To provide outreach sexual health service to vulnerable young people in areas of socio-economic deprivation and hard to reach group <25
MyHealthnet need a health service bus to focus on the task of helping to Reduce Rates of Unintended Underage Pregnancies and Sexually Transmitted Infection and HIV. Furthermore, for Providing Community Confidential Counselling and Psychosexual Health Advice and Support to Volunteers. We provide volunteering opportunities for work experience, and training with an accompanying multi-Agency Strategy and Action Plan. So far, it has been difficult to raise adequate running capital and to meet cost for a health bus, nonetheless our efforts continues. We have concentrated on developing comprehensive Sex and Relationships education alongside offering sensitive and appropriate sexual health services for young people.
We support young people in many ways through Youth Clinics, Youth Outreach Drop Ins and workshop, support to youth centres and colleagues in social care, education and Primary Care wanting to extend their work with young people and having an adapted bus will improve access for service users and families. At MyHealthnet, we support young people’s rights to outstanding sexual health services and support, we are dedicated to campaign and develop nationally available services through outreach work and online services for effectiveness and inclusive service.
One of the most effective initiatives developed in recent years is the Young People’s Health Bus. In a local Audit of young people’s sexual health support, they found the outreach health bus as one of the top three best services. Youth Sexual Health Matters, and withy our funding we are very keen to continue to improve access though our youth health bus service and which will enable collaboration with other out reach service providers to develop this facility further.
Project Objectives and Scope
The Youth Health Bus, during its first 3 years of operation will run five sessions per week, targeting young people in areas of highest deprivation and teenage pregnancies with its services. It was extremely effective in reaching young people who had not previously accessed sexual health services and particularly young men.
Renting a vehicle was mostly restrictive, unsustainable and unsuitable, and neither is borrowing a bus. Borrowing meant that its use always requires endless negotiations around the needs of the owner, and young people and we could not customise the vehicles for use. We need to buy a suitable size bus and convert it into a safe and secure mobile health clinic. Buying an old used and cheaper bus comes with no warranty and the conversion could be prove little too expensive and less value for money in the long-term.
We will use part of the funds raised on meeting service-running cost and obtaining resources including health educational materials, test kits and condoms, which will be distribute around twenty regional Primary Care settings to support sexual health promotion initiatives.
We will continue to identify funding to support sexual health service, health promotion and education and youth lifeline and skill development initiatives.
A fully converted mobile clinic is effective in attracting those young people who have not previously used health services, but that in particular young men -who are reluctant to access traditional building-based sexual health services -make up a large proportion of people in need.
The Current Situation
The current situation is that we work very hard covering many locations and in inflexible settings as required. We are organised enough to maintain an accessible locations for young people but the difficulties restricts progress.
We use free open space to reach out as necessary to promote service awareness. We use space in buildings made available on shared rotation basis between 3 - 6 month licences when available. However, had not storage permission so, we could not store service materials in such spaces. Therefore, all have to carry back and for the resources including furniture we might require on clinic days. This is because we have to clear up the room for other services. We have to be bring bulky items to set up clinic at the start of each day service, pack up, and vacate daily. We also rent council properties, community centres and private venues that are often either expensive or with difficult property owners, who open late and we have no key access... Venues in some regions are often available for limited period only and such venues have limited facilities or restricted facilities for service users and staff. The daily heavy lifting tasks overwhelms our staff who are mostly volunteers.
Now, there is a strong sense of being on someone else’s territory. Having to tread carefully dealing with people or losing money renting, or borrowing vehicles and meeting the expenses of such vehicle. Running a 'Clinic in a Box' and constant moving centres removes the sense of being rooted and constant change of direction, hence the online service but many people wants the face to face service too.
We rent space in colleges and university buildings for seminars and use open sport fields for relevant male-targeted workshops as well as set up as a Youth Health Outreach Service unit at community road shows for health promotion. We pay for council grounds at regional community events at expensive rates, which is less than ideal, but we try to reach out to a very large number of young people attending such events.
Our limited financial status makes the delivery of services in various areas very difficult. We have had to be innovative to meet service gaps but the issues above makes running a reliable service less ideal for the following reasons:
- Lack of adequate funds to warrant renting a bus,
- Meeting service-running expenses.
- Lack of space for storage of clinic equipment and materials, lifting and handling health and safety risks and loss or resources, damage ad loss of equipment during handling.
- Loss of staff to other charities with better facilities and less demanding tasks.
- No sense of control over environmental issues like rain, heat and cold weather in open spaces.
- The additional cost to use public toilet or take shade in facilities away from the elements
- Lack of space to ensure confidential consultation and maintain privacy from prying eyes.
- Loss of paid damaged literatures from excessive handling and damaged temporary structures from excessive wind etc.
- Limited or lack of service in regions affected by poor weather conditions.
- We continue to exclude many potential service users that are house bound due to mental health condition and other reasons if we are unable to reach out to them.
- We either struggle or cannot collect donated goods when we require a large vehicle for collection furniture or bulky items.
- We cannot effectively deliver a confidential youth health service in a regular health bus.
