Guidance on providing advice on sex education to young people under the age of sixteen

Aug 2 2004

British doctors and health professionals will be sent new, clearer guidance on providing advice on contraception, sexual and reproductive health and treatments to young people under the age of sixteen.

The new guidance highlights for the first time that where a request for contraception is made by a person under the age of 16, doctors and other health professionals should establish a rapport with the young person and give the young person the time and support to make an informed choice.

They should do this by discussing:

The emotional and physical implications of sexual activity, including the risks of pregnancy and sexually transmitted infections;

Whether the relationship is mutually agreed or whether there may be coercion or abuse;

The benefits of informing their GP and encouraging discussion with a parent of carer. Any refusal should be respected. In the case of abortion, where the young woman is competent to consent but cannot be persuaded to involve a parent, every effort should be made to help them find another adult to provide support, for example another family member of specialist youth worker;

Any additional counselling or support needs.

The existing guidance, issued in 1986 immediately following the House of Lords judgement in the Gillick case, is now almost twenty years old. The new guidance does not change the legal framework established in the Gillick case. This states that health care professionals are justified in giving confidential contraceptive advice and treatment to under 16s provided that certain conditions are met.

As before, the duty of confidentiality is not, however, absolute. Where a health professional believes that there is a risk to the health, safety or welfare of a young person or others which is so serious as to outweigh the young person's right to privacy, they should follow agreed child protection protocols. In these circumstances, the over-riding objective must be to safeguard the young person.

Public Health Minister Melanie Johnson said:

"Providing young people with clear support and advice about relationships and contraception is essential if we are to protect them, reduce the number of teenage pregnancies and tackle the spread of sexually transmitted infections.

"By updating this guidance we are ensuring that doctors, nurses and healthcare professionals are clear about providing young people with advice about sexual health and contraception and are providing the best possible care."

Dr Vivienne Nathanson, BMA Head of Science and Ethics welcomed this updated guidance. She said:

"The BMA supports this best practice guidance on contraceptive, sexual and reproductive health advice and treatment for young people under 16. This guidance usefully helps to clarify good practice for health care professionals and in turn also clarifies for competent young people that they can be secure, when seeking advice and treatment, that it will be in confidence. It is essential that competent young people's autonomy continues to be recognised and respected in this way, to ensure a good doctor-patient relationship, based on trust, within which young people feel they are able to seek advice."

The updated guidance has also been welcomed by the Royal College of Nursing and the Faculty of Family Planning and Reproductive Health Care and the Royal College of General Practioners.