The Parallel

BASIC INFORMATION

Case study date: November 2005

Local authority in which project based: Bolton

Date started: 2003

Type of organisation: Health Service

Brief description, including aims and objectives:

The Parallel is a young persons' health centre designed by young people for young people. The project offers a range of health and well-being services for young people aged 11 to 19 through a holistic approach involving collaboration with partner organisations. The Parallel aims to work with young people in securing their right to a positive and health lifestyle through their involvement in all stages of planning for the future direction of the centre.

Collaboration - details of lead agency and other partners:

Bolton Primary Care Trust, CAMHS, Connexions, social services, education and various voluntary organisations.

Funding:

Initially funding 2002-2006 came from Neighbourhood Renewal Fund monies. This year - 2005 is part funded from the Primary Care Trust with full funding from the PCT commencing 2006.

Staffing:

1 full-time team coordinator
1 administration and facilities coordinator
4 part time nurses
1 emotional health practitioner
3 sessional GP's, two of whom are GP's with special interest in adolescent health
2 caretakers
Drop in clinic sessions take place on 4 weekdays and on Saturdays.

Other agencies working in partnership with The Parallel support:
1 full time teenage pregnancy funded post
1 consultant in sexual health and 1 specialist sexual health nurse who work around five hours per week in The Parallel
1 full time gay and bisexual community development worker who provides daily counselling and support alongside a weekly youth group

1 full time Attention Deficit Hyperactivity Disorder (ADHD) nurse specialist
Midwifery and Health visiting support for weekly 'bumps & babies' session
Under 19s substance misuse service
Holiday projects run by the school nursing team
Weekly visit by Connexions
1 part time youth worker - 3 hour clinic session per week.

NATURE OF PROVISION

Which groups of young people does the project work with and why? Information on numbers, age range, gender, ethnicity and any other relevant aspects

The Parallel works with young people aged 11-19 in the Bolton area - of all races, cultures, religions, sexualities and gender. Approximately 150 young people drop in to the centre for services each week and up to 50 young people a week participate in workshops and groups both within The Parallel and in outreach settings such as schools, youth centres and pupil referral units. Drop-in's and support groups are provided for example, gay & bisexual support, midwifery & health visiting, emotional health groups, creative groups.

How was the need for the project identified, and by whom?

The original concept came from a local consultant in public health who identified the need for specialist provision for adolescents. Many workers from a variety of agencies working with young people were frustrated about the lack of specific services for young people. Young people were accessing either children's or adult services and were not always happy with the resulting outcomes. A needs assessment was commissioned by Save The Children, which provided the evidence of needs, and plans were made to develop the service.

How do young people become involved? What, if any, commitment do you ask for?

An open-door policy is in operation with no appointments necessary

What are the main approaches used and activities offered?

The Parallel provides a holistic approach to health, looking at everything affecting emotional, social, sexual and physical health and well-being. One-to-one support service offers young people the opportunity to talk to someone about anything that may be bothering them or causing distress in their life. Regular services focus on contraception, general health and well-being, drug and alcohol issues (Project 360), sexual health and gay and bi-sexual drop-ins and support groups. School nurses run workshops in school holidays covering activities such as preparing healthy lunches, bike maintenance, gardening, and experiencing alternative therapies such as aromatherapy and Indian head massage. The school nurses also run support groups on particular areas of risk-taking behaviour, for example, help with giving up smoking. Music and art classes are also offered, helping young people uncover and understand their feelings. The young people's steering group members offer support to the groups and have been involved in a peer education project in one school that will hopefully be rolled out to other schools in the future.

How are young people involved in shaping the project/programme?

Large numbers of young people are consulted in service planning, monitoring and evaluation. A smaller group make up The Parallel young people's steering group, a representative group of around 12 young people who meet regularly on a voluntary basis. The group helps inform management about the future direction of the Parallel, and provides opportunities to put forward views on the service and ways to improve. Members were heavily involved in setting up the centre through taking part in recruitment and selection processes, naming the centre, design and promotion of the building, its layout and interior and all the posters and leaflets used. Steering group members have their own suggestion box to enable feedback to the rest of the team, and quite often will be present in the waiting area to ask service users their opinions of services provided and how improvements can be made. Involvement also extends to mentoring, peer education, public speaking and designing resources such as leaflets, posters, condom packs etc.

How does the project respond to the needs of different young people, particularly the most marginalised?

