This chapter was part of a previous edition of the Wirral Children's Services Procedures Manual but has now been reviewed and re-added in September 2018. As a result the chapter Appendix 1: Government Strategies to Support this Policy has been updated.
The purpose of this Policy is to establish a consistent and effective means to ensure that any member of staff working with young people in any setting, on a one to one basis, will have the skills, knowledge and confidence to actively promote positive and safe sexual health that is free from abuse and at an appropriate level to the needs of that young person and within their professional boundaries.
Accompanying guidance will support the Policy implementation.
The Policy and guidance will support any member of staff working with young people to ensure that they achieve the five outcomes listed in Every Child Matters:
Sexual health can be defined as:
"A state of physical, emotional, mental and social wellbeing 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. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled."
This definition derives from a World Health Organisation-convened international technical consultation on sexual health and was subsequently revised by a group of experts from different parts of the world.
This emphasises the need to ensure a holistic, young people centred approach is adopted which draws on multi-disciplinary working.
"Children and Young People in Wirral are our most important asset. We should help them all grow into confident and successful adults. They can do this for themselves but we will help them by ensuring they receive information and services when they are needed and in a way they can best make use of them. We are committed to removing barriers that prevent us from providing the services that children and young people tell us they need."
(Wirral Health and Well Being Charter for Wirral Children and Young People, 2008)
Diversity: We recognise and acknowledge that individuals and communities are not all the same and young people have a right to their own spiritual, social, cultural and moral views;
Empowerment: We work in partnership to support and enable people to make healthy sexual choices;
Ethical practice: Sharing practice, knowledge and expertise is acknowledged as the way of working to achieve objectives and meet the challenges;
Fairness: We are committed to treating young people fairly, based on needs;
Human rights: Children and young people will be supported in their human right to develop good relationships including sexual relationships. Children and young people also have the right to not have sex. To be respected for that choice and still have sexual rights;
Integrity: We work towards the highest standards in a caring and professional manner. We believe that the promotion of self-esteem and emotional wellbeing is important and helps form and maintain satisfying relationships;
Openness: We provide access to information in order to help young people understand and influence local sexual health services, interventions and support;
Valuing People: We will respond to people as individuals and recognise the assets and contribution which they bring to achieving positive sexual health;
Respect: We will promote and encourage respect for self and others as the basis of positive relationships and good sexual health.
The aim of the Policy is to enable any member of staff to assess and respond appropriately to young people's needs with regards to sexual health, within their professional boundaries, and from an informed perspective.
As part of any assessment with a young person staff will provide the following health promotion interventions to promote healthy relationships, positive sexual health and wellbeing. It is important to ensure that all workers involved with young people are appropriately equipped with the skills and knowledge to support and provide the following Foundation Interventions:
As part of this assessment, the aim is to establish whether a young person (male or female) is:
Wirral's Young people services are committed to, and will use this Policy to develop further guidance for their workers/carers which is specific to their agency/organisation.
This Policy is intended for use by:
Learning Mentors, Specialist Services, Foster Carers, Residential Staff, Schools and Colleges teaching and non-teaching staff, Education Welfare, Voluntary Organisations, Community Organisations, Drugs and Alcohol Services, Community Pharmacists, Police and Criminal Justice, Youth Service, Area Teams, Health Trainers, Community Health Workers, Midwifery, Health Visiting, School Nursing, LAC Nurses.
Workforce training for those working with young people will be developed to support the Policy.
Condom distribution guidance will be developed to support this Policy, with Brook Wirral being the preferred provider.
The Health and Well Being Resource Centre, Wirral CCG, will provide information and resources.
The Policy and guidance will be centrally disseminated by the Children and Young People's Department to all those working within Children's Services and all young people's services in Wirral. It will also be put on the intranet. It is anticipated that this Policy will also be commended to schools.It is intended that this Policy will be reviewed on an annual basis by the Children and Young People's Department and by the Teenage Pregnancy Strategy Steering Group taking into consideration the review of the Safeguarding Children Board Procedures or following changes in legislation and/or a change in national guidance.
Process evaluation of the Policy will use both qualitative and quantitative data. It is anticipated that a reference group will be established to support evaluative work. Agency and organisation engagement is key to the implementation of the Policy and regular reports will be requested to highlight any areas of difficulties. Feedback from young people's groups will also be collected.
Writing this document has been supported by access to policies and guidelines from the following:
There are national Government strategies that relate to improving young people's sexual health and reduction of under 18 conceptions. These strategies are listed as below:
The legal age for young people to consent to have sex is still 16, whether they are straight, gay or bisexual. The aim of the law is to protect the rights and interests of young people, and make it easier to prosecute people who pressure or force others into having sex they don't want.
For the purposed of the under 13 offences, whether the child consented to the relevant risk is irrelevant. A child under 13 does not, under any circumstances, have the legal capacity to consent to any form of sexual activity.
