The Teenage Pregnancy Strategy for England [PDF], which ran from 1999-2010, led to a 72% reduction in the under-18 conception rate (1998-2021). There has been a similar decline in the under-16 conception rate. Both rates are at the lowest level for over 40 years. 

However, at a national level England's teenage birth rate remains higher than levels in comparable Western European countries and progress in reducing rates varies considerably between local areas. There is a seven-fold difference in the under-18 conception rate between local authorities and 60% of local areas have at least one ward with a rate significantly higher than England. The Government has asked local areas to maintain their focus as part of tackling inequalities and maximising the life chances for young people and giving every child the best start in life.

Continuing to reduce the rate of under-16 and under-18 conceptions is one of four priority areas in the Department of Health's Sexual Health Improvement Framework and is likely to be a key issue in DHSC’s forthcoming Sexual and Reproductive Health Action Plan. The under-18 conception rate is an indicator in the Public Health Outcomes Framework (PHOF) which sets the context for improving health and reducing inequalities at national and local level.

Progress on reducing teenage pregnancy - and improving support for young parents - also helps local government improve at least 25% of the wider PHOF indicators which disproportionately affect teenage parents and their children. These include child poverty, infant mortality, poor maternal mental health and levels of young people not in education, employment or training.

Public Health England and the Local Government Association have published two pieces of national guidance to support local areas continue their progress.

The Teenage Pregnancy Prevention Framework and the Framework for Supporting Teenage Mothers and Young Fathers are designed to:

• help local areas assess their local programmes to see what’s working well
• identify and address any gaps in services
• strengthen the prevention and support pathways for young people, young parents and their children, and maximise all the assets in the local area.

Both frameworks provide an evidence-based structure for a collaborative whole system approach to prevent teenage pregnancies and support teenage parents. Local areas are using the Framework in a variety of ways, as illustrated by these examples from Croydon, Havering, Oxfordshire, Buckinghamshire, Barnsley, Middlesbrough and Warwickshire. Use of Framework - examples [PDF]

One of the recommendations for targeted prevention is to use a Making Every Contact Count approach and encourage practitioners working with young people to help them to access contraceptive and sexual health services [PDF]. This messaging for partner agencies has been adapted from a template developed by the Sexual Health, Reproductive Health and HIV team in Public Health England during the Covid pandemic.

The Local Government Association has also published two briefings for councillors, highlighting the importance of a continued focus on teenage pregnancy and young parents, with case studies illustrating effective local practice. Teenage pregnancy and young parents: good progress but more to do [PDF] and Supporting young parents fulfil their full potential

PHE's teenage pregnancy narrative reports bring together key data and information for local authorities to help inform commissioning decisions with their partner agencies, to reduce unplanned teenage conceptions and improve outcomes for young parents. The PHE local Sexual and Reproductive Health Profiles are also very helpful for monitoring progress and informing commissioning.

Other helpful resources for teenage pregnancy prevention and support work include:

Public Health England’s Women’s Reproductive Health Programme 2020-21. The three main themes of the RH programme are: improving reproductive health related quality of life; fulfilment of reproductive choice; and early identification of reproductive morbidity. The programme takes a life-course approach from menstruation to menopause and provides a national framework to support regionally and locally-led action. As well as providing an update on the work of the programme during 2020, the publication includes: a new tool estimating the return on investment of contraception provision in maternity services and the provision of long acting reversible contraception (LARC) in primary care; and a report describing a new set of reproductive health indicators that were chosen via a consensus Delphi process and will be developed by PHE and local partners for improved monitoring of reproductive health.

C-card condom distribution schemes: why, what and how – published by Brook and PHE is designed to support local areas establish and maintain effective c-card schemes. A national report on condom schemes by PHE, published in 2017 provides an assessment of the number and types of condom distribution schemes in England and a knowledge base from which to develop a standardised framework for the evaluation and benchmarking of C-Card schemes.

Moving to statutory relationships and sex education

In March 2017, Government laid an amendment via the Children and Social Work Act (2017) to introduce compulsory relationships education in primary schools and compulsory relationships and sex education in all secondary schools from September 2019. The Act also provides a power for the Secretary of State to make PSHE mandatory in all schools through regulations at a later date if wished. The Department for Education's policy statement set out Government's rationale, approach and timeline for the proposed statutory changes and highlights the overwhelming support from parents and young people for high quality statutory RSE.

New statutory guidance for schools

After initial consultation on the content, draft statutory guidance on relationships education at primary level, relationships and sex education at secondary level and health education in both primary and secondary, was published for consultation in July 2018. The final statutory guidance for RSHE was published in June 2019.

The guidance applies to all schools, including free schools, academies and faith schools. Two parent guides were also published for schools to inform and engage with parents.

In principle, statutory provision was due to start in September 2020, but because of the covid pandemic, schools were given flexibility during the first year of implementation. However, from September 2021 all schools are required to implement the guidance and will be inspected accordingly by Ofsted through the new School Inspection Handbook. The handbook includes a specific section on how schools are addressing sexual harassment, online sexual abuse and sexual violence.

Support for implementation of statutory RSHE

Three steps to RSHE success

The pandemic has created significant difficulties for schools and challenges in preparing for statutory RSHE. Recognising this, the Sex Education Forum, the PSHE Association, the teaching unions (ASCL, NAHT, NEU) the Association for Young People’s Health and PHE, have worked together to publish practical advice on three key steps to successfully implementing the statutory changes: Consulting with parents and pupils, and developing policy; What to teach and how to teach it; and Sustaining success. Includes a range of relevant tools and information to help schools optimise their PSHE education to meet statutory requirements.

To find out more and have access to the latest evidence and good practice, visit the Sex Education Forum. Organisations, including local authorities, and individuals involved in RSE can gain the full benefits of the Forum and join the RSE community with a Partner, Educator or Supporter membership.

RSE briefing for local councillors

The briefing, published by the Local Government Association, the Sex Education Forum, the RSE Hub and PHE, sets out: the statutory requirements – and the contribution of RSE to schools statutory duties on safeguarding, wellbeing and equality; the evidence: on RSE’s protective benefits for children and young people and the ingredients for effective delivery; the views of children, young people and parents; what is RSE? explaining content at different ages and stages; case study examples of partnership approaches in and out of school settings; the contribution of RSE to other council priorities; and actions that can councillors take.