Monday, 23 September 2013

Brook Northern Ireland turns 21 - guest blog post from Mary Crawford

As Brook Northern Ireland turns 21 this blog is a guest post from Mary Crawford, Director, Brook NI. 

This September, Brook Northern Ireland was 21 years old.  We celebrated the event on the roof top garden of a local hotel with staff, management committee and invited guests.  Simon has asked me to share with you some of the story of what started out as Brook Belfast, so here goes!

Since 1992, Brook Belfast has experienced financial difficulties, a hostile environment, abuse, intimidation and threats.  Pickets of up to 300 were not unusual in the early days, followed in the late 90s by candlelit vigils, white baby coffins, and protestors in mantillas.  We have a collection of rosary beads, holy pictures and medals that have been given to us.  We have been prayed for more than any other organisation in Northern Ireland!

Young people were escorted in and out by staff, committee members, and on bad days, police officers.  In 1999 every house in my street received a letter stating that I was sending 70 young people a week to England for abortions.  Dr Caroline Hunter and I had our names on placards saying we murdered babies.  The police advised me on security for my home and alternative routes to and from work.  We were constantly on the radio, local television and once on Newsnight.

We started out running two weekly clinic sessions.  Much of my time was spent dealing with the shutter being superglued, the answering machine being blocked, suppliers refusing our business (we were taking supplies out of the boots of drug reps’ cars) and an anonymous caller pretending to carry out research on our behalf.  This person spent a year making ‘dirty calls’ to unsuspecting women.  As a result I had to deal with distressed women and their partners shouting down the phone. After a year the police found the culprit in an office above our then Chair.  

To give some political context, when Brook Belfast first opened NI was ruled directly from Westminster with a Health Minister spending 20 minutes per week on all health issues relating to NI.  During this time Brook Belfast with its high profile was invited to speak about our work at the House of Commons and two Labour Party fringe meetings.  It was not until 1998, with the Good Friday Agreement, that a devolved government was installed and with it a completely new way of working.

All NGOs in NI had to operate in either a democratic deficit or with an Assembly where ‘orange and green’ issues dominated.  Policy and implementation tended to be left to senior civil servants.  Brook Belfast devoted considerable time to building personal relationships with relevant civil servants to ensure that sexual health was on the public health agenda.

Within NI either you were in favour of Brook services or you were opposed, with no middle ground.  We operated an open door policy, inviting both our supporters and detractors to visit the service.  We employed staff for specific sessions to spread the word into statutory services of what we provided for young people, dispelling myths.  Some staff felt unable to tell some of their family and friends that they were employed by Brook due to the intense strength of feeling the service generated.

Our impact on sexual health policy developments in the North has meant that we have developed the range of clinic services available to young people:

  • Through the ‘90s we added two more sessions 
  • Although in 2000 we had to drop the age to under 19s for young women, over the next three years we opened a boys and young men’s clinic, two more sessions. 
  • In November 2003, we finally had our seventh (Sunday) clinic established.  We also became a regional organisation in 2003.  
  • In September 2007 Brook Coleraine opened two clinics a week 
  • January 2012 marked the start of a dedicated STI session in Belfast.  

The relationships that had been developed in the early days ensured that funding followed as we set up new clinics and developed outreach work.

Other major milestones included financial support for over 10 years from Caroline Woodroofe, the GlaxoSmithKline Award in 2004, $1million support from Atlantic Philanthropies in 2005, the EllaOne trial in 2008, Innovation Award March 2011 and RQIA registration in December 2011.

Since we moved premises in April 2010 the pickets have rarely been seen, and we at last lost a picket who has been with us every Friday afternoon for 17 years.

At our birthday party, Dr Gabriel Scally, who had been the Director of Public Health in 1992 (he received a death threat as a result of inviting Brook to open in Belfast), laid out the amazing social history context. He recalled the enthusiasm of Margaret Jones, then Brook National’s Chief Executive, for the challenge of setting up a service in Northern Ireland.  Dr Michael McBride (Chief Medical Officer) commended the tenacity of Brook to not only keep sexual health at the forefront of public health, but also the part Brook NI has played in reducing teenage pregnancies since 1992.

The management committee members over the years have given freely of their time to ensure the excellent governance and strategic direction of Brook NI.

Leaving the best to last, it was the staff of Brook NI who were the stars at our event in the same way they are the stars at every clinic session.  Providing the service in the early days was difficult, especially for the young people who had to pass pickets jeering and shouting at them but once they came into the building staff put their needs first.  That same attitude applies today.

It has been the calibre of staff, as well as their commitment and dedication to young people, that has made Brook NI what it is today both in terms of clinic service, training and advocacy.  Thank you!

Mary Crawford, Director, Brook NI. 

Monday, 16 September 2013

Seven years at Brook and the start of Sexual Health Week

On Monday 15 September 2006 – seven years ago – I arrived at 'Brook Central' in Kentish Town, London, for my first day as CEO, which fits in rather nicely that today kicks off Sexual Health Week. I remember vividly the feeling as I walked from Kentish Town tube to Brook’s offices at Highgate Studios – a heady mix of nerves, excitement and wonderment. I imagine every CEO starts their first day with a degree of trepidation and I certainly did at Brook.

Ten years earlier I had starting working at the Family Planning Association, as a complete novice when it came to young people, sexual health and sex education. Right from the start of my time in the sector I had been impressed by Brook's approach, Brook's values and Brook's people. I particularly valued the way Brook used its experience of their work with young people in clinics to inform publications, education and their policy and advocacy work.