The Serious Crime Act (2015) has introduced an offence of sexual communication with a child. This applies to an adult who communicates with a child and the communication is sexual or if it is intended to elicit from the child a communication which is sexual and the adult reasonably believes the child to be under16 years of age. The Act also amended the Sex Offences Act 2003 so it is now an offence for an adult to arrange to meet with someone under 16 years having communicated with them on just one occasion (previously it was on at least two occasions).
The act has created three new categories of offences to provide additional protection with a mental disorder:
Although the age of consent remains at 16, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Young people, including those under 13 will continue to have the right to confidential advice on contraception, condoms, pregnancy and abortion.
"The government should reaffirm the guidance in 'Working Together to Safeguard Children' so that the Police are notified as soon as possible when a criminal offence has been committed, or is suspected of having been committed against a child - unless there are exceptional reasons not to do so".
Children have varying needs that change over time. Judgements on how best to intervene when there are concerns about harm to a child will often, and unavoidably, entail an element of risk - at the extreme, of leaving a child for too long in a dangerous situation or of removing a child unnecessarily from his or her family. The way to proceed in the face of uncertainty is thorough competent professional judgements, based on a sound assessment of the child's needs, the parents' capacity to respond to those needs - including their capacity to keep the child safe from significant harm - and the wider family circumstances.
Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including Child Sexual Exploitation, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (e.g. rape, buggery or oral sex non-penetrative acts. They may include non-contact activities, such as involving children in looking at, or in the production of, sexual online images, watching sexual activities, or encouraging children to behave in sexually inappropriate ways.
Children involved in Child Sexual Exploitation and other forms of commercial sexual exploitation should be treated primarily as the victims of abuse, and their needs require careful assessment. They are likely to be in need of welfare services and, in many cases protection under the Children Act 1989 (see www.crimereduction.gov.uk/toolkits for further guidance). This group may include children who have been victims of human trafficking.
The Local Safeguarding Children's Board (LSCB) should actively enquire into the extent to which children are involved in Child Sexual Exploitation in the local area. They should assume that this is a local issue unless there is clear evidence to the contrary. The Home Office and Department of Health jointly published guidance in May 2000 on Safeguarding Children Involved in Child Sexual Exploitation. The guidance promotes an approach whereby agencies should work together to:
Those who abuse or exploit children through Child Sexual Exploitation should feel the full force of the law. The Sexual Offences Act 2003 introduced a number of new offences to deal with those who abuse and exploit children in this way. The offences protect children up to the age of 18 and can attract tough penalties. These include:
This difference in procedure reflects the position that, whilst sexual activity under 16 remains illegal, young people under the age of 13 are not capable to give consent to such sexual activity.
In 1985 the "Gillick Competency" principle emerged from the House of Lords (Gillick v West Norfolk and Wisbech Authority and Department of Health and Social Security). Lord Fraser ruled that a doctor or recognised health professional can provide contraceptive advice and treatment to a young person under 16 without parental consent providing the doctor is satisfied:
The Fraser Guidelines and Section 73 of the Sexual Offences Act (2004) provides workers/carers with the required framework for informing decisions about the provision of contraception and sexual health advice to children and young people aged 16 and under, regarding:
Section 14 (2) and (3) or the Sexual Offences Act states that a person (and that means workers/carers) will not be guilty of aiding, abetting or counselling a number of sexual offences against young people under 16 if s/he is acting to:
This is an issue that can cause anxiety for young people and staff alike. It is essential that the boundaries of confidentiality be clearly understood by all members of staff and young people.
All young people have the right to high quality, confidential information and support, if required, while making and maintaining positive personal relationships throughout their teenage years. In working with young people, it must always be made clear to them that absolute confidentiality cannot be guaranteed, and that there will be some circumstances where the needs of the young person can only be safeguarded by sharing information with others. In such a case, Wirral's Local Safeguarding Children Board Policy and procedures should be followed. Wirral services will endeavour to ensure that a young person is informed of this decision where appropriate.
Detailed information about a young person's sexuality, their sexual activity or sexual health should not be recorded unless there are concerns that the child is potentially or actually suffering significant harm.
Information should be recorded in line with the need of the individual service and in accordance with the service's record keeping Policy.
Young people should always be consulted beforehand about what is going to be brought up in formal meetings (as they should be about all matters) and have some say in whether they want issues discussed in this forum.
Information should be shared on a need to know basis and in line with Wirral Local Safeguarding Children Board Procedures.
However should the young person or another young person be at risk then confidentiality should not be maintained and safeguarding guidance should be followed (Wirral Local Safeguarding Children's Board). The member of staff would need to explain to the young person the need to report this and discuss how this will proceed.
Decisions to share information with parents and carers will be taken using professional judgement, consideration of Fraser guidelines and in consultation with Safeguarding Children Board Procedures. Decisions will be based on the child's age, maturity and ability to appreciate what is involved in terms of the implications and risks to themselves. This should be coupled with the parents' and carers' ability and commitment to protect the young person. Given the responsibility that parents have for the conduct and welfare of their children, staff should encourage the young person, at all points, to share information with their parents and carers wherever safe to do so.
