) highlighted action relating to addressing smoking as missing. Another (Acad) identified the benefits of work with young fathers in prison in terms of impacting on behaviour, and called for action towards supporting them on release to build upon this.

Workforce training was cited by five respondents across four sectors, as requiring more attention in the section. They considered that training is required to address the negative attitudes of some staff towards young parents; and that all relevant agencies should support ongoing CPD for staff by facilitating their release from employment to attend this. One respondent (Prof Rep) highlighted Community Pharmacy staff in particular as requiring continued training on topics such as Child Protection.

Two respondents (Ind, Third) recommended that greater prominence be given to access to mental health services and other related services which promote wellbeing (perhaps delivered via peers). Another (NHS) called for inclusion of mention of access to related Allied Health Professionals such as dieticians.

Four mentions (three NHS, one Third) were made of flexible and affordable childcare for young parents, particularly those continuing with school education. Concerns were raised over the practicalities of providing such flexibility, particularly in geographical areas where numbers may be low. Clearer actions and roles relating to these aims were requested.

Other topics were identified:

• Need to link to UNCRC Article 27 regarding the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral and social development (Third).
• Should be stronger linking of information on accessing welfare resources to the wider preventative agenda so that whilst young parents are supported they do not need to rely on state benefits and tax credits and are therefore not disproportionately affected by welfare reforms (Third).
• Need to address the impact of Child Protection procedures on young parents with alcohol and/drug problems who may not come forward for help (NHS).
• The section should make more of the wider context of measures to tackle poverty and social disadvantage (NHS).

Specific concerns regarding aspects of the section

One respondent (Faith) considered the promotion of invasive forms of contraception (LARCs – long-acting reversible contraception) within the parenthood section to be concerning, given the young age of the individuals involved.