Brook

Brook and C-Card Schemes

Condom Distribution Schemes (CDS), widely known as C-card schemes, are commissioned by local authorities across the UK to provide young people with free condoms to promote safe sex and reduce unplanned pregnancies and STI rates. The first C-card scheme was developed in 1989, and the original delivery model has changed little in the past 35 years.  

In that time, technology advanced rapidly while young people’s lives, behaviours, and habits also changed. Reflecting these changes is a charity called Brook, which operates several sexual health and well-being services across the UK, many of which are primarily targeted towards people under 25. Brook is also a leader in the sector when it comes to sexual health outreach and relationships and sex education (RSE) for young people. 

Brook’s dedication to furthering sexual health and well-being has led to their collaborative efforts with us, Reason Digital, to revolutionise Condom Distribution Schemes (CDS), also known as C-Card. Brook sees a huge opportunity for innovation in CDS to better meet the needs of young people, increase habitual usage of condoms and promote safe sex. This is especially important at a time when some STIs are at their highest rates since records began – with condoms being the only method that protect against them. To explore this, we carried out research alongside Brook to see what a new digital c-card scheme could look like. As part of our research, we addressed the challenges faced by young people in accessing free condoms. Here’s what we found… 

Challenges for Young People 

After conducting four exploration workshops with Brook staff, a focus group session with young people, and a survey of 263 people between the ages of 18 and 25, we found that variation in the method of CDS delivery poses a significant challenge for young people and leads to inconsistent experiences. This is especially the case for those who move often or live in multiple locations, such as university students who occupy different residences outside of term-time. The survey also revealed a concerning lack of awareness, with only 38% of young people knowing about free condom schemes or how to access them, potentially depriving them of a crucial service. Additionally, access hurdles that we sought to address included physical limitations, living in remote areas, neurodivergence, or cultural barriers. As a result of these barriers, many young people’s only method of collecting condoms was from physical outlets like local pharmacies, which they would prefer to avoid, if possible.

Challenges for Providers and Commissioners: 

Most free condom schemes currently run as outlet-based models, meaning that they use locations such as pharmacies, student unions, clinics, and youth clubs to give out condoms to young people registered with a C-card. However, this model presents challenges for both providers (like Brook) and commissioners: 

•  Firstly, training and managing outlets as CDS scheme distributors requires substantial investment and coordination.  
• Secondly, outlets are burdened with the administrative challenge of accurately recording distributed condoms, which impacts the quality of data that providers need to measure success. 
• Additionally, contraception services are commissioned differently across the UK, with many having differing reporting metrics, which makes it challenging to assess the broader impact of CDS on key sexual health indicators like STI rates and unplanned pregnancies. 

Young People’s Preferences 

Our research also highlighted young people’s preferences beyond free access to condoms. Convenience emerged as a paramount factor, emphasising the need for easy access, whether picking up condoms nearby or ordering online for home delivery. The importance of choice extended beyond access methods to encompass the type of condoms, considering factors like size and variety. Discretion proved crucial, reflecting young people’s desire to access condoms without uncomfortable interactions, leading to a preference for self-checkouts to maintain privacy in purchasing. 

What we recommended 

In response to these challenges and preferences, our research recommended a digital transformation of CDS, incorporating social media campaigns, engaging content, and streamlined online processes to enhance awareness and accessibility. The proposed digital solutions align with the preferences identified, offering convenient online registration, digital C-cards, and discreet yet expansive ordering and delivery options. While embracing digital innovation, the importance of maintaining face-to-face options and embedding safeguarding procedures for vulnerable groups was, of course, still emphasised. 

The collaborative efforts of Brook and Reason Digital underscore the necessity for adapting CDS to modern expectations of discretion, convenience, inclusion, social media prominence, and harm reduction. Our proposed recommendations aimed to bridge the gap between outdated contraception distribution models and the evolving needs of young people, ultimately contributing to the promotion of safe sex, reduction of STI rates, and improvement of overall sexual health outcomes. We think the quality of our collaboration with Brook is best described by Brook’s Director of Digital & Communication, Laura Hamzic: 

We can’t wait to see our work implemented by Brook in the near future, and we have faith that our recommendations—co-created with young service users’ insight—will bring CDS into the 21st century.