Brook's direct experience of working with young people in clinical and education settings means the organisation is naturally forthright and outspoken because Brook speaks of young realities and the truth for the thousands of young people we see each week. During my time as CEO it is that innate trust of young people and the commitment of everybody at Brook – from young volunteers, to clinic support workers, to the Board of Trustees – to say what needs to be said, however palatable or not it be for some, that continues to inspire me.

When I started seven years ago I knew there were 17 Brook organisations licensed by 'Brook Central' and that I was the guardian of the brand. What that actually meant in practice, if I hadn't realised it already, I soon knew I had a lot to learn. Some key points along our journey as an organisation at a national level over the last seven years are set out below. At local level our services have developed, changed and evolved in response to young people's needs in that local context.

Securing funding to undertake the ‘2020 – building a robust Brook Network for the next decade’ research and insights programme. This research with staff, clients, commissioners and customers was designed to inform Brook's strategy.

Submitted a strategic capacity building application to Private Equity Foundation. Although ultimately unsuccessful in securing the funding, the process of development involved input from New Philanthropy Capital, one of the PEF sponsors, and Bain and Company. The Department of Health provided almost half the required funding to invest in strategic development and capacity building of the Brook Network.

The first ever Leaders' Conference in November was the beginning of a major dialogue between Chairs and CEOs/Directors of the 17 Brook charities about shared strategy, clarity of purpose, effective collaboration and quantifying mutual value as a Network.

After much heated discussion and debate we launched a new visual identity (the one we currently have), and used this as the basis for redeveloping our publications range including our popular Ask Brook… booklet range.

We launched the first ever Brook Awards which ultimately preceded the UK Sexual Health Awards.

Following extensive debate, the Brook Network launched our shared strategic framework for the next ten years (2009 – 2019). This framework marked a shared commitment to:

  • unify our charitable goals and delivery models 
  • double the number of young people we have direct contact with from 200,000 per year to 400,000 per year 
  • involve young people in everything we do 
  • focus on quality, evidence and improvement – operationalised through a license agreement which was reviewed by a working group of Trustees and CEOs/Directors.

Hot off the heels of the Strategic Framework publication the national Board instructed me to lead a review of Brook's organisational design and governance structure to ensure we were 'fit to deliver'.

Eve Martin was appointed as Chair mid-way through the review process.

Following extensive research, consultation and engagement with staff, Trustees and young people, almost 150 Trustees of 16 Brook organisations agree to become a unified Brook organisation with a single accountability and governance structure.

The review was funded by FutureBuilders, Department of Health and the Network of Brook Charities. Bain and Company provided pro bono advice through the process.

A shadow Brook Board was elected from Trustees across the Network.

Following a change in law and regulation all Brook services in England were registered with the Care Quality Commission.

'One Brook' was formally launched on 1 April with an interim senior management team. I was appointed as CEO of the new organisation to lead the transformation project to unify systems, processes and to build a governance and staffing structure for the unified organisation.

We merged with Education For Choice – the specialist young people and pregnancy choices charity.

We entered into a formal collaboration with FPA, and launched Sex:Positive, our young people led campaign to change our culture towards young people and sex. A major part of the campaign was the launch of research that called for 21st Century Sex and Relationships Education.

Brook's new executive, management and middle management structure was established and implemented. We launched a major three-way collaboration with FPA and Reckitt Benckiser (Durex).

Durex was a headline sponsor for the first ever UK Sexual Health Awards launched in partnership with FPA, which included the Lifetime Achievement Award. The collaboration also launched the XES – We Can't Go Backwards campaign, documenting people's experience of services in the face of major changes in public spending and health service commissioning.

The final stages of the new structure for Brook are now almost completely implemented and we are set to develop and respond to new opportunities and challenges with a keen eye on what children and young people want and need.

Based on feedback from young people, evidence from our service delivery, and dialogue with stakeholders, Brook’s Board has agreed a strategic goal of ensuring young people receive more integrated health services.

Research and work with partners and commissioners has begun to task the CEO with developing innovative models of practice.

The three-way collaboration between Brook, FPA and Durex issued Unprotected Nation, a report which models the economic case for improving investment in sexual health, and the potential negative impact of reducing investment.

Whilst inside Brook the constitutional and structural changes have been going on, outside the change of government with all its legal and policy changes has been going on, and against that backdrop it is testament to every single member of staff and volunteer that between 2008 and 2012 Brook increased the number of young people we see from around 200,000 to 284,000 individual young people per year (many of them multiple times).

During that same period our income increased by 47% from approximately £10m to approximately £15m per annum.

Brook will be 50 years old, and we will be celebrating 50 years of learning, 50 years of innovation and 50 years of excellence.

As Brook heads towards our 50th birthday, now more than ever we need to work with young people to be vocal and speak truth to power. We must continue our tirelessly determined efforts to ensure children and young people get all the information, support and education they need to move confidently through puberty, into adolescence and adulthood.

We will continue to involve young people in all we do to create platforms for young people themselves to influence Sex and Relationships Education, the pornography debate and the development of health services for young people.

I am grateful to colleagues within and outside Brook for hard work, fun, challenge, ideas and thinking over the past seven years and I look forward to working with staff teams, collaborators, partners and funders in the years ahead.