Sexual Health Policy for Staff Working with Young People Under 19 Years

1. Introduction

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:

Being Healthy;
Staying Safe;
Enjoying and Achieving;
Making a positive contribution;
Achieving Economic well-being.

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.

2. Statement of Purpose

"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)

2.1 Values Underpinning the Policy

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.

3. Sexual Health Policy and Guidance for Under 19s

3.1 Policy Aim

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.

3.2 Policy Objectives

To encourage young people to engage in positive and safe relationships and sexual health. To ensure professionals all adhere to the principles of safeguarding;
To encourage and support young people to talk to their parents/carers about issues raised with the professional;
To help facilitate open discussions between members of staff and young people on sex and relationships even if that young person is not yet sexually active;
To support members of staff to provide clear messages to young people, boys and girls, on the negative consequences of having sex at an early age and the benefits of delaying sexual activity until they are ready;
To provide young people with the knowledge, skills and confidence to resist any pressure to have inappropriate, early or unwanted sexual relationships and to manage their sexual health;
To use discussion about sex and relationships to help young people develop their self-esteem and self-awareness;
To allow young people space to explore their values and attitudes;
To encourage young people to make informed decisions about their behaviour, personal relationships and sexual health;
To improve young people's access to advice and support regarding contraception and sexual health.

4. Roles and Responsibilities of Working with Children and Young People under 19 Years

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:

Be proactive in addressing unmet needs around positive sexual health, sexuality and relationships;
Provide verbal advice / information (appropriate to age, maturity and culture) around sexual health including messages of delay;
Emphasis the links between alcohol, drugs and safe sexual health;
Carry out an assessment to identify the young person's sexual health needs;
Refer young people with complex needs, or who require further advice or intervention to appropriate young person service;
Raise awareness of local sexual health and advice services;
Following training provide brief interventions for hazardous and harmful drinkers / substance mis-users (e.g. TWIST tool);
Following training be able to provide condoms, pregnancy testing and assist young people with the self-screening test for Chlamydia.

As part of this assessment, the aim is to establish whether a young person (male or female) is:

Sexually active;
Has basic knowledge of contraception;
Is aware of local services;
Has any immediate risk following unprotected sex and is aware of the associated risks (e.g. pregnancy);
Is aware of STI and HIV prevention and symptoms;
Is aware of the link between alcohol / substance misuse and sexual health;
Has any sexuality / identity issues;
Has any relationship issues.

This is not a checklist, but a guide to priority issues that can be discussed with the young person.

5. Partnership Working

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, CLA Nurses.

5.1 Agency Roles and Responsibilities

Agencies will:

Brief their worker/carers on this Policy and ensure they are fully aware of their contribution in supporting children and young people in the development of healthy relationships and sexual health and wellbeing;
Ensure the job descriptions of workers/carers who work with children and young people include details of their role and responsibilities in relation to this Policy. Local induction programmes should include detailed information about this Policy and the contribution to strategies which relate to this Policy and the Wirral Teenage Pregnancy Strategy;
Ensure their workers/carers work within the Wirral Sexual Healthy Training Strategy (currently under development) and assist their staff in identifying their training needs, supporting them in accessing relevant training;
Identify a Sexual Health Champion within their agency who will act as the key contact. Their role will be to:
1. Promote good practice;
2. Disseminate good practice across their agency and to share this with the wider sexual healthy community;
3. Identify communication issues both externally and internally which either promotes or hinders good communication within their own agency and with others;
4. Contribute to the development of actions to improve sexual health outcomes for young people;
5. Regularly attend local Sexual Health/Teenage Pregnancy network meetings to ensure effective networking/working together;
6. Act as the point of contact for their agency and the Teenage Pregnancy Coordinator.
Ensure children and young people have access to good quality information and services which are easily accessible and based on assessed need. Available information must also include negotiation skills, promote delaying sexual activity until ready, and emphasise awareness of the need to use contraception when sexually active;
Identify areas where children and young people can access condoms and assistance with a pregnancy test. For non-clinical services, identify which part of their services are suitable for the issue of condoms and pregnancy tests to young people;
(Non-clinical services) should identify approved workers who have successfully completed an approved training course and who work strictly within the Working with Sexually Active Under 18s Guidance and Safeguarding Children Procedure (refer to Good Practice Guidance document). Managers should keep an up-to-date list of approved workers and ensure they receive support from clinical services with this extended role;
Ensure that the sexual health needs of children and young people are seen as part of core delivery of their service, and that information and support is readily available;
Ensure children and young people are treated as individuals and have their sexual health needs assessed. Any risk taking behaviour once identified, should be addressed by the offer of tailor made services which reduce risk and ensure safety. Agencies will ensure the Wirral Local Safeguarding Children Board Procedures are applied when assessing needs;
Ensure national and local guidance is reflected at local level in the services provided, and a positive message regarding relationships and good sexual health is promoted;
Work together to develop and deliver a number of initiatives for parents, carers and children/young people which promote respect and responsibilities;
Ensure all their services are young person friendly and audit accessibility by children and young people on a regular basis;
Work together in developing a comprehensive training package. Training will be available to all workers/carers to assist them in carrying out their roles and responsibilities.

