The public health team at Buckinghamshire County Council has worked with multiple partners to help tackle child sexual exploitation (CSE). It has involved training for staff and a project with community pharmacists to help them spot those at risk when they come in for emergency hormonal contraception (EHC). This case study forms part of our sexual health resource.
There has been growing awareness about the risks of CSE in recent years following a number of high profile cases. It has become clear that CSE can be experienced in all communities.
As a result, Buckinghamshire’s Children’s Safeguarding Board has made the issue a top priority.
The board has committed to do all it can to prevent it happening, protect those at risk and pursue those responsible as part of its ‘CSE Promise’.
An exploitation sub-committee exists to oversee this work and includes a range of different partners, including the sexual health public health lead.
Public Health Principal Angie Blackmore said: “One of the real benefits of being in local government is to really develop the opportunity to work with different partners – education, youth and community, social care, police and the voluntary sector – CSE is the perfect illustration of that.
“We knew our sexual health services could have a role in tackling this and so we have tried to play our part.”
One of the first steps taken in 2014 was the introduction of training on for those working in specialist sexual health services to help them identify those at risk of CSE.
Workshops using the national British Association for Sexual Health and HIV and Brook Spotting the Signs screening tool were organised. Around 140 participants have taken part to date, as well as attending Buckinghamshire safeguarding training to understand local policies and procedures.
Ms Blackmore has also worked with community pharmacists over their dispensing of EHC.
EHC requests are monitored to look for unusual patterns of attendance with community pharmacies using a registration system to help them recognise when unusual patterns emerge and then report cases.
Ms Blackmore worked with a specialist CSE social worker in the Swan Unit – a unit initially set up across the police, social care and health dedicated to tackling CSE – to follow up on individual cases.
Training was offered on site to the pharmacists, complementing the face-to-face training already being delivered on safeguarding and CSE.
The community pharmacists who have been supported say it is making a real difference to the work they can do, enabling them to spot those who may be a risk and raise the alarm.
One said: “The training has updated my knowledge of CSE, provided useful ideas and information to consider. It has been very informative and made me think about the things I hadn’t considered before.”
Another added: “As I work front of house I deal with many different members of the community. The training will help me spot the signs of CSE easier.”
The work has also attracted national attention. Buckinghamshire has shared as best practice via England’s Sexual Health and HIV Commissioners Network.
Evidence was also given to a Buckinghamshire Health and Social Care Select Committee about the importance of spotting the signs of CSE through sexual health services and expert public health advice to a Buckinghamshire Serious Case Review on multiple cases of historic CSE in the county.
“Working on sexual and reproductive health often brings new daily challenges, said Ms Blackmore.
“By being in local government, it facilitates sexual health leads thinking much more broadly and with access daily to a broad range of other key services and partners. Sexual health is much more than just sexual health service provision and it is great we have been able to use everyone’s expertise in the local authority more effectively.”
However, Ms Blackmore said when it comes to CSE you have to be prepared for the gangs to be “highly sophisticated”.
“We know they can target pharmacists in different geographical areas to access EHC for girls and we have to be one step ahead and always ensure there are strong local communication networks and referral pathways in place.
“A pharmacy setting offers anonymity especially in main town centres. People can attend for a range of other things at the same time, for example toiletries, make-up and young people, in particular, value immediate access with a level of anonymity – it’s not like using their family GP surgery.”
How is the approach being sustained?
Alongside sexual health practitioners, the wider team who have a role in sexual health have been involved too.
GPs, practice nurses, community pharmacists, school nurses, teenage pregnancy midwives, family nurse partnerships, looked after children and youth offending nurses, substance misuse services, domestic abuse and youth workers have all played an active role in recent workshops on topics ranging from exploitation and trans health to teenage pregnancy. Representatives are all members of the Bucks Sexual Health Network led by public health.
More recently Buckinghamshire has been exploring how else sexual health services can work with partners. A joint public health and education post – Personal, social health and economic (PSHE) lead public health/schools has been created and part of the role is to help schools prepare for the introduction of compulsory relationships and sex education (RSE) in 2020.
It involves working and training teachers and in particular, working closely with PSHE coordinators on preparing for the change.
Ms Blackmore said: “This is a really important moment for sexual health to ensure safe, consensual, healthy relationships and age appropriate work on sexual health is delivered in schools which is a key setting identified by young people in the last National Survey of Sexual Attitudes Lifestyle. It is so important we invest and prepare for it.
“The funding of the PSHE post to support the implementation of RSE is an excellent example of a further approach required to make a difference. In Buckinghamshire we will be looking to build on this type of work in the future.”
Public Health Principal , UKPHR
Buckinghamshire County Counci