The Youth Health Bus Proposal
MyHealthnet proposes that:
We buy a New Youth Health Bus
That the bus is adapted and equipped to contain group-work space and consultation-rooms and storage space.
That the new Bus, as a vehicle for Young People’s Health work will be managed by two part -time project leaders, probably based at the Head Office base in North Kent and London for HIV and Sexual Health as part of its Health Promotion role,in partnership with the Sexual & Reproductive Health Services.
That these initiatives will focus on reducing the rates of unintended and underage pregnancies and sexually transmitted infections HIV and related risks will lead to a reduction in inequalities in both access and delivery of services and increase support efforts to bring such work closer to the homes and communities in which people live and work.
Staff are recruited to work on the bus in Young People’s Health support roles, while maintaining the provision of some clinical and counselling services (with mainly counsellor or nurse-led)
To work at a local, regional level alongside online services and in collaboration with Primary Care Teams to increase their awareness of the sexual health service needs of young people in their catchment areas and their confidence and skills in offering appropriate youth-friendly services
The youth health bus will be an effective way of developing and delivering tailored service to young people in almost every respect. For instance, the mobile service
Ø will have the capacity to target directly those young people living in areas of high social deprivation
Ø will create links with disproportionately high numbers of boys and young men
Ø will offer a youth-friendly service in a range of community settings
Ø will continue to work directly with local services, namely Primary Care Teams, school nurses and carers and youth workers to ensure that the local work is sustainable and continues once the bus has moved on to other areas.
That we designate the bus for use with our service users with particular target group of vulnerable young people but has the overall aim of delivering sexual health and HIV education and support service, and reducing the rates of sexually transmitted infections, and unintended and underage pregnancies.
Whilstreducing health inequalities by working with communities (whether geographicalor “communities of interest”) experiencing high levels of social exclusion or socio-economic deprivation. This vulnerable group includes young people from all communities, young people in areas of high teenage pregnancies, young people in public care, young women, young men, and young people with disabilities or learning disabilities.
The 'Bus' is just one method of undertaking community sexual and reproductive health and HIV service development; and outreach health promotion work with vulnerable or marginalised communities of young people alongside other forms of outreach and community-based work programmes and health promotion initiatives
Other service providers in areas of health can use the bus in along sexual health -include smoking cessation, alcohol and drugs education and mental health or stress reduction, CHD prevention and health promotion.
There would also be a focus on introducing young people to Primary Care services in their areas. Use of the Youth Outreach Bus offers a highly targeted “simple” way to target a number of areas of greatest deprivation, thereby reducing health inequalities.
Evaluation has also shown that the bus is an excellent way to target young people who otherwise would not use any health service.
One of the main aims for all the activities undertaken by the bus would be the linked mainstream health services, with local on Primary Health Care service and service commissioning group.
Rigorous assessment of the impact of the Youth Outreach Bus has shown high user-satisfaction rates and its particular success in attracting large number of hard to reach boys and young men – not traditionally users of sexual health services in Sheffield. The provision of free condoms has been anattraction for young people generally, offering a ‘way in’ for them to seekinformation on a range of other health matters. Young people regularly reported that they would prefer the bus to remain in their area for a longer period.
The risks of not responding to the needs of vulnerable young people in any way possible are far greater than the risk of inactivity. The greatest “selling-point” for having the Youth Health Bus is that we have strong evidence to show its effectiveness, provided by rigorous evaluation of the first two years of the operation of the proposed outreach service.
New single-decker bus, including refurbishment £ 85, 000
Equipment £ 5, 000
Service Capital i.e. Health Promotion Resources Insurance etc. £ 10, 000
Total cost £100, 000
Project timetable, management arrangements and post project evaluation
i) Project Timetable. Indications are that the process to obtain the vehicle would take between 6 and 9 months to achieve. During this stage, other preparations will include fund-raising for further staffing costs, liaison with partner agencies including Primary Care teams, social services and identifying first sites for bus visits and press coverage for the Bus launch.
ii) Management arrangements. MyHealthnet service has been operating for twenty years, and has an established management system. MyHealthnet charity has lead managers for Sexual and Reproductive Health, for HIV and Sexual Health and the service management team. A dedicated and efficient outreach health bus manager will be appointed to project manage and coordinate maximum use and maintenance of the bus in collaboration with the outreach team.
iii) Project Evaluation. Regular and ongoing project evaluation will be done using the same measures and mechanisms as those which have already been successfully employed in Sheffield PCT Sexual & Reproductive Health and HIV/Sexual Health and the Local Teenage Pregnancy service at Sheffield Health). Six months after launching the health service bus, we plan to undertake an initial review of service to ensure all systems are safe. Another review after three months to address and update findings from previous evaluation. Other developmental six monthly reviews will follow as necessary to effect and evaluate change. Afterwards, will be implement recommendations following service audit, reassess effectiveness, progress and impact to communities served, and staff development... We believe the Bus service will have far-reaching impact on youth health and communities much more than justifying the early hopes for its effectiveness and of MyHealthnet services in general.
If we do not meet our target, any money raised will still go towards the running cost of other services and chosen smaller community projects.