The Parallel includes services focusing on particular issues, such as drugs and alcohol, teenage pregnancy and gay and bisexual young people. The effective support network means that the centre can respond to a range of needs of different young people through signposting to other services if necessary. Teenage pregnancy staff based at The Parallel provide outreach services to all the pupil referral units and "looked after" young people in Bolton. Vulnerable young people identified from other services are brought to The Parallel by staff working with them.

OUTCOMES OF WORK

How do young people benefit from their involvement in the project?

The Parallel provides a safe and confidential place to discuss health concerns or worries with no appointment necessary. Workshops, support groups and classes all contribute to helping young people uncover and understand their feelings and learn new skills. Opportunities to contribute to decisions about the direction of the service have been beneficial to all of the young people concerned. For example, following a bike maintenance session in the holidays one young man was offered an apprenticeship at the firm hired for the event; two members from the young people's steering group have secured work as receptionists - one in sexual health, the other at The Parallel; while another young man has become sufficiently interested in the service to go on a health & social care course.

How do other young people, organisations or the wider community benefit from the project?

Because of the young people friendly service provided, young people feel more welcome, safe and comfortable. Most bring at least one or two friends, who will often access the service at a later date. Whilst accompanying friends, they also receive health promotion messages and information. Other organisations are able to access a centre of excellence for the young people visiting their services.

Support for the wider community comes in various ways, for example: support to parents and carers, both one to one and in groups; support for schools; and contributing to public health issues e.g. promoting reduction in sexually transmitted infections, increasing uptake of immunisations, reduction in teenage pregnancy rate.

Does the project contribute to community cohesion? If so, how?

The Parallel contributes to community cohesion in a variety of ways including raising self-esteem and contributing to developing young people's skills and reducing substance dependency, which in turn relates to reduction in related crime.

How are young people's progress and achievements measured and recorded?

Under development via peer education and mentoring.

MEASURING EFFECTIVENESS

How is the project evaluated and by whom?

Evaluation includes regular young people's surveys and consultations. Health data collection, staff appraisal and development. Clinical governance standards and participation standards provide benchmarks.

What are the findings of any evaluations (including Ofsted inspections) to date?

Parallel was highlighted by Youth Matters green paper as an example of good practice in terms of its holistic approach to youth people's health. Beverley Hughes, minister for young people and families, said the initiative 'puts young people at the centre of services designed for them; making their voices heard where it matters'. The project is currently under consideration by the Department of Health as an Adolescent Health demonstration site. Small-scale research projects have been carried out, but it is too early to have evaluation outcomes.

What changes/developments have occurred - or are planned - as a result of evaluation?

Expansion of the service is currently being planned as a "model of service delivery" rather than a clinic setting. This service has also been responsive to the ongoing needs of the adolescent population in both service provision and training for staff in working with young people.

What factors help the work? Please be specific

They include: young people friendly staff and a committed workforce; partnerships; the steering group and strategic commitment.

What factors hinder the work? Please be specific

The main issues hindering work are finance and deprivation - which affects both the vulnerability of young people and, research suggests, increases risk taking behaviour patterns. Media influences also contribute.

PARTNERSHIP/MULTI-DISCIPLINARY WORKING

When working in partnership, what is the distinctive contribution of your organisation/project?

The Parallel is considered to be the "hub" of a "hub and spoke" model and a centre of excellence for adolescent health both for provision of services and training.

Has this partnership resulted in greater collaboration or increased understanding between partners? If so, how?

Yes- it has provided a better understanding of each other's roles. Within the voluntary sector there has been increased working in health issues. Youth services and Connexions now have staff trained in health issues. Social services have an increased awareness of issues affecting adolescents.

STRATEGIC IMPACT

Do you consider this project to be innovative? If so, how?

In addition to the holistic approach to health provision where nothing is treated in isolation, the centre is set in a relaxed and young person friendly environment. It puts young people at the centre of both their own health care and of service provision.

How do you disseminate the learning from the project?

Via strategic partnerships, operations groups, young people; through the media such as magazine articles, news stories, television and radio; and also by sharing best practice with other areas.

Has the learning from this work influenced wider organisational/service strategies? If so, how?

Yes- The PCT is keen to expand adolescent health services as a result of the good work undertaken. Young people's policies have been developed and more staff have been trained to work with young people.

What plans do you have to sustain/develop this work?

The Parallel is now a mainstream service after beginning as a funded project. It is fully responsive to the needs of young people.

CONTACT DETAILS

Margaret Clugston/Jayne Littler
The Parallel
9A Churchgate
Bolton BL11HU

Tel: 01204 526805