6. Supporting the Delivery of the Policy

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 ICB, will provide information and resources.

7. Arrangements for Dissemination and Review of the Policy and Guidance

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.

8. Evaluation of the Policy

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.

9. Acknowledgements

Writing this document has been supported by access to policies and guidelines from the following:

Blackburn and Darwen Borough Council;
Brook London;
Lancashire's Children and Young People's Strategic Partnership;
Metropolitan of Wirral, Department of Specialist Services;
Regional Teenage Pregnancy Coordinator.

Appendix 1: Government Strategies to Support this Policy

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:

United Nations Convention on Rights for Children

All children have the right to non-discrimination, freedom of expression, protection from exploitation and abuse and the rights to health care, education, play and leisure;
All agencies have made a commitment to supporting the diverse needs of all young people in relation to their sexual health, relationships and positive emotional health and wellbeing. All children and young people will be entitled to:
- Education;
- Information;
- Services;
- Support.
appropriate to their age, gender, sexual orientation, culture and developmental needs.

Appendix 2: The Sexual Offences Act 2003

The Age of Consent

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)

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).

Protecting People with a Mental Disorder

The act has created three new categories of offences to provide additional protection with a mental disorder:

The Act covers offences committed against those who, because of a profound mental disorder, lack the capacity to consent to sexual activity;
The act covers offences where a person with a mental disorder is induced, threatened or deceived into sexual activity;
The Act makes it an offence for people provided care, assistance or services to someone in connection with a mental disorder to engage in sexual activity with that person.

Children and Families: Safer from Sexual Crime - (The Sexual Offences Act 2003)

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.

Bichard Inquiry - Recommendation Number 12

"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".

Working Together to Safeguard Children (April 2006, Archived)

Paragraph 1.12 - An integrated Approach

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.

Paragraph 1.32 - Sexual Abuse

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.

Paragraph 6.2 - Children Abused through Sexual Exploitation

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 Wirral Safeguarding Children Partnership 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:

Recognise the problem;
Treat the child primarily as a victim of abuse;
Safeguard the children involved and promote their welfare;
Work together to prevent abuse and provide children with opportunities and strategies;
To exit from Child Sexual Exploitation; and
Investigate and prosecute those who coerce, exploit and abuse children.

Paragraph 12.2

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:

Paying for the sexual services of a child;
Causing or inciting Child Sexual Exploitation;
Arranging or facilitating Child Sexual Exploitation;
Controlling a child prostitute.

Young People under the Age of 13

Under the Sexual Offences Act 2003, children under the age of 13 are considered to be of insufficient age to give consent to sexual activity. In such circumstances, reference should be made to the Wirral Safeguarding Children Partnership Procedures, Working with Young People Engaged in Sexual Activity Procedure;
Full assessment is required in all cases where a sexually active young person is under the age of 13;
Each case must be individually assessed and careful consideration for making a Child Protection referral to the Children's Specialist Services Single Assessment Team must be made. In order for this to be meaningful, the young person will need to be identified, as will their sexual partner, if details are known;
A decision not to refer can only be made following a case discussion with the designated lead for child protection within the agency/Local Authority. The professional and agency are fully accountable for the decision made and a good standard of record keeping must be demonstrated including the reason for not making a referral;
When a girl under 13 is found to be pregnant, a referral to the Children's Specialist Services Initial Assessment Team must be made and they will hold a strategy discussion with the police and/or other agencies. At this stage a multi-agency support package should be form.

Young People between 13 and 16

The Sexual Offence Act 2003 reinforces that, whilst mutually agreed, non-exploitative sexual activity between teenagers does take place and that often no harm comes from it, the age of consent should still remain at 16. This acknowledges that this group of young people are still vulnerable, even if they do not think that they are;
Consideration should be given in every case involving a sexually active young person aged 13-16 years old. Discussion with Children's Specialist Services will depend on the level of risk/need assessed by those working with the young person.

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.