The legal framework for confidentiality is contained in the common law duty of confidence, the Children Act 1989, the Human Rights Act 1998, the EU General Data Protection Regulations (GDPR) and the Data Protection Act 2018.
When sharing confidential information, a balanced view has to be taken about the professional or carer's need to know and the right of the child or young person to confidentiality.
The approach to sharing confidential information should be the same whether this is internal or shared with an external agency.
The Child Sex Offender Review (CSOR) Disclosure Scheme is designed to provide members of the public with a formal mechanism to ask for disclosure about people they are concerned about, who have unsupervised access to children and may therefore pose a risk. This scheme builds on existing, well established third-party disclosures that operate under the Multi-Agency Public Protection Arrangements (MAPPA).
Police will reveal details confidentially to the person most able to protect the child (usually parents, carers or guardians) if they think it is in the child's interests.
The scheme has been operating in all 43 police areas in England and Wales since 2010. The scheme is managed by the Police and information can only be accessed through direct application to them.
If a disclosure is made, the information must be kept confidential and only used to keep the child in question safe. Legal action may be taken if confidentiality is breached. A disclosure is delivered in person (as opposed to in writing) with the following warning:
If the person is unwilling to sign the undertaking, the police must consider whether the disclosure should still take place.
This summary looks at the few parts of the Act that may affect children under 16 years of age. It also explains the position of young people aged 16 and 17 years and the overlapping laws that affect them.
Within the MCA's Code of Practice, 'children' refers to people aged below 16. 'Young people' refers to people aged 16-17. This differs from the Children Act 1989 and the law more generally; where the term 'child' is used to refer to people aged under 18.
Children Under 16
The Act does not generally apply to people under the age of 16 but there are two exceptions:
Young People Aged 16-17 years
Most of the Act applies to young people aged 16-17 years, who may lack capacity within Sections 2(1)* to make specific decisions but there are three exceptions:
People carrying out acts in connection with the care or treatment of a young person aged 16-17 who lacks capacity to consent within Section 2(1)* will generally have protection from liability (Section 5), as long as the person carrying out the act:
When assessing the young person's best interests, the person providing care or treatment must consult those involved in the young person's care and anyone interested in their welfare - if it is practical and appropriate to do so. This may include the young person's parents. Care should be taken not to unlawfully breach the young person's right to confidentiality (see chapter 16 of the Code of Practice).
Nothing in Section 5 of the Act excludes a person's civil liability for loss or damage, or his criminal liability, resulting from his negligence in carrying out the act.
Sometimes there will be disagreements about the care, treatment or welfare of a young person aged 16 or 17 who lacks capacity to make relevant decisions. Depending on the circumstances, the case may be heard in the family Courts or the Court of Protection.The Court of Protection may transfer a case to the family Courts, and vice versa. This means that the choice of Court will depend on what is appropriate in the particular circumstances of the case. For example, if the parents of a 17 year old who has profound learning difficulties cannot decide on the young person's residence or contact, it may be appropriate for the Court of Protection to deal with the disputed issues as any orders made under the Children Act 1989 will expire on the young person's 18th birthday.
It was identified by the multi-agency forum of the Teenage Pregnancy Strategy that Wirral did not have a generic Sexual Health Policy specifically for Young People. Organisations/agencies/young people's settings operated using in-house policies that were not consistent with one another. In light of current guidance and legislation a need was expressed for the development of a multi-agency Sexual Health Policy.
A reference group was set up to support the development of the Policy. This group consisted of:
|Alison Hayman||Senior Nurse, Women's Services|
|Ann Clarkson||Project Development Coordinator, Social Inclusion|
|Caroline McKenna||Principal Safeguarding Manager for children and young people|
|Corinne Lands||Principle Manager of PSHE & pupil response|
|Deborah Williams||Health Promotion Strategy Manager, Public Health|
|Harriet Gill||Centre Manager, Wirral Brook|
|Lindsey Davidson||Deputy Head of Youth & Play Service|
|Pat Rice||Head of Response|
|Rebecca Mellor||Sexual Health Promotion Project Officer, Public Health|
|Sue Barker||Project Manager for Additional Services, Forum Housing Association|
|Sue Edwards||Lead School Nurse Manager|
|Wendy Nulty||Teenage Pregnancy Coordinator, Public Health|
During the process of writing this Policy, consultation has been widespread. Consultation has taken place with:
The views of all those who have contributed to the consultation process were taken into account when writing up the final version.The Policy has been written by the Sexual Health Promotion Officer and the Health Promotion Strategy Manager, both who are employed by Wirral Clinical Commissioning Group, and Project Development Coordinator, Social Inclusion, Children and Young Peoples Department.