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All children and young people are entitled to high-quality education about sex, relationships and alcohol to help them make responsible decisions and acquire the skills and confidence to delay sex until they are ready. Evidence demonstrates that this type of education delivered as part of a planned and timetabled programme by trained and confident teachers helps children and young people better understand their own physical and emotional development. Research also suggests effective sex, relationships and alcohol education can help a child make responsible, healthy and safe choices, and improve their performance at school.

In draft guidance, issued for public consultation today (17 June), NICE recommends that children from primary school age upwards are given sex and relationships education that is appropriate to the maturity of the pupils, sensitive to diverse cultural, faith and family perspectives, and based on an understanding of their needs. For children at primary school age, this education starts with learning about the value of friendships and having respect for others.

This draft guidance also aims to ensure children and young people with particular needs, such as those with physical, learning or communication difficulties, receive good quality sex, relationships and alcohol education, consistent with the education provided in schools and colleges. Teaching should promote tolerance and inclusion and understanding diversity.

Research shows 40% of young people rated their sex and relationships education in school as poor or very poor1 and other studies demonstrate that effective education on these topics can have a positive impact on young people’s health and wellbeing.

Good quality sex, relationships and alcohol education can help young people to understand the risks and consequences of their actions, the meaning of ‘consent’, and their rights and responsibilities. This includes learning how to resist pressure to take part in activities they are not comfortable with, such as binge drinking, and that it is wrong to put pressure on others to do something they don’t want to do. This type of education also gives them the skills and confidence to know when and how to seek advice and help from health services.

This guidance is mainly aimed at, school and college governors, school heads and teachers, college principals, lecturers and tutors, commissioners and managers in children’s trusts and children’s services, local authorities and primary care trusts. It is also for all those who have a direct or indirect role in, and responsibility for, school, college and community-based PSHE education focusing on sex and relationships and alcohol.

Key draft recommendations include:

• Ensure all children and young people are taught effectively about sex and relationships and alcohol. This should take place within a planned programme of PSHE education in schools, special schools, pupil referral units and colleges. It should start in primary school and continue through all the key stages of their educational career, until early adulthood.
• Reassure parents that sex and relationships education does not promote early sex, increase rates of sexual activity or increase the likelihood of sexual experimentation. Rather, it helps children and young people to resist pressure to get involved in activities that might damage their health. It also gives them the skills and confidence to delay sex until they are ready to enjoy a responsible and mutually loving relationship.
• Ensure education about sex and relationships and alcohol starts in primary school. Topics should be introduced and covered in a way that is appropriate to the maturity of pupils and is based on an understanding of their needs and is sensitive to diverse cultural, faith and family perspectives. The lead teacher or lecturer should coordinate the design of a scheme of work that is developmental and allows topics to be expanded and revisited in subsequent years, in secondary school and college.
• Ensure all teachers, lecturers and tutors who are willing to teach about sex and relationships and alcohol have received accredited training. They should have the skills and competence to fulfil the role and the support they need to improve their knowledge and teaching skills.
• Offer parents the opportunity to attend a course in parenting strategies and effective communication skills in relation to sex and relationships and alcohol. This should include advice on how to help their children develop communication, decision-making and negotiation skills. Provide them with ongoing support throughout the programme, and tell them where they can get support after the programme has ended.

Gillian Leng, NICE Deputy Chief Executive, said: 'We know a planned PSHE education programme which progresses throughout a child’s time in education helps them understand the importance of valuing and having respect for others. It can also give them the ability to make sense of the world around them and make responsible decisions.

'Starting PSHE education early can help improve a child’s ability to develop and sustain friendships, and understand the importance of valuing and having respect for others, building the foundation for later teaching about important subjects such as alcohol and sexual relationships. We also know education about sex and relationships is more effective if it is introduced before young people first have sex.’

Simon Blake, Chief Executive of the young people’s sexual health charity, Brook, and Programme Development Group member said: ‘As a member of the NICE programme development group, I helped develop this draft guidance. Sex and relationships education is vital to protect children and young people from harm and enable them to enjoy their relationships safely.

'It’s a myth that sex and relationships education encourages children to be more promiscuous or have sex at an early age. In fact, evidence demonstrates this type of education helps children and young people resist pressures to get involved in activities that might damage their health. Importantly, it helps them develop the skills to only have the sex they choose when they are able to enjoy and take responsibility for their personal relationships and sexual health.

'These draft recommendations are set to make a real difference by helping parents and carers feel reassured about the benefits of sex and relationships education. Our aim is to make sure all young men and women receive high quality sex and relationships education which can give them the skills and confidence to know when and how to seek advice and help from health services.”

Professor Mark Bellis, Director of the Centre for Public Health, Liverpool John Moores University, and Programme Development Group member said: ‘For most children, attitudes to alcohol start to develop long before they begin to drink. Parental drinking, advertising and sponsorship ensure that children can grow up in environments steeped in references to alcohol. Even at an early age, children require a basic understanding of alcohol, the part it plays in society and the dangers relating to its use.

'This draft guidance identifies the importance of continually building up children’s understanding of alcohol throughout their development in ways which are sensitive to their personal needs and circumstances. It makes clear that this is something best achieved through the involvement of well prepared teachers, parents and health professionals.

'We hope this draft guidance will provide effective delivery of quality alcohol education for children and young people, and reduce the threat to young people’s health and social development that alcohol currently represents.'

Anyone wishing to submit comments on this draft guidance is invited to do so via the NICE website until 15 July 2010. Final guidance is expected in January 2011.

Notes to Editors

About the guidance

1. The draft guidance will be available on the NICE website from Thursday 17 June 2010. Consultation will take place between 17 June and 15 July 2010.

2. Only stakeholders can comment formally on consultations, but organisations can register to be a stakeholder at anytime during this process, The criteria to become a stakeholder are available on our website.

Organisations from England and organisations with operations in England can register to comment on this draft guidance.

3. Final guidance is expected in January 2011. Although NICE public health guidance is not statutory, the NHS, local authorities and the wider public, private, voluntary and community sectors are expected to follow it.

4. This guidance complements but does not replace NICE guidance on community based interventions to reduce substance misuse; alcohol and schools; reducing sexually transmitted infections and teenage pregnancy; and social and emotional wellbeing in primary and secondary education. For more information, visit www.nice.org.uk.

5. Personal, social, health and economic (PSHE) education is a planned programme of learning opportunities and experiences that helps children and young people grow and develop as individuals and as members of families and communities. Developing health literacy - a level of knowledge, personal skills and confidence that allows improvements to personal and community health and wellbeing - is central to this.

About NICE

6. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

7. NICE produces guidance in three areas of health:

• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.