Young People between 16 and 18

Although sexual activity in itself is no longer an offence over the age of 16, young people under the age of 18 are still offered the protection of Local Safeguarding Procedures under the Children Act 2004;
Consideration still needs to be given to issues of sexual exploitation through Child Sexual Exploitation and abuse or power in circumstances outlined below. Young people, of course, can still be subjected to offences of rape and assault and the circumstances of an incident may need to be explored with a young person;
Young people over the age of 16 and under the age of 18 are not deemed able to give consent if the sexual activity is with an adult in a position of trust or a family member as defined by the Sexual Offences Act 2003.

Appendix 3: Gillick and Fraser Guidelines

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 young person understands the advice;
The young person cannot be persuaded to inform his or her parents or allow his or her parents or allow the doctor to tell them they are seeking contraceptive advice;
The young person is likely to begin or continue to have unprotected sex;
The young person's physical or mental health are likely to suffer unless he or she receive contraceptive advice or treatment;
It is in the young person's best interest to provide contraceptive advise and treatment.

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:

Condoms;
Assistance with administering a pregnancy test;
Support when they are attending or have attended another sexual health service for treatment/advice;
Sexual health information and advice.

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:

Protect the child's safety;
Protect them from sexually transmitted infections;
Prevent the child becoming pregnant;
Promote their emotional well-being by the giving of advice.

Confidentiality

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.

Please refer to the Wirral Local Safeguarding Children Board Procedures, Children and Young People who display Sexually Harmful Behaviour Procedure.

Recording Information

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.

Safeguarding and Information Sharing

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.

Sharing Information with Parents and Carers

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.

Data Protection

The legal framework for confidentiality is contained in the common law duty of confidence, the Children Act 1989, the Human Rights Act 1998, the UK General Data Protection Regulations (UK 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.

Child Sex Offender Disclosure Scheme

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:

'That the information must only be used for the purpose for which it has been shared i.e. in order to safeguard children;
The person to whom the disclosure is made will be asked to sign an undertaking that they agree that the information is confidential and they will not disclose this information further;
A warning should be given that legal proceedings could result if this confidentiality is breached. This should be explained to the person and they must sign the undertaking' (Home Office, 2011, p16).

If the person is unwilling to sign the undertaking, the police must consider whether the disclosure should still take place.

Mental Capacity Act

Click here to view the Mental Capacity Act 2005.

How does it apply to Children and Young People?

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.

Summary

Children Under 16

The Act does not generally apply to people under the age of 16 but there are two exceptions:

The Court of Protection can make decisions about a child's property or finances (or appoint a deputy to make these decisions) if the child lacks capacity to make such decisions within Section 2(1)* of the Act and is likely to still lack capacity to make financial decisions when they reach the age of 18 (Section 18(3));
Offences ill treatment and wilful neglect of a person who lacks capacity within Section 2(1)* can also apply to victims younger than 16 (Section 44).

Nevertheless, care must be undertaken even when seeking to safeguard, protect and meet the needs of young people under 16 years that they have not been deprived of their liberty unlawfully under Article 5 of the European Convention of Human Rights by their parent or anyone else with Parental Responsibility. A distinction must be made with regard to 'deprivation' and 'restriction' (which is considered to be within the proper realm of Parental Responsibility). Arrangements and actions which effectively deprive a child of their liberty may fall within the 'zone of parental responsibility' but otherwise such decisions can only be made on a case by case basis by a High Court using its inherent jurisdiction.

(See Re-AB (A Child: Deprivation of Liberty) [2015] EWHC 3125 (Fam)).

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:

Only people aged 18 and over can make a Lasting Power of Attorney;
Only people aged 18 and over can make an advance decision to refuse medical treatment;
The Court of Protection may only make a statutory will for a person aged 18 or over.

Care or Treatment for Young People aged 16-17

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:

Has taken reasonable steps to establish that the young person lacks capacity;
Reasonable believes that the young person lacks capacity and that the act is in the young person's best interests; and
Follows the Act's principles.

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.

The lack of capacity to make a decision is caused by an impairment or disturbance that affects how the mind or brain works.

Legal Proceedings Involving Young People Aged 16-17

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.

Appendix 4: The Development of the Policy and Guidance

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:

Young people;
Young people organisations/agencies/services including Barnardo's, Brook, Connexions, Confidential Advice Service (CAS), Forum Housing Association, Response, Terrence Higgins Trust;
Children and Young People's Department including Youth Service and Youth Offending, Social Inclusion, Leaving Care Team (CLA), Education Wirral Primary Care and Wirral Hospital Trust services/teams including Children's A&E, Child Protection, Chlamydia service, Health Visitors, Healthy Schools, Walk in Centres, Women's Services;
Teenage Pregnancy Steering Group (TPSG) including TPSG sub groups; Better Contraception and Better Support.

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 Integrated Care Board, and Project Development Coordinator, Social Inclusion, Children and Young Peoples Department.